ArticleJournal of inherited metabolic disease2009
Tetrahydrobiopterin deficiency in human rabies.
Article in Journal of inherited metabolic disease, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 41 citations in OpenAlex.
- Tetrahydrobiopterin: Beyond Its Traditional Role as a Cofactor.Antioxidants (Basel, Switzerland) · 2023Review
- Hydrogel-based 3D human iPSC-derived neuronal culture for the study of rabies virus infection.Frontiers in cellular and infection microbiology · 2023Article
- Immunological impact of tetrahydrobiopterin on the central nervous system in a murine model of rabies virus infection.Revista do Instituto de Medicina Tropical de Sao Paulo · 2021Article
- NMR metabolomics of cerebrospinal fluid differentiates inflammatory diseases of the central nervous system.PLoS neglected tropical diseases · 2018Article
- Lyssaviruses and rabies: current conundrums, concerns, contradictions and controversies.F1000Research · 2017Review
- A Case of Fatal Serotonin Syndrome-Like Human Rabies Caused by Tricolored Bat-Associated Rabies Virus.The American journal of tropical medicine and hygiene · 2016Article
- Virology, immunology and pathology of human rabies during treatment.The Pediatric infectious disease journal · 2015Article
- Diagnosis, management and post-mortem findings of a human case of rabies imported into the United Kingdom from India: a case report.Virology journal · 2014Article
- Metabolomics of cerebrospinal fluid from humans treated for rabies.Journal of proteome research · 2013Article
- Rabies: still a uniformly fatal disease? Historical occurrence, epidemiological trends, and paradigm shifts.Current infectious disease reports · 2012Article
- Recovery from and clearance of rabies virus in a domestic ferret.Journal of the American Association for Laboratory Animal Science : JAALAS · 2011Article
- Central tetrahydrobiopterin concentration in neurodevelopmental disorders.Frontiers in neuroscience · 2010Article
- Serum phenylalanine concentrations in patients post trauma and burn correlate to neopterin concentrations.Journal of inherited metabolic disease · 2009Article
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Authors and funding
10 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Rabies is a fatal viral encephalitis characterized by a clinically acute and progressive course. With rare exceptions, there is a discrepancy between clinical outcome and frank histological alterations in rabies. Investigators have postulated that rabies virus may modify neurotransmission through occupancy of cellular receptors or alteration of ion channels. We took advantage of these observations to improvise a successful therapy for rabies. The Milwaukee protocol ( www.mcw.edu/rabies ) was further modified to treat two German patients. We measured pterins and monoamine neurotransmitter metabolites in the CSF of patients with rabies by HPLC with electrochemical or fluorescent detection. We report loss of tetrahydrobiopterin (BH(4)) and associated pathological decrease of dopaminergic and serotoninergic neurotransmission in three successive patients with rabies. CSF levels of BH(4) and neurotransmitter metabolites increased in two patients who were supplemented. Our findings support the long-standing speculation of modified neurotransmission in the pathogenesis of rabies, but by another mechanism. Brain turnover of dopamine and serotonin is reduced following rabies-acquired BH(4) deficiency. Neuronal nitric oxide synthase is BH(4)-dependent and may also be involved, possibly causing cerebrovascular insufficiency in one patient. This work must be carefully replicated in animal models and future patients. We are cautiously optimistic at the prospect of readily available, metabolically specific, enteral therapy for rabies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.