SUMMARYHerpes simplex virus 1 (HSV-1) can be responsible for life-threatening HSV encephalitis (HSE). The mortality rate of patients with HSE who do not receive antiviral treatment is 70%, with most survivors suffering from permanent neurological sequelae. The use of intravenous acyclovir together with improved diagnostic technologies such as PCR and magnetic resonance imaging has resulted in a reduction in the mortality rate to close to 20%. However, 70% of surviving patients still do not recover complete neurological functions. Thus, there is an urgent need to develop more effective treatments for a better clinical outcome. It is well recognized that cerebral damage resulting from HSE is caused by viral replication together with an overzealous inflammatory response. Both of these processes constitute potential targets for the development of innovative therapies against HSE. In this review, we discuss recent progress in therapy that may be used to ameliorate the outcome of patients with HSE, with a particular emphasis on immunomodulatory agents. Ideally, the administration of adjunctive immunomodulatory drugs should be initiated during the rise of the inflammatory response, and its duration should be limited in time to reduce undesired effects. This critical time frame should be optimized by the identification of reliable biomarkers of inflammation.

中文翻译：

---

单纯疱疹病毒性脑炎的免疫调节策略。

总结单纯疱疹病毒1（HSV-1）可能导致威胁生命的HSV脑炎（HSE）。未接受抗病毒治疗的HSE患者的死亡率为70％，大多数幸存者患有永久性神经系统后遗症。静脉注射阿昔洛韦与改进的诊断技术（如PCR和磁共振成像）一起使用已使死亡率降低了近20％。但是，仍有70％的存活患者无法恢复完整的神经功能。因此，迫切需要开发更有效的治疗方法以获得更好的临床结果。众所周知，HSE引起的脑损伤是由病毒复制和过度的炎症反应引起的。这两个过程都是开发针对HSE的创新疗法的潜在目标。在这篇综述中，我们讨论了可用于改善HSE患者预后的治疗方法的最新进展，特别强调了免疫调节剂。理想情况下，应在炎症反应加剧期间开始辅助免疫调节药物的给药，并且应在时间上限制其持续时间以减少不良反应。应通过鉴定可靠的炎症生物标志物来优化这一关键时间框架。在炎症反应加剧期间应开始辅助免疫调节药物的给药，并应及时限制其持续时间以减少不良反应。应该通过鉴定可靠的炎症生物标记物来优化这个关键的时间框架。在炎症反应加剧期间应开始辅助免疫调节药物的给药，并应及时限制其持续时间以减少不良反应。应该通过鉴定可靠的炎症生物标记物来优化这个关键的时间框架。