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Humoral immunological response of patients with epidemic neuropathy against a virus isolated from the cerebrospinal fluid of a clinical case Musacchio, Alexis; Herrera, Luis; Rodriguez, Pilar; Alvarez, Reinaldo; Gonzalez-Griego, Martha; Penton, Eduardo & de la Fuente, Jose Abstract Serum specimens from patients with epidemic neuropathy (EN) were tested in immunoblots for the presence of IgG, IgM and IgA antibodies against the structural proteins of: a virus isolated from the cerebrospinal fluid of a patient (isolate C-47), coxsackie B2 and poliovirus. Sera from blood bank donors, healthy workers from the CIGB and healthy children were used as controls. All the sera had IgG antibodies against the C-47 VP0 protein, but only sera from patients with EN had IgG and/or IgM/IgA antibodies against the C-47 VP1 protein. Immunological response to poliovirus was as expected for a vaccinated population. Practically all the sera recognized the viral VP1 structural protein, as the most important protein for protection against this virus. In the case of coxsackie virus B2 (CVB2), most of the sera recognized VP0, VP1 and VP2 structural proteins, thus indicating the previous circulation of this virus among the population. Antibodies against the C-47 isolate were detected in the CSF of the patients but not in healthy controls. The data obtained from the analysis of areas with low and high incidence of the disease showed that the virus associated with the EN circulated among the population. These results supported our hypothesis that the causal agent of the disease could be the virus in combination with nutritional deficiencies and stress that made the population more susceptible to the appearance of clinical symptoms because of the infection with the virus, although it could play the main role in the neurological damage. Keywords coxsackie, epidemic neuropathy, immunology, virus

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Musacchio, Alexis; Herrera, Luis; Rodriguez, Pilar; Alvarez, Reinaldo; Gonzalez-Griego, Martha; Penton, Eduardo & de la Fuente, Jose Resumen Muestras de suero de pacientes con neuropatia epidemica (EN) se analizaron en inmunoblots para la presencia de anticuerpos tipo IgG, IgM e IgA contra las proteinas estructurales de un virus aislado del liquido cefalorraquideo (LCR) de un paciente (aislamiento C-47), virus coxsackie B2 (CVB2) y polio. Se emplearon como control sueros provenientes de donantes de sangre, trabajadores sanos del CIGB y ninos sanos. Todos los sueros mostraron reaccion frente a la proteina VP0 del C-47, pero solo los provenientes de pacientes con EN tenian IgG y/o IgM/IgA contra la proteina VP1. La respuesta inmunologica frente al virus polio fue la esperada para una poblacion vacunada. Practicamente todos los sueros reconocian la VP1 como la proteina mas importante para la proteccion frente al virus polio. Para el virus CVB2, la mayoria de los sueros reconocieron las proteinas VP0, VP1 y VP2, indicando la previa circulacion de este virus en la poblacion. Se detectaron anticuerpos tipo IgG contra el aislamiento C-47 en el LCR de pacientes y no en controles sanos. Los datos obtenidos de regiones con baja y alta incidencia de la enfermedad mostraron que el virus asociado a la EN circulo en la poblacion. Estos resultados apoyaron nuestra hipotesis de que el agente causal de la EN puede ser el virus en combinacion con deficiencias nutricionales y stress que hacen a la poblacion mas susceptible a la aparicion de sintomas clinicos producto de la infeccion con el virus, aunque este pueda jugar el papel fundamental en el dano neurologico.

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