脑炎后帕金森病：独特的病理和临床特征——初步数据。

Postencephalitic Parkinsonism: Unique Pathological and Clinical Features-Preliminary Data.

机构信息

Institute of Pathology, Department of Neuropathology, University of Wuerzburg, 97080 Wuerzburg, Germany.

Department of Medical Physiology, University of Nairobi, P.O. Box 30197, Nairobi 00100, Kenya.

出版信息

Cells. 2024 Sep 10;13(18):1511. doi: 10.3390/cells13181511.

DOI:10.3390/cells13181511

PMID:39329695

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11430219/

Abstract

Postencephalitic parkinsonism (PEP) is suggested to show a virus-induced pathology, which is different from classical idiopathic Parkinson's disease (PD) as there is no α-synuclein/Lewy body pathology. However, PEP shows a typical clinical representation of motor disturbances. In addition, compared to PD, there is no iron-induced pathology. The aim of this preliminary study was to compare PEP with PD regarding iron-induced pathology, using histochemistry methods on paraffin-embedded post-mortem brain tissue. In the PEP group, iron was not seen, except for one case with sparse perivascular depositions. Rather, PEP offers a pathology related to tau-protein/neurofibrillary tangles, with mild to moderate memory deficits only. It is assumed that this virus-induced pathology is due to immunological dysfunctions causing (neuro)inflammation-induced neuronal network disturbances as events that trigger clinical parkinsonism. The absence of iron deposits implies that PEP cannot be treated with iron chelators. The therapy with L-Dopa is also not an option, as L-Dopa only leads to an initial slight improvement in symptoms in isolated cases.

摘要

脑炎后帕金森病（PEP）被认为表现出病毒诱导的病理学，与经典的特发性帕金森病（PD）不同，因为没有α-突触核蛋白/路易体病理学。然而，PEP 表现出典型的运动障碍临床表现。此外，与 PD 相比，没有铁诱导的病理学。本初步研究的目的是使用石蜡包埋的死后脑组织的组织化学方法，比较 PEP 与 PD 之间的铁诱导病理学。在 PEP 组中，除了一例稀疏的血管周围沉积外，没有发现铁。相反，PEP 提供了与 tau 蛋白/神经原纤维缠结相关的病理学，仅有轻度至中度的记忆缺陷。据推测，这种病毒诱导的病理学是由于免疫功能障碍导致（神经）炎症引起的神经元网络紊乱，这些事件引发了临床帕金森病。没有铁沉积物意味着 PEP 不能用铁螯合剂治疗。L-Dopa 的治疗也不是一个选择，因为 L-Dopa 仅在少数情况下导致症状的初始轻微改善。