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Hirschenberger M, Hunszinger V, Sparrer KMJ. Implications of Innate Immunity in Post-Acute Sequelae of Non-Persistent Viral Infections. Cells 2021; 10:2134. [PMID: 34440903 PMCID: PMC8391718 DOI: 10.3390/cells10082134] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/12/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
Non-persistent viruses classically cause transient, acute infections triggering immune responses aimed at the elimination of the pathogen. Successful viruses evolved strategies to manipulate and evade these anti-viral defenses. Symptoms during the acute phase are often linked to dysregulated immune responses that disappear once the patient recovers. In some patients, however, symptoms persist or new symptoms emerge beyond the acute phase. Conditions resulting from previous transient infection are termed post-acute sequelae (PAS) and were reported for a wide range of non-persistent viruses such as rota-, influenza- or polioviruses. Here we provide an overview of non-persistent viral pathogens reported to be associated with diverse PAS, among them chronic fatigue, auto-immune disorders, or neurological complications and highlight known mechanistic details. Recently, the emergence of post-acute sequelae of COVID-19 (PASC) or long COVID highlighted the impact of PAS. Notably, PAS of non-persistent infections often resemble symptoms of persistent viral infections, defined by chronic inflammation. Inflammation maintained after the acute phase may be a key driver of PAS of non-persistent viruses. Therefore, we explore current insights into aberrant activation of innate immune signaling pathways in the post-acute phase of non-persistent viruses. Finally, conclusions are drawn and future perspectives for treatment and prevention of PAS are discussed.
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Da Silva CP, Miller LA, Morrel EC, Wang W. Predictive Abilities of Balance Confidence and Fear of Falling Measures on Falls in Polio Survivors. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2019. [DOI: 10.1080/02703181.2019.1610542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Carolyn P. Da Silva
- School of Physical Therapy, Texas Woman’s University, Houston, Texas, USA
- TIRR-Memorial Hermann Rehabilitation and Research Out-Patient Medical Specialty Clinic, Post-Polio Clinic, Houston, Texas, USA
| | - Lesley A. Miller
- School of Physical Therapy, Texas Woman’s University, Houston, Texas, USA
- Physical Therapy Department, Lyndon B Johnson Hospital, Houston, Texas, USA
| | - Emily C. Morrel
- School of Physical Therapy, Texas Woman’s University, Houston, Texas, USA
- Vitalico, Houston, Texas, USA
| | - Wanyi Wang
- Center for Research Design and Analysis, Office of Research and Sponsored Programs, Texas Woman's University, Houston, Texas, USA
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Lo JK, Robinson LR. Postpolio syndrome and the late effects of poliomyelitis. Part 1. pathogenesis, biomechanical considerations, diagnosis, and investigations. Muscle Nerve 2018; 58:751-759. [DOI: 10.1002/mus.26168] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/06/2018] [Accepted: 05/08/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Julian K. Lo
- Sunnybrook Health Sciences Centre; Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto; 2075 Bayview Avenue, Toronto Ontario Canada
| | - Lawrence R. Robinson
- Sunnybrook Health Sciences Centre; Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto; 2075 Bayview Avenue, Toronto Ontario Canada
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Baj A, Colombo M, Headley JL, McFarlane JR, Liethof MA, Toniolo A. Post-poliomyelitis syndrome as a possible viral disease. Int J Infect Dis 2015; 35:107-16. [PMID: 25939306 DOI: 10.1016/j.ijid.2015.04.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 04/22/2015] [Accepted: 04/23/2015] [Indexed: 12/27/2022] Open
Abstract
This review summarizes current concepts on post-polio syndrome (PPS), a condition that may arise in polio survivors after partial or complete functional recovery followed by a prolonged interval of stable neurological function. PPS affects 15-20 million people worldwide. Epidemiological data are reported, together with the pathogenic pathways that possibly lead to the progressive degeneration and loss of neuromuscular motor units. As a consequence of PPS, polio survivors experience new weakness, generalized fatigue, atrophy of previously unaffected muscles, and a physical decline that may culminate in the loss of independent life. Emphasis is given to the possible pathogenic role of persistent poliovirus infection and chronic inflammation. These factors could contribute to the neurological and physical decline in polio survivors. A perspective is then given on novel anti-poliovirus compounds and monoclonal antibodies that have been developed to contribute to the final phases of polio eradication. These agents could also be useful for the treatment or prevention of PPS. Some of these compounds/antibodies are in early clinical development. Finally, current clinical trials for PPS are reported. In this area, the intravenous infusion of normal human immunoglobulins appears both feasible and promising.
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Affiliation(s)
- Andreina Baj
- Laboratory of Clinical Microbiology, University of Insubria Medical School, Viale Borri 57, 21100 Varese, Italy
| | - Martina Colombo
- Laboratory of Clinical Microbiology, University of Insubria Medical School, Viale Borri 57, 21100 Varese, Italy
| | - Joan L Headley
- Post-Polio Health International, Saint Louis, Missouri, USA
| | | | - Mary-Ann Liethof
- Laboratory of Clinical Microbiology, University of Insubria Medical School, Viale Borri 57, 21100 Varese, Italy; Polio Australia Incorporated, Kew, Victoria, Australia
| | - Antonio Toniolo
- Laboratory of Clinical Microbiology, University of Insubria Medical School, Viale Borri 57, 21100 Varese, Italy.
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Tsunoda I. Axonal degeneration as a self-destructive defense mechanism against neurotropic virus infection. Future Virol 2008; 3:579-593. [PMID: 19079794 DOI: 10.2217/17460794.3.6.579] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Theiler's murine encephalomyelitis virus (TMEV) and other neurotropic virus infections result in degeneration of each component of the neuron: apoptosis of the cell body, axonal (Wallerian) degeneration, and dendritic and synaptic pathology. In general, axonal degeneration is detrimental for hosts. However, axonal degeneration can be beneficial in the case of infection with neurotropic viruses that spread in the CNS using axonal transport. C57BL/Wld(S) (Wld(S), Wallerian degeneration slow mutant) mice are protected from axonal degeneration. Wld(S) mice infected with the neurovirulent GDVII strain of TMEV are more resistant to virus infection than wild-type mice, suggesting that axonal preservation contributes to the resistance. By contrast, infection with the less virulent Daniels strain of TMEV results in high levels of virus propagation in the CNS, suggesting that prolonged survival of axons in Wld(S) mice favors virus spread. Thus, axonal degeneration might be a beneficial self-destruct mechanism that limits the spread of neurotropic viruses, in the case of less virulent virus infection. We hypothesize that neurons use 'built-in' self-destruct protection machinery (compartmental neurodegeneration) against neurotropic virus infection, since the CNS is an immunologically privileged site. Early induction of apoptosis in the neuronal cell body limits virus replication. Wallerian degeneration of the axon prevents axonal transport of virus. Dendritic and synaptic degeneration blocks virus transmission at synapses. Thus, the balance between neurodegeneration and virus propagation may be taken into account in the future design of neuroprotective therapy.
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Affiliation(s)
- Ikuo Tsunoda
- Department of Pathology, Division of Cell Biology & Immunology, University of Utah School of Medicine, 30 North 1900 East, MREB, Room 218, Salt Lake City, Utah 84132, USA
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Fiorini M, Zanusso G, Baj A, Bertolasi L, Toniolo A, Monaco S. Post-polio syndrome: clinical manifestations and cerebrospinal fluid markers. FUTURE NEUROLOGY 2007. [DOI: 10.2217/14796708.2.4.451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Post-polio syndrome (PPS) refers to a constellation of new neurological, musculoskeletal and general symptoms occurring in survivors of poliomyelitis decades after acute paralytic and nonparalytic disease. The common manifestations of PPS include generalized, central and peripheral fatigue, muscle weakness and musculoskeletal pain. The pathogenesis of PPS remains obscure. Three prevailing hypotheses have been advanced: stress-induced degeneration of surviving neurons, persistent poliovirus replication or virus reactivation and immune-mediated damage. The diagnosis of PPS is based on medical history and clinical examination, since no specific diagnostic tests are available. In the light of recent studies demonstrating a partial beneficial effect of intravenous immunoglobulin, this article will focus on cerebrospinal fluid biomarkers reflecting disease activity and pathogenic processes in PPS.
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Affiliation(s)
- Michele Fiorini
- University of Verona, Department of Neurological & Visual Sciences, Policlinico GB Rossi, Piazzale LA Scuro, 10, 37134 Verona, Italy
| | - Gianluigi Zanusso
- University of Verona, Department of Neurological & Visual Sciences, Policlinico GB Rossi, Piazzale LA Scuro, 10, 37134 Verona, Italy
| | - Andreina Baj
- University of Insubria Medical School, Laboratory of Medical Microbiology, Viale Borri, 57, 21200 Varese, Italy
| | - Laura Bertolasi
- University of Verona, Department of Neurological & Visual Sciences, Policlinico GB Rossi, Piazzale LA Scuro, 10, 37134 Verona, Italy
| | - Antonio Toniolo
- University of Insubria Medical School, Laboratory of Medical Microbiology, Viale Borri, 57, 21200 Varese, Italy
| | - Salvatore Monaco
- University of Verona, Department of Neurological & Visual Sciences, Policlinico GB Rossi, Piazzale LA Scuro, 10, 37134 Verona, Italy
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