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Infezioni virali del sistema nervoso centrale: meningoencefaliti ed encefalopatie croniche progressive

Viral infections of central nervous system: meningoencephalitis and chronic progressive encephalopathies

  • Rassegna
  • Published:
La Rivista Italiana della Medicina di Laboratorio - Italian Journal of Laboratory Medicine

Riassunto

In questa rassegna sono stati descritti i principali virus che presentano uno spiccato tropismo per il sistema nervoso centrale (SNC) e sono in grado di produrre patologie sia acute sia croniche. Con l’avanzare delle conoscenze, si amplia sempre di più il pannello di virus considerati neurotropi e, di conseguenza, la necessità di idonei strumenti diagnostici. I test di amplificazione genica hanno svolto un ruolo chiave, in quanto hanno notevolmente migliorato i tempi di refertazione, la qualità della diagnosi e la tempestività terapeutica. Alcuni virus neurotropi, come quelli appartenenti alla famiglia Herpesviridae, sono ben conosciuti ed è ora possibile una diagnosi rapida e, di conseguenza, una terapia precoce. Tuttavia, altri virus appartenenti alla famiglia Picornaviridae, come i Parechovirus e l’enterovirus 71, invece, sono stati recentemente identificati come patogeni umani. Sono state anche illustrate alcune encefalopatie croniche progressive, come la panencefalite progressiva da virus della rosolia (PRP), la panencefalite subacuta sclerosante (PESS) da virus del morbillo e la leucoencefalopatia multifocale progressiva (PML) da virus JC (JCV). Infine, particolare rilievo è stato dato alle infezioni virali cosiddette “emergenti”. Cambiamenti climatici, modificazione delle abitudini sociali e culturali, mutazioni genetiche degli stessi virus e cambiamenti nell’ecologia dei vettori hanno contribuito all’emergenza di queste infezioni. Di conseguenza, l’epidemiologia delle infezioni virali del SNC sta cambiando e richiede appropriati sistemi di sorveglianza per una precoce individuazione e una tempestiva azione di controllo.

Summary

In this review the most important neurotropic viruses, able to cause acute and chronic infections, have been described. The panel of neutropic viruses is increasing and improved diagnostic tools are necessary. Molecular tests play a key role in microbiological diagnosis, because they are fast and reliable. The viruses of Herpesviridae family are well known and now a rapid diagnosis allows an early therapy. Other viruses of the Picornaviridae family, as Parechovirus and enterovirus 71, have been recently identified as human pathogens. Some chronic progressive encephalopathies, as the progressive panencephalitis by rubella virus, the subacute sclerosing panencephalitis by measles virus and the progressive multifocal leukoencephalopathy by JC virus have been illustrated. Finally, the emerging viral infections have been described. Several factors, including human and animal behaviors, travel, climate change, mutation of a pathogen genome and the changes in the ecology of vectors contribute to the emergence of infectious pathogens. As a consequence, the worldwide epidemiology of viral CNS diseases continuously evolves and enhanced surveillance regimes have been issued.

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  1. SC Microbiologia, Ospedale “S. Maria della Misericordia”, Località Sant’Andrea delle Fratte-San Sisto, 06132, Perugia, Italia

    Alessandra Sensini, Roberto Castronari, Eleonora Pistoni & Francesco Bistoni

  2. Sezione di Microbiologia, Dipartimento di Medicina Sperimentale e Scienze Biochimiche, Università degli Studi di Perugia, Perugia, Italia

    Alessandra Sensini, Roberto Castronari, Eleonora Pistoni & Francesco Bistoni

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  3. Eleonora Pistoni
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  4. Francesco Bistoni
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Correspondence to Alessandra Sensini.

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Sensini, A., Castronari, R., Pistoni, E. et al. Infezioni virali del sistema nervoso centrale: meningoencefaliti ed encefalopatie croniche progressive. Riv Ital Med Lab 10, 63–81 (2014). https://doi.org/10.1007/s13631-014-0052-4

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  • DOI: https://doi.org/10.1007/s13631-014-0052-4

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