Causes of acute flaccid myelitis: A Synthesis of Findings from 4 Studies

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Original Abstract of the Article

Main Research Findings

Several studies have shown that the human immune system plays a crucial role in fighting against the virus. found that human antibodies recognize diverse antigenic variants and protect mice from EV-D68 infection and paralytic disease.

4 showed that virus-like particle (VLP) vaccines induce a protective neutralizing antibody against homologous and heterologous EV-D68 subclades. In this study, it was demonstrated that VLP vaccines elicit comparable B1 EV-D68 neutralizing activity as an inactivated viral particle vaccine in mice. Both immunogens induced weaker cross-neutralization against heterologous viruses.

On the other hand, demonstrated that histone deacetylase SIRT-1 is essential for autophagy and EV-D68 infection. Knockdown of SIRT-1 inhibits autophagy and reduces EV-D68 extracellular titers.

Reasons for the Causes

EV-D68 is known to infect the respiratory system and cause severe respiratory diseases and acute flaccid myelitis (AFM), a debilitating paralytic disease.

Common Causes

Viral Infection

EV-D68 infection is one of the major causes of AFM. 3 , , , EV-D68 is a virus that causes respiratory infections and has been linked to AFM outbreaks. Although AFM is associated with EV-D68 infection, the exact mechanism of this association is yet to be fully understood.

Invasion of the Nervous System

EV-D68 has the potential to invade the nervous system and affect the gray matter of the spinal cord. , , , This invasion can lead to damage of motor neurons in the spinal cord, resulting in paralysis.

Immune Response

The immune response to EV-D68 infection can potentially cause damage to nerve tissue. This possibility is suggested by the higher frequency of AFM cases occurring during EV-D68 infections.

Measures to Address the Causes

Vaccination

Currently, there is no vaccine available for the prevention of EV-D68. 4 However, VLP vaccines have shown to induce protective neutralizing antibodies against homologous and heterologous EV-D68 subclades, raising hopes for future vaccine development.

Antibody Therapy

Antibody therapy for the treatment of EV-D68 infection is being developed. This therapy aims to prevent viral infection and suppress AFM development by administering antibodies against EV-D68.

Symptomatic Treatment

Symptomatic treatment is used to alleviate the symptoms of AFM. This treatment aims to reduce the severity of paralysis and improve the quality of life of patients.

Comparison Between Studies

Commonalities Between Studies

Many studies have indicated that EV-D68 is a significant cause of AFM. 3 , , , These studies highlight the connection between EV-D68 infection and AFM outbreaks.

Differences Between Studies

There are differences in details regarding the route of EV-D68 infection, the mechanism of nervous system invasion, and the development of AFM, depending on the study. For example, showed that SIRT-1 is essential for EV-D68 infection, while other studies did not mention SIRT-1.

Cautions for Applying to Real Life

EV-D68 is a dangerous virus, especially for young children. , Children have a higher risk of developing AFM from EV-D68 infection and require special attention. It is important to thoroughly implement preventive measures such as handwashing for children. Also, if AFM symptoms appear, seek medical attention immediately.

Current Limitations of Research

Research on the causes and development mechanisms of AFM is still inadequate. Treatment and prevention methods for AFM have not yet been established.

Future Research Directions

Further research is necessary to clarify the route of EV-D68 infection, the mechanism of nervous system invasion, and the mechanisms behind AFM development. Research is also needed to develop effective treatment and prevention methods.

Conclusion

EV-D68 is a virus that can cause severe respiratory diseases and AFM. , Children, especially, have a high risk of developing AFM from EV-D68 infection, and caution is needed. It is essential to implement preventative measures and seek medical attention immediately if AFM symptoms appear. Further research is needed to understand the causes and development mechanisms of AFM and to develop effective treatment and prevention methods.

Literature analysis of 4 papers
Positive Content
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Neutral Content
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Negative Content
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1.

Epidemiology of acne vulgaris.

Author: BhateK, WilliamsH C

Improved acne understanding
Low GI diet potential
Validated core outcomes
Acne heritability high
Acne persists into adulthood
Acne prevalence high
Acne severity correlates with puberty
Dietary association unclear
High economic impact
Severe acne linked to suicidal ideation
Smoking association unclear

Despite its prevalence, we still don't know much about the causes and spread of acne. While the role of bacteria in acne is not fully understood, antibiotics seem to work by both killing bacteria and reducing inflammation. Around 20% of young people have moderate to severe acne, and severity is linked to puberty. It's unclear if ethnicity influences acne, but Black individuals are more prone to dark spots after acne and specific types of acne like "pomade acne." Acne can persist into adulthood, affecting 64% of people in their 20s and 43% in their 30s. Genetics plays a major role, with acne being more likely and severe in people with a family history. Those with severe acne are more likely to have thoughts of suicide. Acne costs billions of dollars annually in the U.S. due to treatment and lost productivity. While the connection between diet and acne is unclear, one small study suggests low glycemic index diets might help. There might be a link between dairy and acne that needs more investigation. Sunlight and poor hygiene are not linked to acne, and the link between smoking and acne is likely due to other factors. Future research should use standardized measures to make it easier to combine findings.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

2.

Enterovirus A71-associated acute flaccid paralysis in a pediatric patient: a case report.

Author: AkinnurunOluwafemi M, Narvaez EncaladaMarco, OrthJulia, PetzoldMarkus, BöttcherSindy, DiedrichSabine, SmitkaMartin, SchröttnerPercy

Early intervention
Improved paresis
Difficult diagnosis
Rare complication

This case report describes a 13-month-old girl with enterovirus A71-associated acute flaccid paralysis. The patient presented with sudden onset of left arm paresis despite negative virological investigations of cerebrospinal fluid. Stool analysis confirmed enterovirus A71, and the child responded well to intravenous immunoglobulin treatment. This case highlights the importance of considering enterovirus A71 as a possible cause of acute flaccid paralysis in children.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Acute flaccid myelitis associated with enterovirus-D68 infection in an otherwise healthy child.

Author: EspositoSusanna, ChidiniGiovanna, CinnanteClaudia, NapolitanoLuisa, GianniniAlberto, TerranovaLeonardo, NiestersHubert, PrincipiNicola, CalderiniEdoardo

AFM

This case report describes a 4-year-old boy who presented with sudden weakness and limited mobility in his left arm following an upper respiratory illness. The patient was diagnosed with EV-D68-associated acute flaccid myelitis (AFM).

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

EV-D68 virus-like particle vaccines elicit cross-clade neutralizing antibodies that inhibit infection and block dissemination.

Author: KrugPeter W, WangLingshu, ShiWei, KongWing-Pui, MossDaniel L, YangEun Sung, FisherBrian E, MorabitoKaitlyn M, MascolaJohn R, KanekiyoMasaru, GrahamBarney S, RuckwardtTracy J

Improved immune response
Protective neutralizing antibody
Weaker cross-neutralization

A virus-like particle (VLP) vaccine against enterovirus D68 (EV-D68) was developed. VLPs elicited neutralizing antibodies against homologous and heterologous EV-D68 subclades, suggesting potential for a broad-spectrum vaccine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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