Acute encephalitis, a poliomyelitis-like syndrome and neurological sequelae in a hamster model for flavivirus infections

Infection of hamsters with the murine flavivirus Modoc results in (meningo)encephalitis, which is, during the acute phase, frequently associated with flaccid paralysis, as also observed in patients with West Nile virus encephalitis. Twenty percent of the hamsters that recover from the acute encephalitis develop life-long neurological sequelae, reminiscent of those observed, for example, in survivors of Japanese encephalitis. Magnetic resonance imaging and histology revealed severe lesions predominantly located in the olfactory-limbic system, both in hamsters with acute encephalitis as in survivors. Prominent pathology was also detected in the spinal cord of hamsters with paralysis. Modoc virus infections in hamsters provide a unique model for the study of encephalitis, a poliomyelitis-like syndrome and neurological sequelae following flavivirus infection.

The alpha/beta interferon response controls tissue tropism and pathogenicity of poliovirus

Poliovirus selectively replicates in neurons in the spinal cord and brainstem, although poliovirus receptor (PVR) expression is observed in both the target and nontarget tissues in humans and transgenic mice expressing human PVR (PVR-transgenic mice). We assessed the role of alpha/beta interferon (IFN) in determining tissue tropism by comparing the pathogenesis of the virulent Mahoney strain in PVR-transgenic mice and PVR-transgenic mice deficient in the alpha/beta IFN receptor gene (PVR-transgenic/Ifnar knockout mice). PVR-transgenic/Ifnar knockout mice showed increased susceptibility to poliovirus. After intravenous inoculation, severe lesions positive for the poliovirus antigen were detected in the liver, spleen, and pancreas in addition to the central nervous system. These results suggest that the alpha/beta IFN system plays an important role in determining tissue tropism by protecting nontarget tissues that are potentially susceptible to infection. We subsequently examined the expression of IFN and IFN-stimulated genes (ISGs) in the PVR-transgenic mice. In the nontarget tissues, ISGs were expressed even in the noninfected state, and the expression level increased soon after poliovirus infection. On the contrary, in the target tissues, ISG expression was low in the noninfected state and sufficient response after poliovirus infection was not observed. The results suggest that the unequal IFN response is one of the important determinants for the differential susceptibility of tissues to poliovirus. We consider that poliovirus replication was observed in the nontarget tissues of PVR-transgenic/Ifnar knockout mice because the IFN response was null in all tissues.

[Lipid peroxidation in neurological pathology in children]

The intensity of lipid peroxidation (LPO) was studied by the content of the listed below in erythrocytes of children with neurological pathology: diene conjugates, trienketones and LPO products. Intensified LPO processes were registered in children with neurology and primarily in those with cerebral spastic infantile paralysis (CSIP). The detected changes in the LPO products of erythrocyte membranes depended on a disease variation on an intellectual development of sick child. The LPO activation affects possibly the development (lesion) of craniocerebral innervation in patients. Changed LPO parameters were found in examined sick children to be most closely related with the development of their motor skills and with the formation of the bone-muscle system, thus, an essentially higher content of LPO products was registered in erythrocytes of children with a reduced muscular activity (in those not capable of sitting, standing or walking). Considering the above stated and with respect to the deficit of Vitamin E registered in such patients, children with CSIP or with impending CSIP need, obviously a prolonged membrane-stabilizing therapy by antioxidants and essential phospholipids including traps of radicals, which should cut the number of children with severe CSIP and with residual perinatal lesions of the central nervous system.

Theodore E. Woodward Award: The devastating backlash of a dread disease: poliomyelitis

The paper is in three parts. 1) A description of acute anterior poliomyelitis; 2) A summary of the condition of post-polio syndrome; 3) A description of two small epidemics of poliomyelitis juxtaposed and related to one another.

A poliomyelitis model through mucosal infection in transgenic mice bearing human poliovirus receptor, TgPVR21

Transgenic mice bearing the human poliovirus receptor (TgPVR) are less susceptible to oral inoculation, although they are susceptible to parenteral inoculation. We investigated the susceptibility of TgPVR 21 line [Arch. Virol. 130 (1994) 351] to poliovirus through various mucosal routes. Intranasal inoculation of a neurovirulent Mahoney strain (OM1) caused flaccid paralysis with viral replication in the central nervous system at a dose of 10(6) cell culture infectious dose (CCID50), in contrast, no paralysis following oral or intragastric inoculation of the same dose. Intranasal inoculation of a vaccine strain, Sabin 1, at 10(6) CCID50, resulted in no paralysis. Initial replication of poliovirus in the nasal cavity was confirmed by virus isolation and detection of negative-stranded replicative intermediates by RT-PCR and viral antigens using a high-sensitive immunohistochemistry and genome/transcripts by in situ hybridization. Poliovirus-specific IgG antibodies were elevated in the sera of surviving TgPVR21. This model can be used as a mucosal infection model and for differentiation of neurovirulent and attenuated poliovirus strains.

[Relationship between tibia callus diameter ratio and prognosis during tibia lengthening]

OBJECTIVE

To investigate the relationship between the tibia callus diameter ratio (CDR) and prognosis during tibial distraction and the occurrence of late deformity or fracture.

METHODS

We measured tibial lengthening callus diameter and added up the cases of angular deformity and fracture in 68 cases from January 1996 to December 2001, to calculated callus diameter ratios and compare the relationship between the tibia callus diameter during tibial distraction and the occurrence of late callus angular deformity or fracture.

RESULTS

In 23 cases of CDR < 80%, 13 cases had new bone fracture, 21 cases had angular deformity > 5 degree. In 6 cases of 81% < CDR < 85%, there were 4 cases of angular deformity > 5 degree. In the other 39 cases of CDR > 85%, there were no fracture and angular deformity.

CONCLUSION

When the CDR was > 85%, there were no angular deformity and fracture, but when the CDR was < 80%, the complications of fracture and angular deformity occur. CDR is a better alarming index for preventing the complications occurring in tibial lengthening.

Electrodiagnostic features of acute paralytic poliomyelitis associated with West Nile virus infection

West Nile virus (WNV) infection is a potentially fatal disease, with meningoencephalitis being its most common neurological manifestation. Guillain-Barré syndrome (GBS) has also been described, but acute paralytic poliomyelitis has only recently been recognized. We report the clinical and electrodiagnostic findings of five patients with WNV infection, who presented with acute paralytic poliomyelitis. Three patients manifested focal asymmetrical weakness, and two had rapid ascending quadriplegia mimicking GBS. Electrodiagnostic studies during the acute illness showed normal sensory nerve action potentials, compound motor action potentials of normal or reduced amplitude, and no slowing of nerve conduction velocities. Depending on the timing of the examination, fibrillation potentials were widespread, including in those with focal weakness. Cervical magnetic resonance imaging in one patient showed abnormal T2-weighted signals in the spinal cord gray matter. On follow-up, signs of clinical improvement were seen in one patient, whereas two remained quadriplegic and ventilator-dependent 5 months after the onset. This report highlights the value of the electrodiagnostic studies in the diagnosis and prognosis of focal or generalized weakness due to acute paralytic poliomyelitis associated with WNV infection.

The double-stranded RNA-activated protein kinase mediates viral-induced encephalitis

The double-stranded (ds) RNA-activated protein kinase (PKR) plays an important role in control of viral infections and cell growth. We have studied the role of PKR in viral infection in mice that are defective in the PKR signaling pathway. Transgenic mice were derived that constitutively express a trans-dominant-negative kinase-defective mutant PKR under control of the beta-actin promoter. The trans-dominant-negative PKR mutant expressing transgenic mice do not have a detectable phenotype, similar to observations with PKR knock-out mice. The requirement for PKR in viral pathogenesis was studied by intracerebral infection of mice with a mouse-adapted poliovirus. Histopathological analysis revealed diffuse encephalomyelitis with severe inflammatory lesions throughout the central nervous system (CNS) in infected wild-type mice. In contrast, histopathological evaluation of virus-injected trans-dominant-negative PKR transgenic mice as well as PKR knock-out mice yielded no signs of tissue damage associated with inflammatory host responses. However, the virus did replicate in both models of PKR-deficient mice at a level equal to that observed in wild-type infected mice. Although the results indicate a clear difference in susceptibility to poliovirus-induced encephalitis, this difference manifests clinically as a slight delay in fatal neuropathy in trans-dominant-negative PKR transgenic and PKR knock-out animals. Our observations support the finding that viral-induced PKR activation may play a significant role in pathogenesis by mediating the host response to viral CNS infection. They support PKR to be an effective target to control tissue damage due to deleterious host responses to viral infection.

Immunohistochemical detection of osteopontin in the spinal cords of mice with Theiler's murine encephalomyelitis virus-induced demyelinating disease

The spinal cords of mice that were infected with the BeAn 8386 strain of Theiler's murine encephalomyelitis virus (TMEV) were studied to elucidate the involvement of osteopontin in the course of TMEV-induced demyelination. Immunohistochemistry showed staining for osteopontin in the vessels of the normal spinal cords, and more intense immunoreactivity in the vessels within the demyelinating lesions. Intense osteopontin immunoreactivity was observed in the cell bodies, as well as in the extracellular space of the demyelinating lesions, where some glial cells, which included activated microglia/macrophages, were also immunopositive for osteopontin. These findings suggest that osteopontin is upregulated in the demyelinating spinal cord, and that osteopontin from either microglia or astrocytes may be involved in the chemotaxis of inflammatory cells and astrocytes, which ultimately leads to chronic inflammation and astrogliosis in this model system.

[The prevalance of orthopedic disabilities in the district of Cay, Afyon, Turkey]

OBJECTIVES

Data were collected on disabilities from a sample population in order to estimate the prevalence of orthopedic disabilities in the general population.

METHODS

A two-stage field study was conducted in Cay, a district of Afyon, Turkey. In the first stage, a list of all individuals with orthopedic disabilities was derived. Then, medical histories were elicited and examinations were made by a team of specialists of orthopedics and traumatology. Radiographic studies were made when necessary. Orthopedic disabilities were defined as any muscle or skeletal abnormality that was associated with a permanent functional loss and were classified as congenital, traumatic, cerebral palsy, poliomyelitis, and other causes.

RESULTS

The overall population was 35,571, of whom 189 had orthopedic disabilities (53/10,000). The male-to-female ratio was 1.8. The most common cause was congenital diseases (25.9%; 13.7/10,000), followed by trauma (23.8%; 12.6/10,000), cerebral palsy (21.7%; 11.5/10,000), poliomyelitis (10.1%; 5.3/10,000), and others (18.5%; 9.8/10,000). The lowest mean age (19+/-5 years) was found in those with cerebral palsy, which was associated with the highest degree of functional loss. The mean age in patients with poliomyelitis was 29+/-7 years. It was found that 37% of the disabled could benefit from either a limited or extensive surgical intervention, and 9% could have significant improvement both in functional ability and life quality through physical therapy or the use of a prosthesis/orthosis. Only 18% were under the coverage of a health insurance, though.

CONCLUSION

The data of this study may throw some new light on the prevalence and implications of orthopedic disabilities in Turkey.

Persistence of Vaccine‐Derived Polioviruses among Immunodeficient Persons with Vaccine‐Associated Paralytic Poliomyelitis

To estimate long-term poliovaccine virus persistence among immunodeficient patients with vaccine-associated paralytic poliomyelitis (iVAPP), cases reported in the United States during 1975-1997 were reviewed, with subsequent follow-up and virological testing. Six (16.2%) of 37 subjects excreted poliovaccine viruses for > or =6 months. Partial genomic sequencing of their available poliovirus isolates showed considerable divergence from the prototype Sabin strain in all cases. Poliovirus persistence declined over time since the last oral poliovaccine dose: at 6 months, 19.4%; 1 year, 14.3%; 5 years, 4%; and 10 years, 0% (P<.05) of patients. Despite the high prevalence of poliovaccine virus persistence among patients with iVAPP, this group appears to be an unlikely source of poliovirus reintroduction in developed countries because of the rarity and high fatality rate of iVAPP and the possible spontaneous clearance of polioviruses. These results are important for developing "endgame" strategies for the Global Poliomyelitis Eradication Program.

Quadriceps muscle strength and voluntary activation after polio

Quadriceps strength, maximal anatomical cross-sectional area (CSA), maximal voluntary activation (MVA), and maximal relaxation rate (MRR) were studied in 48 subjects with a past history of polio, 26 with and 22 without postpoliomyelitis syndrome (PPS), and in 13 control subjects. It was also investigated whether, apart from CSA, MVA and MRR were determinants of muscle strength. Polio subjects had significantly less strength, CSA, and MRR in the more-affected quadriceps than control subjects. MVA was reduced in 18 polio subjects and normal in all controls. PPS subjects differed from non-PPS subjects only in that the MVA of the more-affected quadriceps was significantly lower. Both CSA and MVA were found to be associated with muscle strength. Quadriceps strength in polio subjects was dependent not only on muscle mass, but also on the ability to activate the muscles. Since impaired activation was more pronounced in PPS subjects, the new muscle weakness and functional decline in PPS may be due not only to a gradual loss of muscle fibers, but also to an increasing inability to activate the muscles.

Fcgamma receptor IIIA polymorphism as a risk factor for acute poliomyelitis

Poliomyelitis is a viral infection that causes flaccid paralysis in approximately 1% of cases. The Fc receptors for immunoglobulin G (FcgammaR) are associated with modifying effects of several infectious and autoimmune diseases. To assess the influence of FcgammaR polymorphisms on the acute and late course of poliomyelitis, 110 Norwegian patients with well-defined histories of acute poliomyelitis were genotyped, of whom 50 suffered from the postpolio syndrome (PPS). In comparison with healthy control subjects without a history of poliomyelitis, significantly fewer patients had the FcgammaRIIIA genotype V/V (P<.01). However, this genotype was not an independent risk factor for PPS. The FcgammaRIIA and IIIB genotypes and allele frequencies did not differ between the patients and control subjects. The FcgammaRIIIA V/V genotype may lower the risk for contracting acute poliomyelitis through better clearance of poliovirus.

The muscle adaptation process as a result of pathological changes or specific training procedures

Muscle responses to tetanic electrical stimulation were detected by the non-invasive tensiomyographic (TMG) measuring method. The main objective of this study was to find out whether the TMG measuring method is suitable for monitoring the unfused tetanus (stimulation frequencies ranging from 1 Hz to the fusion frequency (ff)--the frequency at which tetanus occurs), and whether this monitoring provides any information on skeletal muscles' structural or functional changes. The muscle adaptation process was observed in damped unfused tetanus (DUT). The measured results in the clinical environment as well as on the sports field indicate that DUT is caused by a type II muscle fibres fatigue process. Separate observation of type II muscle fibres enables more efficient treatment and observation of pathological changes, and helps professional athletes and their trainers to better understand the influence of training stimuli on the training process.

ICAM-1 is crucial for protection from TMEV-induced neuronal damage but not demyelination

Previous work has suggested that the factors protecting mice from Theiler's murine encephalomyelitis virus (TMEV)-induced spinal cord demyelination are distinct from those involved in protection of the brain during the acute encephalitic phase. In this study, we examined the requirement for intercellular adhesion molecule-1 (ICAM-1) in both of these processes. During the acute phase of infection (days 7 to 10 after intracerebral infection with TMEV), no differences in brain or spinal cord pathology or virus burdens were observed between ICAM-1-knockout mice and the infected immunocompetent control mice of a similar background. Examination of brain pathology later in infection (that is, day 45 post infection [p.i.]) revealed that ICAM-1-deficient mice experienced increased levels of pathology in gray matter regions of the brain. We observed an increase in striatal damage and meningeal inflammation in the brains of TMEV-infected ICAM-1-knockout mice compared to C57BL/6J mice. Despite the increase in brain pathology, no immunoreactivity to viral antigens was detected, suggesting that the virus had been cleared by this time. Resistance to demyelination was similar in both groups, indicating that the resulting immune response was sufficient for protection of the spinal cord white matter.

The neuropathology observed in wild-type mice inoculated with human poliovirus mirrors human paralytic poliomyelitis

Human paralytic poliomyelitis results from the destruction of spinal cord anterior horn motor neurons by human poliovirus (PV). CNS disease pathology similar to human poliomyelitis has been observed in experimentally infected chimpanzees, monkeys and wild-type mice. In this study we present a detailed examination of the clinical and histopathological features in the wild-type mouse after intracranial (i.c.) and novel intramuscular (i.m.) injection of poliovirus. Either route of poliovirus administration results in a clinical disease characterized predominately by flaccid paralysis. The observed histopathological features are compared with the histopathology reported for human paralytic poliomyelitis, experimentally infected chimpanzees, monkeys and transgenic mice expressing the human poliovirus receptor (hPVR). The observation of flaccid paralysis and anterior horn motor neuron destruction mirrors what is observed in human paralytic poliomyelitis. Our results suggest that the neuropathology observed in the wild-type mouse model is similar to what has been observed in both the human disease and in other experimental animal models, with the possible exception of the transgenic mouse model. The observed neuropathology of the wild-type mouse model more closely reflects what has been observed in human poliomyelitis, as well as in experimentally infected chimpanzees and monkeys, than does the hPVR transgenic mouse model. The previously reported poliovirus-induced white matter demyelinating disease was not observed.

Comparison of neuropathogenicity of poliovirus in two transgenic mouse strains expressing human poliovirus receptor with different distribution patterns

In order to determine the influence of poliovirus receptor (PVR) expression on poliovirus cell tropism and neuropathogenesis, two transgenic (tg) mouse models were produced in which PVR was expressed under the transcriptional control of the human PVR gene promoter (hg-PVR mice) and the CAG promoter (CAG-PVR mice). Then the pathogenicity of poliovirus after intracerebral inoculation of the type 1 Mahoney strain was compared. These showed completely different clinical and pathological changes. In the former, the expression of PVR in neurons in the central nervous system (CNS) conferred susceptibility to poliovirus, and a paralytic disease that resembled the human poliomyelitis occurred. In the latter, PVR expression was detected in glial and ependymal cells in addition to the neurons. Paralysis of the limbs and death were rarely observed and mice survived without showing substantial clinical abnormality. Histopathological examination revealed that glial and ependymal cells also became susceptible to poliovirus infection. Poliovirus antigens were mainly detected in ependymal and glial cells and hippocampal neurons near the lateral ventricles in the brain, but were not frequently detected in neurons in the brainstem unlike in the hg-PVR mice. The levels of viral antigens and virus recovered from the CNS of CAG-PVR mice began to decrease as early as 2 days after inoculation, which suggested induction of a fast immune response. These results suggest that the neuropathogenicity of poliovirus changes markedly depending on the specific expression of the PVR molecule in the CNS.

Cytoskeletal changes during poliovirus infection in an intestinal cell line

BACKGROUND & OBJECTIVES

Although polioviral replication has been extensively studied, cytoskeletal changes in the host cell during poliovirus replication have not been extensively investigated. We studied the ultrastructural and cytoskeletal changes in host cells during poliovirus infection.

METHODS

Fluorescence staining of filamentous actin with a fluorescein-isothiocynate labelled mycotoxin, in the absence and presence of microfilament inhibitors cytochalasins B and D, and electron microscopy were used to investigate the role and fate of actin microfilaments during poliovirus infection, morphogenesis and release in an intestinal cell line, HRT-18.

RESULTS

At 10 h post-infection, fluorescence staining of actin showed focal areas of fluorescence in the cytoplasm. By 16 h, these became more prominent and increased in number, and by 18-22 h they coalesced to enclose areas of the cytoplasm. These changes in the actin profile were confirmed by electron microscopy, where small actin bundles appeared in association with vesicles, increased in size, number and thickness, enclosed areas of cytoplasm with numerous vesicles and were finally seen in association with crystalline arrays of virus near the periphery of the cells. The addition of microfilament inhibitors cytochalasins B and D, after the initial period of adsorption resulted in complete inhibition of changes in the actin profile and of viral release, indicating that microfilament inhibitors prevented both polymerization of actin and movement of the virus within the cell.

INTERPRETATION & CONCLUSION

In poliovirus infection, both intracellular movement and release of virus appear to be related to cytoskeletal changes, particularly involving actin microfilaments.

Age-dependent poliomyelitis in mice is associated with respiratory failure and viral replication in the central nervous system and lung

Age-dependent poliomyelitis (ADPM) is a virally induced neuroparalytic disease of mice and a model for amyotrophic lateral sclerosis (ALS). ADPM is triggered in genetically susceptible mice by immunosuppression and infection with lactate dehydrogenase-elevating virus (LDV). Both ADPM and ALS are characterized by progressive degeneration of anterior horn motor neurons, and death in ALS is usually associated with respiratory failure. To assess respiratory function in ADPM, we investigated ventilation in conscious control and LDV-infected C58/J mice breathing air and then 6.5% CO(2) in O(2). Three days after LDV infection, ventilation in response to CO(2) was half of that compared to the uninfected state, but become normalized by 10 days. Administration of cyclophosphamide alone (200 mg/kg, ip), an immunosuppressant, had no effect on ventilation. Induction of ADPM by concomitant administration of LDV to cyclophosphamide-treated mice resulted in altered gait, hindlimb paralysis, wasting, decreased metabolism, and decreased body temperature by 4 degrees C relative to controls. Compared to baseline values, mice with ADPM had decreased tidal volume and ventilation while breathing air, and while exposed to the CO(2) challenge they were unable to increase tidal volume, frequency of breathing, or ventilation. Using in situ hybridization, LDV replication was noted within the spinal cord, brain, and lung, but not in the diaphragm. Thus, respiratory failure is a contributory mechanism leading to death in ADPM and is associated with LDV replication in the CNS and lung. This animal model may be useful to investigate physiological and molecular mechanisms associated with the development of respiratory failure in neurodegenerative diseases.

Comparison of neuropathogenicity of poliovirus type 3 in transgenic mice bearing the poliovirus receptor gene and cynomolgus monkeys

To clarify the similarities of poliovirus infection in cynomolgus monkeys and transgenic mice bearing the poliovirus receptor, TgPVR21, we compared the pathological changes of these animals following intraspinal inoculation of two strains of poliovirus type 3 using immunohistochemical detection of the capsid antigen. All of the monkeys inoculated with 10(6) TCID(50) viruses showed flaccid paralysis 2 or 3 days post-inoculation (p.i.). TgPVR21 mice showed paralysis starting from 2 to 3 days p.i. Histologically, neurons having pyknotic nuclei and eosinophilic cytoplasm and neuronophagia were characteristically observed in both animals, but central chromatolysis was not observed in infected TgPVR21. The median lesion scores in the monkeys and TgPVR21 were well correlated, though the distribution of poliovirus-infected lesions in the central nervous system was different. In both animals the motor neurons and the brainstem nuclei responsible for flaccid paralysis were infected by the virus, while the cerebral cortex and thalamus were infected in the monkeys but not in TgPVR21. These results confirmed the reliability of neurovirulence tests using TgPVR21 as a substitute for monkeys, in respect to the spinal and brainstem lesions of poliovirus type 3.

Neural hearing loss in a child with poliomyelitis: a histopathological study

The temporal bones of a 26-month-old white female with a paralytic syndrome clinically and pathologically identical to poliomyelitis were examined. The aetiological agent was unknown although a non-poliomyelitis enterovirus infection seemed likely. There was a complete absence of the cochlear neurons and substantially reduced peripheral and central axons with loss of some inner hair cells but preservation of outer hair cells. Scarpa's ganglion, and the geniculate ganglion were partially atrophied. The saccule and utricle were mildly dilated and Reissner's membrane of the apical turn was bulging. In two previous audiological studies a 10--20 dB bilateral sensorineural hearing loss was found in poliomyelitis patients and a neuronal lesion was postulated which is now supported by our findings. This is a rare example of an almost pure neural hearing loss.

Remodeling the endoplasmic reticulum by poliovirus infection and by individual viral proteins: an autophagy-like origin for virus-induced vesicles

All positive-strand RNA viruses of eukaryotes studied assemble RNA replication complexes on the surfaces of cytoplasmic membranes. Infection of mammalian cells with poliovirus and other picornaviruses results in the accumulation of dramatically rearranged and vesiculated membranes. Poliovirus-induced membranes did not cofractionate with endoplasmic reticulum (ER), lysosomes, mitochondria, or the majority of Golgi-derived or endosomal membranes in buoyant density gradients, although changes in ionic strength affected ER and virus-induced vesicles, but not other cellular organelles, similarly. When expressed in isolation, two viral proteins of the poliovirus RNA replication complex, 3A and 2C, cofractionated with ER membranes. However, in cells that expressed 2BC, a proteolytic precursor of the 2B and 2C proteins, membranes identical in buoyant density to those observed during poliovirus infection were formed. When coexpressed with 2BC, viral protein 3A was quantitatively incorporated into these fractions, and the membranes formed were ultrastructurally similar to those in poliovirus-infected cells. These data argue that poliovirus-induced vesicles derive from the ER by the action of viral proteins 2BC and 3A by a mechanism that excludes resident host proteins. The double-membraned morphology, cytosolic content, and apparent ER origin of poliovirus-induced membranes are all consistent with an autophagic origin for these membranes.