Abstract
Measles remains a major cause of morbidity and mortality worldwide among vaccine preventable diseases. Recent decline in vaccination coverage resulted in re-emergence of measles outbreaks. Measles virus (MeV) infection causes an acute systemic disease, associated in certain cases with central nervous system (CNS) infection leading to lethal neurological disease. Early following MeV infection some patients develop acute post-infectious measles encephalitis (APME), which is not associated with direct infection of the brain. MeV can also infect the CNS and cause sub-acute sclerosing panencephalitis (SSPE) in immunocompetent people or measles inclusion-body encephalitis (MIBE) in immunocompromised patients. To date, cellular and molecular mechanisms governing CNS invasion are still poorly understood. Moreover, the known MeV entry receptors are not expressed in the CNS and how MeV enters and spreads in the brain is not fully understood. Different antiviral treatments have been tested and validated in vitro, ex vivo and in vivo, mainly in small animal models. Most treatments have high efficacy at preventing infection but their effectiveness after CNS manifestations remains to be evaluated. This review describes MeV neural infection and current most advanced therapeutic approaches potentially applicable to treat MeV CNS infection.
Highlights
Measles remains a major cause of morbidity and mortality worldwide among vaccine preventable diseases
A better understanding of Measles virus (MeV) central nervous system (CNS) invasion remains a priority in the field of MeV studies, 12
While the vaccine remains the most efficient prevention against MeV infection, To date, the emergence of the mutations observed in the brain of sclerosing panencephalitis (SSPE) or measles inclusion-body encephalitis (MIBE) patients is still the decreasing combined to thecould increasing number of immunocompromised people difficult poorlycoverage understood
Summary
Measles virus (MeV) is the etiologic agent responsible for measles disease. Humans are the only known reservoir for MeV. The rate of vaccination decreased due to a vaccination hesitancy, and as consequence the decreased herd immunity led to large outbreaks and today measles is considered re-emerged [4,9] This year, in many developed countries including USA and France, there is a 300% increase in reported MeV cases compared to last year [10]. To initiate the infection of the main target cells, the MeV H protein binds to entry receptor on the surface. This attachment triggers the F protein and leads to exposure of its hydrophobic fusion peptide that inserts into the host cell membrane.
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