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Measles virus antigen in panencephalitis

An immunomorphological study stressing dendritic involvement in SSPE

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Summary

In a retrospective study of 42 cases with a histopathologic diagnosis of subacute sclerosing panencephalitis (SSPE) or similar panencephalitic processes, measles virus antigen was traced by means of indirect immunofluorescence (IF) and peroxidase-antiperoxidase (PAP) techniques on protease-pretreated histological sections from formol-fixed, paraffin-embedded brain biopsy or autopsy tissue, stored for up to 32 years. Measles virus antigen was detected in 28 brains which were thus definitely diagnosed as SSPE or in one case as subacute measles encephalitis under immunosuppression. These cases were divided into three groups: group A, nine brains with excessive antigen amounts; group B, seven cases with a patchy distribution of a moderate number of antigen-containing cells; and group C, twelve cases with very few scattered reacting cells. Patients with excessive antigen amounts usually died at an earlier age and after a shorter course than cases with very few antigen-containing cells. An adult onset (beyond 20 years) was seen in five patients. The brain of a 5-day-old baby born to an SSPE mother did not contain any measles virus antigen. Complement fixing measles serum antibody titers were negative or low in four patients with measles virus antigen in the brain. Most of the cases found to be negative for measles virus antigen in the brain did not show clinical and/or histopathologic features of typical SSPE, including cases with a “pseudosystemic” lesion pattern.

Measles virus antigen was found almost selectively in cytoplasm, nuclei, and processes of pyramidal cells in the cerebral cortex, of large brain stem neurons, and oligodendrocytes. Protease pretreatment of the sections was important for best visualization of prominent dendritic involvement which was also confirmed by immunoelectron microscopy in one case. Apical dendrites of pyramidal cells were filled by viral antigen up to the upper cortical layers. Mononuclear cells in leptomeningeal and perivascular infiltrates and astrocytes rarely contained measles virus antigen. In contrast, IgG deposition was found mainly in astrocytes and mononuclear cells. Measles antigen production in most or all oligodendrocytes of a given area was not necessarily combined with demyelination in this area, especially in cases of short clinical duration.

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Authors and Affiliations

  1. Institute of Neurology, University of Vienna, Schwarzspanierstr. 17, A-1090, Vienna, Austria

    H. Budka & H. Lassmann

  2. Institute of Virology, University of Vienna, Austria

    Th. Popow-Kraupp

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  1. H. Budka
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  2. H. Lassmann
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  3. Th. Popow-Kraupp
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Budka, H., Lassmann, H. & Popow-Kraupp, T. Measles virus antigen in panencephalitis. Acta Neuropathol 56, 52–62 (1982). https://doi.org/10.1007/BF00691182

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  • DOI: https://doi.org/10.1007/BF00691182

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