Abstract
Measles is an acute systemic viral disease with initial amplification of infection in lymphoid tissue and subsequent spread over 10–14 days to multiple organs. Failure of the innate response to control initial measles virus (MeV) replication is associated with the ability of MeV to inhibit the induction of type I interferon and interferon-stimulated antiviral genes. Rather, the innate response is characterized by the expression of proteins regulated by nuclear factor kappa B and the inflammasome. With eventual development of the adaptive response, the rash appears with immune cell infiltration into sites of virus replication to initiate the clearance of infectious virus. However, MeV RNA is cleared much more slowly than recoverable infectious virus and remains present in lymphoid tissue for at least 6 months after infection. Persistence of viral RNA and protein suggests persistent low-level replication in lymphoid tissue that may facilitate maturation of the immune response, resulting in lifelong protection from reinfection, while persistence in other tissues (for example, the nervous system) may predispose to development of late disease such as subacute sclerosing panencephalitis. Further studies are needed to identify mechanisms of viral clearance and to understand the relationship between persistence and development of lifelong immunity.
Highlights
Measles is a highly contagious systemic viral disease that remains one of the most important causes of worldwide morbidity and mortality in children[1]
There is a need to define the relationship between measles virus (MeV) and the immune system, including the sites of virus replication and the mechanisms, rapidity, and effectiveness of immune-mediated virus clearance as well as the importance of persistent viral RNA when clearance is incomplete[5,6]
Summary Major advances in the understanding of the pathogenesis of measles have come through detailed investigation of MeV infection in rhesus macaques using reporter viruses to identify infected tissues, reverse transcription–quantitative polymerase chain reaction to detect and quantify viral RNA in tissue, cellular assays to analyze T and B lymphocyte function, and mathematical modeling of clearance over an extended time during recovery
Summary
F1000 Faculty Reviews are written by members of the prestigious F1000 Faculty. They are commissioned and are peer reviewed before publication to ensure that the final, published version is comprehensive and accessible. The reviewers who approved the final version are listed with their names and affiliations. Any comments on the article can be found at the end of the article
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