Immunopathology of Measles

Immunopathology of Measles
Professor Lachmann PJ

Proc R Soc Med. 1974 Nov;67(11):1120-2.

Introduction
The roots of immunology are to be found in the study of immunity to infectious disease and particularly to viruses. Long before an antibody – not to mention complement or a cytotoxic T cell – had ever been heard of, it was recognized that prior exposure to smallpox virus, or subsequently to vaccinia virus, gave immunity to
subsequent smallpox infection. From these beginnings grew the study of prophylactic immunization against virus infection which probably remains medicine’s major single achievement. Dr Beale (p 1116) has already discussed the
vaccines that have recently been developed for the prophylaxis of measles. There can be no doubt, therefore, that the allergic response to viruses is a ‘good thing’. Nevertheless, it must be recognized that the very allergic responses that prevent virus infection can also play a major part in the pathogenesis of virus disease. This is by no means a new idea. In 1902 von Behring suggested that many of the manifestations of acute infectious disease – the incubation period, the fever, the exanthem – could be explained on an allergic basis. In this, as in so many other things, von Behring showed great insight, as much subsequent work has demonstrated (see Coombs
etal. 1974).
This involvement of immunological processes in the manifestations of the acute virus infection makes a convenient first heading under which to discuss the immunopathology of measles. The involvement of immunological processes in the complications of measles form a second heading and the involvement of immunological responses to measles virus in diseases that are not obviously caused by measles infection at all provides the third.