Antibodies to Enteroviruses in Cerebrospinal Fluid of Patients with Acute Flaccid Myelitis, 2019, Mishra et al

Andy · Aug 13, 2019

ABSTRACT
Acute flaccid myelitis (AFM) has caused motor paralysis in >560 children in the United States since 2014. The temporal association of enterovirus (EV) outbreaks with increases in AFM cases and reports of fever, respiratory, or gastrointestinal illness prior to AFM in >90% of cases suggest a role for infectious agents. Cerebrospinal fluid (CSF) from 14 AFM and 5 non-AFM patients with central nervous system (CNS) diseases in 2018 were investigated by viral-capture high-throughput sequencing (VirCapSeq-VERT system). These CSF and serum samples, as well as multiple controls, were tested for antibodies to human EVs using peptide microarrays. EV RNA was confirmed in CSF from only 1 adult AFM case and 1 non-AFM case. In contrast, antibodies to EV peptides were present in CSF of 11 of 14 AFM patients (79%), significantly higher than controls, including non-AFM patients (1/5 [20%]), children with Kawasaki disease (0/10), and adults with non-AFM CNS diseases (2/11 [18%]) (P = 0.023, 0.0001, and 0.0028, respectively). Six of 14 CSF samples (43%) and 8 of 11 sera (73%) from AFM patients were immunoreactive to an EV-D68-specific peptide, whereas the three control groups were not immunoreactive in either CSF (0/5, 0/10, and 0/11; P = 0.008, 0.0003, and 0.035, respectively) or sera (0/2, 0/8, and 0/5; P = 0.139, 0.002, and 0.009, respectively).

IMPORTANCE The presence in cerebrospinal fluid of antibodies to EV peptides at higher levels than non-AFM controls supports the plausibility of a link between EV infection and AFM that warrants further investigation and has the potential to lead to strategies for diagnosis and prevention of disease.
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Open access at https://mbio.asm.org/content/10/4/e01903-19

Press release from Columbia Uni

Scientists at the Center for Infection and Immunity (CII) at Columbia University Mailman School of Public Health, the U.S. Centers for Disease Control and Prevention (CDC), and the University of California San Diego report antibody evidence in cerebrospinal fluid (CSF) that points to enterovirus (EV) infection as a cause for acute flaccid myelitis (AFM), a disease responsible for partially paralyzing more than 560 children in the United States since 2014. Results of the study appear in the journal mBio.

AFM patients, upwards of 90 percent of whom are children, present with severe weakness in one or more limbs, usually within a month of a respiratory or gastrointestinal illness, leading clinicians and scientists to posit that a pathogen is behind AFM. A preliminary CDC analysis found that more than 40 percent of children with AFM had evidence of EV RNA in respiratory or fecal samples. Yet in CSF, they found EV in only 4 of 567 total confirmed cases.
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https://www.mailman.columbia.edu/pu...ence-points-viral-culprit-afm-child-paralysis

wigglethemouse · Aug 13, 2019

Does anyone know if this is what Ian Lipkin presented at the NIH ME/CFS conference in April? If I remember right he was intending to do a similar investigation in ME......

The Columbia press link @Andy posted does quote Ian Lipkin, so perhaps it is the same....

“Pathogen discovery has historically focused on direct detection of infectious agents. The introduction of new methods that allow us to also test for footprints of exposure will lead to new insights into infectious diseases,” says co-senior author Ian Lipkin, MD, director of CII and the John Snow Professor of Epidemiology.
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Andy · Aug 13, 2019

wigglethemouse said: ↑

Does anyone know if this is what Ian Lipkin presented at the NIH ME/CFS conference in April? If I remember right he was intending to do a similar investigation in ME......

The Columbia press link @Andy posted does quote Ian Lipkin, so perhaps it is the same....
Click to expand...

It isn't what Lipkin presented, other than he talks about using the VirCapSeq-VERT system as part of his Collaborative Research Centres efforts, which has been used in this study as well.

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Antibodies to Enteroviruses in Cerebrospinal Fluid of Patients with Acute Flaccid Myelitis, 2019, Mishra et al

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Antibodies to Enteroviruses in Cerebrospinal Fluid of Patients with Acute Flaccid Myelitis, 2019, Mishra et al

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