Ausencia de ADN de herpesvirus humano 6 en LCR, mediante técnica de PCR anidada, en pacientes con esclerosis múltiple / Lack of human herpesvirus type 6 DNA in CSF by nested PCR among patients with multiple sclerosis

Antecedentes. Hasta la actualidad se desconoce la etiología de la esclerosis múltiple (EM) habiéndose intentado imputar algunos virus, hasta ahora sin éxito, como agentes desencadenantes de la respuesta autoinmune que conlleva a las placas de desmielinización. Existe controversia acerca del papel que puede desempeñar el herpesvirus humano tipo 6 (HVH-6), habiéndose detectado aumento de los títulos serológicos, amplificación del ADN del virus en sangre y líquido cefalorraquídeo (LCR) mediante técnica de reacción en cadena de la polimerasa (PCR), así como su presencia por métodos de inmunohistoquímica en muestras histológicas de sustancia blanca procedente de pacientes con EM. Todo esto ha llevado a algunos autores a imputar a este virus como agente etiológico desencadenante de esta enfermedad. Pacientes y métodos. Se estudia el LCR de 23 pacientes con esclerosis múltiple recurrente-remitente. Se utilizan como controles el LCR procedente de 23 pacientes a los que se les había practicado punción lumbar para realizar raquianestesia, sin presentar ninguno de ellos patología neurológica. En las muestras recogidas se realiza PCR anidada para detectar secuencias de ADN de HVH-6.Resultados. No se ha detectado amplificación de ADN de HVH-6, virus de Epstein-Barr (VEB), virus varicela zóster (VVZ), citomegalovirus (CMV), ni virus del herpes simple (VHS) en ninguna de las muestras estudiadas. Conclusiones. No hemos detectado en LCR de pacientes con EM la presencia de ADN de HVH-6, por lo que creemos que métodos distintos al utilizado por nosotros son imprescindibles para aclarar el papel de este virus en la patogenia de la enfermedad (AU)

[Lack of human herpesvirus type 6 DNA in CSF by nested PCR among patients with multiple sclerosis]. / Ausencia de ADN de herpesvirus humano 6 en LCR, mediante técnica de PCR anidada, en pacientes con esclerosis múltiple.

BACKGROUND: The etiology of multiple sclerosis (MS) is currently unknown. Different viruses have tentatively been involved as causative agents of MS that would trigger an autoimmune response leading to demyelination plaques. There is controversy regarding the role that the human herpesvirus 6 (HHV-6) might play in this condition, and high antibody titers have been detected to HHV-6. HHV-6 DNA has also been detected by PCR both in blood and cerebrospinal fluid by means of the Polymerase Chain Reaction (PCR). Immunohistochemistry studies were performed with histologic specimens from the white matters of patientes with MS. All this has led some authors to incriminate this virus as the triggering etiologic agent of this disease. PATIENTS AND METHODS: CSF specimens from 23 patients with Relapsing-Remitting MS were studied. The CSF specimens from 23 patients undergoing rachianesthesia were used as controls, and none of them had neurologic disorders. A nested PCR was performed in the collected specimens to detect specific DNA sequences of HHV-6. RESULTS: No DNA sequences of HHV-6, EBV, VZV, CMV and HSV were detected in the tested specimens. CONCLUSIONS: No HHV-6 DNA sequences were detected from CSF specimens of patients with MS. Further investigations on the association between HHV-6 and MS should be performed to elucidate the role of HHV-6 in the pathogenesis of this disease.

[Cerebral abscesses. The clinical and evolutionary aspects of 17 cases treated surgically]. / Abscesos cerebrales. Aspectos clínicos y evolutivos de 17 casos intervenidos quirúrgicamente.

Seventeen cases of cerebral abscesses undergoing surgery were reviewed, underlying the characteristics of predisposing factors, infectious sources, microbiological and radiological studies, as well as clinical and evolutive aspects. The average age of the patients was 34 years, with a higher incidence in the second (35%) and sixth (22%) decades. The young patients (< 40 years) showed a greater frequency of adjacent infectious sources (83%) and the older patients (> 40 years), distant infectious sources (75%). The average time gap between the onset of symptoms and the diagnosis was 7 +/- 13 days. CAT showed in all the patients typical hypodense images with a peripheral ring; three patients had multiple abscesses and the remainder, single abscesses. In 12 patients (70.5%), microbiological cultures were positive, 3 (25%) for aerobe germs, 7 (50.3%) for anaerobe germs, 1 (8.33%) for multiple germs and 1 (8.33%) for fungi. Eleven patients underwent surgical drainage, four of which required latter exeresis. Six other patients underwent exeresis as the only surgical treatment. One patient died and the remainder showed a positive evolution. The hospital length of stay was 42.3 +/- 52.3 days. The most frequent sequela was the epilepsia present in 23.5% of the patients. Our findings are similar to the results of recent works, although in our series, there is a higher frequency of anaerobe germs. No differences were observed between the surgical techniques used nor between the past and current antibiotherapy patterns.