Herpes simplex virus encephalitis of childhood: inborn errors of central nervous system cell-intrinsic immunity

Hum Genet. 2020 Jun;139(6-7):911-918. doi: 10.1007/s00439-020-02127-5. Epub 2020 Feb 10.

Abstract

Herpes simplex virus 1 (HSV-1) encephalitis (HSE) is the most common sporadic viral encephalitis in Western countries. Over the last 15 years, human genetic and immunological studies have provided proof-of-principle that childhood HSE can result from inborn errors of central nervous system (CNS)-specific, cell-intrinsic immunity to HSV-1. HSE-causing mutations of eight genes disrupt known (TLR3-dependent IFN-α/β immunity) and novel (dependent on DBR1 or snoRNA31) antiviral mechanisms. Monogenic inborn errors confer susceptibility to forebrain (TLR3-IFN or snoRNA31) or brainstem (DBR1) HSE. Most of these disorders display incomplete clinical penetrance, with the possible exception of DBR1 deficiency. They account for a small, but non-negligible proportion of cases (about 7%). These findings pave the way for the gradual definition of the genetic and immunological architecture of childhood HSE, with both biological and clinical implications.

Publication types

  • Review

MeSH terms

  • Central Nervous System Diseases / epidemiology
  • Central Nervous System Diseases / genetics*
  • Central Nervous System Diseases / immunology
  • Central Nervous System Diseases / virology
  • Child
  • Encephalitis, Herpes Simplex / epidemiology
  • Encephalitis, Herpes Simplex / genetics*
  • Encephalitis, Herpes Simplex / immunology
  • Encephalitis, Herpes Simplex / virology
  • Genetic Predisposition to Disease*
  • Herpes Simplex / complications
  • Herpes Simplex / immunology*
  • Herpes Simplex / virology
  • Herpesvirus 1, Human / immunology*
  • Herpesvirus 1, Human / pathogenicity
  • Host-Pathogen Interactions / genetics*
  • Host-Pathogen Interactions / immunology
  • Humans
  • Immunity, Cellular / immunology*
  • Mutation