Polio and Post-Polio Syndrome (PPS): Summary and Key Insights
Abstract Post-Polio Syndrome (PPS) develops in some survivors of paralytic poliomyelitis decades after recovery and is characterized by new or progressive muscle weakness, fatigue, pain, and reduced endurance. The prevailing pathophysiological model attributes PPS primarily to the gradual deterioration of enlarged motor units formed through compensatory axonal sprouting after the initial poliovirus (PV) infection. Although immune dysregulation and chronic systemic inflammation have been investigated as potential mechanisms, current evidence does not support classifying PPS as a primarily dysimmune or chronically inflammatory disorder. Nevertheless, the possible persistence of poliovirus-derived material and its biological significance remain subjects of investigation. Evidence for viral persistence has been reported in subsets of patients with PPS. In one study of 47 patients, elevated anti-poliovirus IgM antibodies were detected in some individuals, with titers reaching 1:250 compared...