Polio and Post-Polio Syndrome

By SWA

Post-Polio Syndrome Revisited

Post-polio syndrome (PPS) is characterized by recrudescence or worsening of motor neuron disease symptoms decades after recovery from acute paralytic poliovirus infection, i.e., poliomyelitis. PPS afflicts between 25% and 40% of poliomyelitis survivors and mimics motor neuron diseases (MNDs), such as amyotrophic lateral sclerosis (ALS), due to its selective impairment, degeneration, or death of motor neurons in the brainstem and spinal cord. Herein, we report a case of PPS in a 68-year-old man with a remote history of bulbar and cervical cord involvement by poliomyelitis, review the relevant literature, and contrast the salient histopathologic features that distinguish our case of PPS from ALS. https://www.mdpi.com/2035-8377/15/2/35

How do you diagnose post-polio syndrome?
There are no laboratory or diagnostic tests for PPS. Physicians diagnose the condition after completing a comprehensive medical history and physical examination, and by excluding other disorders that might explain the symptoms.13 Mar 2023
 

The poliovirus, which causes poliomyelitis (polio), is a small RNA virus belonging to the Picornaviridae family. 

The virus is composed of an RNA genome enclosed in a protein shell called a capsid. The capsid is made up of four primary structural proteins, which are essential for the virus's ability to infect cells and are the target of the immune response. These proteins are:

  1. VP1:What does VP1 do?

    The VP1 protein is responsible for initiating the process of infecting a cell by binding to sialic acids in glycans, including some gangliosides, on the cell surface. Canonically, VP1 interacts specifically with α(2,3)-linked and α(2,6)-linked sialic acids. This protein is involved in the attachment of the virus to host cells. It interacts with the poliovirus receptor (PVR) on the surface of host cells, facilitating the virus's entry.

  2. VP2:What is VP2 protein?

    VP2 Whey Isolate is a pure isolated whey protein scientifically proven to be over 600% more effective for supporting muscle growth than other proteins. Pure Whey Peptide Isolates • Hydrolyzed Whey Fractions • “Bio-Active” Peptide Isolates • Highest Nitrogen Retention.VP2 along with VP1 and VP3, forms the outer surface of the viral capsid. It plays a role in the structural stability of the virus.

  3. VP3: Similar to VP2, VP3 is a component of the outer surface of the viral capsid and contributes to the overall structure and stability of the virus. Which virus is VP3 protein isolated from?VP3, a Structural Protein of Infectious Pancreatic Necrosis Virus, Interacts with RNA-Dependent RNA Polymerase VP1 and with Double-Stranded RNA.

  4. VP4: This protein is located on the inner surface of the capsid. It is believed to play a role in the release of viral RNA into the host cell after the virus has entered.
    VP4 is an unglycosylated protein of the outer layer of the capsid of rotavirus. It forms spikes that project from the outer layer of mature virions, which is mainly constituted by glycoprotein VP7.

When the poliovirus infects a person, the immune system responds by producing antibodies against these capsid proteins. These antibodies can neutralize the virus, preventing it from infecting cells, which is the basis for immunity against polio. The inactivated polio vaccine (IPV) and oral polio vaccine (OPV) work by stimulating the body to produce these antibodies, providing protection against future poliovirus infections.

In the context of polio and post-polio syndrome, the relevant antibodies are primarily directed against the antigens of the poliovirus itself. Poliovirus, the causative agent of poliomyelitis, is a small RNA virus that comes in three serotypes (type 1, type 2, and type 3), each with its own specific antigens. The immune response to these antigens is crucial for both the resolution of the initial infection and long-term immunity.

  1. Protein Antibodies Against Poliovirus Antigens:

    • Neutralizing Antibodies: These antibodies are specific to the surface proteins of the poliovirus. Each of the three serotypes of the poliovirus has unique capsid proteins against which these neutralizing antibodies are formed. They are critical for preventing the virus from infecting cells and are the primary target of polio vaccines.
    • IgM and IgG Antibodies: The immune system produces IgM antibodies as a first response to a poliovirus infection, which are later replaced by IgG antibodies for long-term immunity. These antibodies are directed against the proteins of the poliovirus.

  2. Antibodies in Post-Polio Syndrome:

    • In the case of post-polio syndrome (PPS), there is no direct association with specific antibodies against poliovirus proteins. PPS is a condition that affects polio survivors years after the initial infection, characterized by muscle weakness, fatigue, and pain. It is not caused by a persistent or reactivated virus but is believed to result from the long-term effects of the initial infection on motor neurons.
    • Research into PPS does not typically focus on antibodies against the poliovirus, as the syndrome is not associated with an active infection. Instead, research might look at broader immune system responses or neurodegenerative processes.

In summary, the protein antibodies associated with the antigens of polio are those that target the specific proteins of the poliovirus's capsid. These antibodies are crucial for immunity against polio. In contrast, post-polio syndrome is not linked to a continued immune response against the poliovirus, so specific antibodies against polio antigens are not a feature of PPS.

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