SEQUENCES SPECIFIC FOR ENTEROVIRUS DETECTED IN SPINAL-CORD FROM PATIENTS WITH MOTOR-NEURON DISEASE

Objective-To investigate the association enteroviruses with motor neur one disease, known as amyotrophic lateral sclerosis. Design-Analysis b y enterovirus polymerase chain reaction of wax embedded material from spinal cords taken at necropsy from subjects with motor neurone diseas e and from age and sex matched controls. Setting-Specimens were collec ted in the west of Scotland and in London between 1982 and 1992. Resul ts-Sequences specific for a non-poliovirus type enterovirus were detec ted in spinal cord tissue from subjects with motor neurone disease. Am plification of a 414 base RNA target sequence in the conserved enterov irus 5' untranslated region from wax embedded tissue sections was succ essful in tissue from eight of 11 cases of sporadic motor neurone dise ase, one of two cases of familial motor neurone disease, and the one c ase of poliomyelitis, but not in the six matched controls or one case of antecedent poliomyelitis. In addition, sequences were detected in s pinal cords from one monkey infected with wild type poliovirus and one monkey infected with polio vaccine. Comparison of sequences from case s of motor neurone disease with sequences of corresponding regions of the 5' untranslated regions of known picornaviruses showed them to be tightly grouped within the enterovirus genus closely related to coxsac kievirus type B but not to polioviruses. Sequences derived from differ ent parts of the spinal cord of the same subjects were identical, but sequences differed between individual subjects. Conclusions-Conserved enteroviral sequences closely related to coxsackie B virus sequences w ere detectable in spinal cords from subjects with sporadic motor neuro ne disease and from one subject with possible familial motor neurone d isease.