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Immunopatological and Genetic Aspects of the Pathogenesisof CNS Lesions in VZV Infection

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This review presents data on the characteristics of the varicella-zoster virus (VZV), the clinical manifestations of CNS lesions in acute and chronic VZV infection in children and adults, and the mechanisms of interaction of the pathogen with the immune system during development of disease. The question of whether neurological disorders in VZV infection should be regarded as a complication or a manifestation of the disease, caused by a defective virus or the presence of subclinical immunodeficiency – as has been confirmed by contemporary scientific studies – is discussed. The critical mechanisms of immune defense against VZV, the main cause of penetration of the virus into the CNS and the development of neurological disorders, and the relationship between VZV genotypes and the presence of mutations in the gE gene and the nature of the course of illness are described; the review also addresses detection of rare variants of the POLR3A, POLR3C, POLR3E, and POLR3F genes, which are associated with impaired interferon induction and the development of severe VZV infection, in which vasculopathy also occurs and is the basis for the use of complex vascular drugs such as Cytoflavin, whose efficacy has been evidenced by the authors. Particular emphasis is given to analysis of intrathecal immunopathogenesis, which may be associated with the presence and severity of neurological manifestations. The causes of severe disease in patients vaccinated against chicken pox are discussed, along with resistance to specific antiviral drugs, which is probably associated with mutations responsible for therapeutic resistance of the virus.

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Authors and Affiliations

  1. Pediatric Scientific-Clinical Center for Infectious Diseases, Federal Medical Biological Agency of Russia, St. Petersburg, Russia

    E. Yu. Skripchenko, G. F. Zheleznikova, N. V. Skripchenko, L. A. Alekseeva, O. V. Goleva, T. V. Bessonova & A. A. Zhirkov

  2. St. Petersburg State Pediatric Medical University, Russian Ministry of Health, St. Petersburg, Russia

    E. Yu. Skripchenko & N. V. Skripchenko

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  2. G. F. Zheleznikova
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Correspondence to E. Yu. Skripchenko.

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Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 122, No. 10, pp. 46–56, October, 2022.

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Skripchenko, E.Y., Zheleznikova, G.F., Skripchenko, N.V. et al. Immunopatological and Genetic Aspects of the Pathogenesisof CNS Lesions in VZV Infection. Neurosci Behav Physi 53, 801–811 (2023). https://doi.org/10.1007/s11055-023-01472-y

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