CORRELATION BETWEEN ENROVIRUS INFECTION AND ACUTE STROKE ON THE GROUND OF VIROLOGICAL, MOLECULAR GENETIC AND SEROLOGICAL METHODS OF DIAGNOSIS

Abstract

Relevance. Numerous virological studies prove the importance of enteroviruses in human somatic pathology. However, the etiopathogenetic role of enterovirus infection in patients with acute cerebrovascular disorder (GVMK) is not sufficiently highlighted.
 Objective: to establish the value of enterovirus infection as a trigger factor in the pathogenesis of acute stroke.
 Materials and methods. The pear blood serum of 72 patients with acute stroke (main group) and 35 patients with neurological pathology without vascular pathology (group of comparison) were screened for presence of enteroviruses using the virological method, detection of enterovirus genomes using a polymerase chain reaction and the presence of specific Ig M and Ig G to enteroviruses in the enzyme-linked immunosorbent assay (ELISA).
 Results. The enterovirus genomes were isolated from blood serum in 23,6±5,9 % of patients with acute stroke, that is significantly higher than in patients of the comparison group – 2,9±2,8 % (p <0,05). The enteroviruses were isolated in 11 cases of 17 PCR-positive blood serum samples of the main group. These viruses were identified as Coxsackie B viruses (serotypes 2, 3, 4) and ECHO viruses (serotypes 6, 9, 27 (two strains), 29), three strains of viruses could not be identified. The presence of specific Ig M and Ig G in blood serum of 4 patients with HPMC, as well as enterovirus genomes, has been established. It suggest that they have a recent enterovirus infection, or can indicate a recent enterovirus infection or exacerbation of chronic enterovirus infection. Only specific Ig G in the absence of Ig M were detected in blood serum of 4 PCR positive patients, that can indicate chronic enterovirus infection. Only Ig M in the absence of Ig G was detected in blood serum of 6 PCR-positive patients, that can indicate acute enterovirus infection. No Ig M or Ig G in serum from three PCR-positive patients were detected, possibly due to the presence of latent enterovirus infection.
 Conclusions. Acute and chronic persistent enterovirus infection plays a possible trigger role in the development of acute stroke.
 The combination of PCR to detect genomes of enteroviruses, virological for the isolation and identification of viruses, and ELISA for the detection of specific Ig M and Ig G to enteroviruses should be recommended for the diagnosis of persistent enterovirus infection in patients with acute stroke.