1 research outputs found
Metabolomics of Cerebrospinal Fluid from Humans Treated for Rabies
Rabies is a rapidly progressive lyssavirus encephalitis
that is
statistically 100% fatal. There are no clinically effective antiviral
drugs for rabies. An immunologically naïve teenager survived
rabies in 2004 through improvised supportive care; since then, 5 additional
survivors have been associated with use of the so-called Milwaukee
Protocol (MP). The MP applies critical care focused on the altered
metabolic and physiologic states associated with rabies. The aim of
this study was to examine the metabolic profile of cerebrospinal fluid
(CSF) from rabies patients during clinical progression of rabies encephalitis
in survivors and nonsurvivors and to compare these samples with control
CSF samples. Unsupervised clustering algorithms distinguished three
stages of rabies disease and identified several metabolites that differentiated
rabies survivors from those who subsequently died, in particular,
metabolites related to energy metabolism and cell volume control.
Moreover, for those patients who survived, the trajectory of their
metabolic profile tracked toward the control profile and away from
the rabies profile. NMR metabolomics of human rabies CSF provide new
insights into the mechanisms of rabies pathogenesis, which may guide
future therapy of this disease