摘要：近年来，关于神经退行性疾病发病机制的研究揭示了一个引人注目的方向：常见病毒感染与阿尔茨海默病、帕金森病、肌萎缩侧索硬化症等疾病之间可能存在潜在关联。传统观点认为这些疾病是年龄增长过程中不可避免的后果，但流行病学数据与生物学机制研究正在挑战这一认知。多国大规模健

正文翻译

近年来，关于神经退行性疾病发病机制的研究揭示了一个引人注目的方向：常见病毒感染与阿尔茨海默病、帕金森病、肌萎缩侧索硬化症等疾病之间可能存在潜在关联。传统观点认为这些疾病是年龄增长过程中不可避免的后果，但流行病学数据与生物学机制研究正在挑战这一认知。多国大规模健康数据库的长期追踪显示，经历流感、肺炎、带状疱疹等严重感染的患者，在后续数年至数十年间罹患神经退行性疾病的风险显著提升。一项覆盖30万芬兰居民的队列研究发现，因病毒性脑炎住院的患者后期阿尔茨海默病发病率激增22至30倍，类似的关联模式在跨地区验证中展现出统计学稳定性。
这种延迟性效应引发了关于病理机制的深入探讨。目前两种假说受到学界关注：其一，神经嗜性病毒可能通过直接入侵中枢神经系统触发持续炎症反应，例如单纯疱疹病毒（HSV-1）在潜伏与复发的循环中刺激β淀粉样蛋白异常沉积，这一过程在小鼠模型中已被观察到可加速神经退行进程；其二，病毒感染可能永久性改变宿主细胞的蛋白折叠系统，导致细胞器在清除病毒后仍持续错误组装内源性蛋白，形成病理性斑块。支持性证据来自HIV药物研究，某些抗病毒制剂意外展现出延缓ALS患者蛋白聚集的作用，提示病毒复制机制与神经退行过程可能存在分子层面共性。
预防医学领域为此提供了间接佐证。流感疫苗、肺炎疫苗的广泛接种不仅降低目标感染发生率，同时关联人群的神经退行性疾病发病率呈现下降趋势。这种现象可能与疫苗减轻感染严重程度有关——需要住院治疗的严重感染患者神经退行风险最高，而疫苗通过降低重症转化率间接切断这一病理链条。值得注意的是，这种保护效应具有广谱性，不同病毒疫苗对应多种神经退行疾病风险的同步下降，提示感染引发的系统性炎症或神经损伤可能是共同致病通路。
尽管因果关系的最终确立仍需长期观察，特别是新冠肺炎大流行为研究急性病毒感染与慢性神经退行过程的关系提供了自然实验场，但现有证据已足够推动公共卫生策略调整。加强呼吸道病毒、疱疹病毒等常见病原体的免疫防护，开发针对神经嗜性病毒的特异性疗法，可能成为预防神经退行性疾病的新突破口。从临床实践角度看，对严重感染患者实施长期神经功能监测，结合抗病毒药物与神经保护剂的协同干预，或将为延缓疾病进展提供新思路。随着分子检测技术的进步，未来有望通过检测特定病毒抗体滴度或神经炎症标记物，建立个体化风险评估体系，在症状出现前启动针对性预防措施。
这一研究方向的突破性在于重构了慢性病与急性感染之间的关联，将神经退行性疾病的防治窗口前移数十年。如果后续研究能确证病毒感染的核心致病作用，意味着人类可能通过完善现有疫苗体系与抗病毒治疗方案，显著降低这类毁灭性疾病的负担。尽管具体机制解析与临床转化仍需时日，但将神经退行性疾病纳入感染后并发症管理范畴，已为对抗这些曾被视为"不可避免"的老年疾病开辟了充满希望的新路径。

评论翻译

@jliller
If viral infections in adults increases chances of neurodegenerative diseases in adults what about in children?
Asking as someone who had mono in Pre-K.

如果成年人的病毒感染会增加患神经退行性疾病的风险，那儿童的情况如何？作为在学前班得过单核细胞增多症的人，我想知道这个问题的答案。

@StYxXx
Virus infections, like the flu, can cause a lot of later illnesses. Hashimoto might also get triggered by such.

病毒感染（比如流感）可能引发多种后续疾病，桥本甲状腺炎也可能因此被诱发。

@garion742
Go figure, another case of prevention is better and likely cheaper than treatment.

不出所料，这又是一个证明预防胜于治疗且成本更低的案例。

@kylenmaple4668
As someone who got COVID twice, and also got the vaccines , this is pretty sucky to hear

作为感染过两次新冠且接种过疫苗的人，听到这个消息真是糟心。
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处

@robindowensauthor9917
My family always believed my father got Alzheimers due to a severe bout of Scarlet fever as a child.

我家一直认为，父亲患阿尔茨海默病是因为他小时候得过严重的猩红热。

@andyt1313
Vaccines truly are one of the most beneficial inventions in human history.

疫苗确实是人类历史上最伟大的发明之一。

@HurricaneOG
So because I caught the flu at 22 I need to think about catching Alzheimers someday?

所以，就因为我22岁时得过流感，现在就得担心未来会得阿尔茨海默病？

@O-Demi
A super worrying video title for me who's caught some sort of respirotary viral infection every month since September; I'm literally sick every month.

这个视频标题让我极度焦虑——自九月起，我每月都会感染某种呼吸道病毒，字面意义上每个月都在生病。

@1dontknow4321
Viruses are lixed to many diseases. They really arent benign and should be avoided if possible. Vaccines could save you from more than the initial infection.

病毒与多种疾病相关，它们绝非无害，应尽可能避免感染。疫苗不仅能预防初次感染，还能提供更多保护。

@acaciawilliams9015
My older brother gave me cold sores as a baby. My mom kept telling him not to kiss me, but he did anyway. I'm pretty upset about it as I was a completely helpless baby who couldn't consent and now I have to live with this for the rest of my life. Stg that if I get any kind of dementia from it...

我哥哥在我婴儿时期把唇疱疹传染给了我。妈妈反复提醒他别亲我，但他还是做了。这件事让我很生气，毕竟我当时毫无反抗能力，现在却要终生承受后果。要是因此患上痴呆症，我发誓...

@sonwig5186
I luckily don't plan to live so long that I'd get Parkinson's. But also how do people even get the Flu. Like I had C*vid several times and some really bad colds but never a flu, idk how people have it every year.

幸好我不打算活到会得帕金森病的年纪。不过话说回来，人们到底是怎么得流感的？我感染过几次新冠和重感冒，但从没得过流感，实在不懂为什么有人每年都中招。

@elinope4745
Dirty teeth and strep throat cause neuro and cardiac diseases.

牙齿不洁和链球菌性咽喉炎会引发神经与心脏疾病。

@jennacarodiskeywiebe4960
Great video.
Vaccination and treatments are definitely vital- but why neglect to mention respirator masks and clean are as preventive measures? Both are easy and effective ways to lower tve risk of infection and lower viral loads.

视频很棒。疫苗接种和治疗当然重要，但为什么不提呼吸器口罩和清洁空气作为预防措施？这两者都是降低感染风险和病毒载量的简便有效方法。

@spookycreachre
Damn, great news to hear when my mom is antivax and I got the flu every single year not to mention the terrible brain fog I've got now. It feels like I'm a different person now, my capabilities are just so different.

真讽刺，我妈是反疫苗人士，而我每年都得流感，更别提现在严重的脑雾。感觉像是变了个人，能力完全不同了。

@OmegaGamer1989
Youre telling me that having a severe infection that beats the crap out of your brain could potentially lead to your brain breaking down later in life? SHOCKER. Truly, a revolutionary epiphany.
(Could you feel the sarcasm in there? Because I REALLY really meant it.)

你是说严重感染把大脑折腾得半死，可能导致晚年脑功能衰退？天呐，这真是颠覆性发现啊。（感受到我的讽刺了吗？因为我真的就是这个意思。）

@Ana2398
I wonder how many studies are/will look at these diseases conecting to Covid

不知道有多少研究正在或将会探索这些疾病与新冠的关联。

@lauravanimpe3173
Wear your respirators people! Good quality masks will save your life and brain.

大家戴好呼吸器吧！优质口罩能拯救你的生命和大脑。

@MurderMostFowl
Nice to hear some positive news in the world of public health I didnt expect to see anything for 4 years while the Secretary of Health and Human Services has the nations collective head in the sand.

听到公共卫生领域的好消息真不错。过去四年卫生与公众服务部长让全国集体逃避现实，我本不指望能看到任何进展。

@jaybanks7718
One paper I read had the theory that each flu/bad cold kills some neurons. This is okay, but with getting sick over the years, the loss of neurons adds up until it isn't okay (heavily paraphrased). Regardless, you could say that it is a lack of fitness, because fit people get sick less. See: "A 2024 study found that people who exercise regularly are much less likely to get COVID-19 or be hospitalized with it, compared with people who don't exercise regularly." The new hotness is Alzheimer's is a vascular disease. So, virus or fitness, either way exercise is the solution.

我读过一篇论文提出理论：每次流感/重感冒会杀死部分神经元。这暂时没问题，但多年累积的神经元损失终将引发问题（大意如此）。不管怎样，可以说这是缺乏锻炼的结果，因为健康人群患病更少。参考："2024年研究发现，定期锻炼者感染新冠或住院的概率远低于不锻炼者"。最新观点认为阿尔茨海默病是血管疾病。所以无论病毒还是体质，锻炼都是解决之道。

@Fofut
Flu injections don't stop the infection only lessons the symptoms & duration so the working don't take as much time off. To some it doesn't affect the virus at all. Specifically where the autoimmune system attacks everything, good or bad.

流感疫苗不能阻止感染，只能减轻症状和缩短病程，让打工人少请病假。对某些人（尤其是免疫系统无差别攻击的人群）来说，疫苗对病毒完全无效。
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处

@nancienordwick4169
The fact that spike protein can lead to rapid onset vascular dementia was very helpful to eliciting this!

刺突蛋白可能导致快速发作的血管性痴呆，这一事实对引发此研究非常关键！
原创翻译：龙腾网 https://www.ltaaa.cn 转载请注明出处

@bonniesmith7277
It would be great to include non pharmaceutical interventions as prevention as well! Respirators, air purifiers, and paid sick leave all make meaningful differences in breaking chains of transmission.

若能纳入非药物干预作为预防措施就更好了！呼吸器、空气净化器和带薪病假都能有效阻断传播链。

@Jacob-bm6wb
I dont get the flu, covid, or mono since I wear n95 masks. I dont get herpes for another reason

自从戴N95口罩后，我没得过流感、新冠或单核细胞增多症。至于疱疹...没得是另有原因。

@Jacob-bm6wb
Studies and people have been yelling about it since like the first year of covid. Luckily masks are effective against all of them especially the flu

从新冠爆发第一年起，研究和民众就在呼吁这事。幸好口罩对所有病毒都有效，尤其是流感。

@diyeana
My grandparents both had dementia, got their flu shots every year, and were never sick. Viruses like the flu, mono, and HSV-1 are so common, how can you reliably make a connection? You can find data, and anecdotes, supporting either way.

我祖父母都患痴呆症，每年接种流感疫苗且从不生病。流感、单核细胞增多症和HSV-1病毒如此普遍，如何建立可靠关联？正反两面的数据和案例都能找到。

来源：龙腾网看世界