Detection of Measles Virus Genomic RNA in Cerebrospinal Fluid of Children with Regressive Autism: a Report of Three Cases
Bradstreet JJ., El Dahr J., Anthony A., Kartzinel J., Wakefield AJ.
In light of encephalopathy presenting as autistic regression (autistic encephalopathy, AE) closely following measles-mumps-rubella (MMR) vaccination, three children underwent cerebrospinal fluid (CSF) assessments including studies for measles virus (MV). All three children had concomitant onset of gastrointestinal (GI) symptoms and had already had MV genomic RNA detected in biopsies of ileal lymphoid nodular hyperplasia (LNH).
Presence of MV Fusion (F) gene was examined by TaqMan realtime quantitative polymerase chain reaction (RT-PCR) in cases and control CSF samples. The latter were obtained from three non-autistic MMR-vaccinated children with indwelling shunts for hydrocephalus. None of the cases or controls had a history of measles exposure other than MMR vaccination. Serum and CSF samples were also evaluated for antibodies to MV and myelin basic protein (MBP).
MV F gene was present in CSF from all three cases, but not in controls. Genome copy number ranged from 3.7 x 104 to 2.42 x 107 per ng of RNA total. Serum anti-MBP autoantibodies were detected in all children with AE. Anti-MBP and MV antibodies were detected in the CSF of two cases, while the third child had neither anti-MBP nor MV antibodies detected in his CSF.
Findings are consistent with both an MV etiology for the AE and active viral replication in these children. They further indicate the possibility of a virally driven cerebral immunopathology in some cases of regressive autism.
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