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Front. Mol. Neurosci. | doi: 10.3389/fnmol.2018.00063

ENTEROVIRAL INFECTION: THE FORGOTTEN LINK TO AMYOTROPHIC LATERAL SCLEROSIS?

  • 1University of British Columbia, Canada
  • 2San Diego State University, United States

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that primarily attacks motor neurons in the brain and spinal cord, leading to progressive paralysis and ultimately death. Currently there is no effective therapy. The majority of ALS cases are sporadic, with no known family history; unfortunately the etiology remains largely unknown. Contribution of enteroviruses, a family of positive-stranded RNA viruses including poliovirus, coxsackievirus, echovirus, enterovirus-A71, and enterovirus-D68, to the development of ALS has been suspected as they can target motor neurons, and patients with prior poliomyelitis show a higher risk of motor neuron disease. Multiple efforts have been made to detect enteroviral genome in ALS patient tissues over the past two decades; however the clinical data are controversial and a causal relationship has not yet been established. Recent evidence from in vitro and animal studies suggests that enterovirus-induced pathology remarkably resembles the cellular and molecular phenotype of ALS, indicating a possible link between enteroviral infection and ALS pathogenesis. In this review, we summarize the nature of enteroviral infection, including route of infection, cells targeted, and viral persistence within the central nervous system. We review the molecular mechanisms underlying viral infection and highlight the similarity between viral pathogenesis and the molecular and pathological features of ALS, and finally, discuss the potential role of enteroviral infection in frontotemporal dementia, a disease that shares common clinical, genetic, and pathological features with ALS, and the significance of anti-viral therapy as an option for the treatment of ALS.

Keywords: Amyotrophic Lateral Sclerosis, Enterovirus, TDP-43 pathology, Nucleocytoplasmic trafficking, RNA metabolism, Autophagy, Neuroinflammation

Received: 05 Jan 2018; Accepted: 14 Feb 2018.

Edited by:

Oliver Wirths, Universitätsmedizin Göttingen, Germany

Reviewed by:

Melissa C. Nassif, Universidad Mayor, Chile
Sara Baldelli, San Raffaele University of Rome, Italy  

Copyright: © 2018 Xue, Feuer, Cashman and Luo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Honglin Luo, University of British Columbia, Vancouver, Canada, honglin.luo@hli.ubc.ca