RISING human rabies cases underscore how virulent rabies virus infection triggers lethal central nervous system immune dysfunction. With global health authorities monitoring spikes in exposure events, understanding why neurological invasion remains uniformly fatal represents a pressing clinical priority. High resolution single cell transcriptomic mapping of over one hundred thousand central nervous system cells now illuminates the precise cellular mechanisms differentiating lethal encephalitic progression from viral clearance. Using comparative murine models infected with the highly virulent CVS-11 strain and the attenuated SRV9 strain, investigators uncovered diametrically opposed immune programs dictating central nervous system pathology.
During fatal rabies virus infection, intracranial resident and infiltrating immune cells experience widespread functional breakdown. Microglia shift away from homeostatic signatures and neuroprotective states toward stress-induced, proinflammatory, and destructive phagocytic phenotypes. This pathologic transition is accompanied by marked upregulation of stress-associated genes, including Fkbp5 and Apod, alongside elevated interleukin-1 beta and tumor necrosis factor expression. Concurrently, brain tissue exhibits extensive infiltration by proliferative neutrophils that drive severe inflammatory tissue injury through Toll-like and NOD-like receptor pathways. While natural killer cells expand into a proliferative subset, they demonstrate profound functional blunting characterized by a failure to upregulate cytotoxic effector genes. Furthermore, infiltrating T lymphocytes display heightened exhaustion scores alongside elevated expression of inhibitory regulators Klf2 and Socs3, while expanded regulatory T cells suppress protective immunity.
Conversely, infection with attenuated viral strains elicits protective neuroimmune architecture capable of intracranial viral clearance. In this setting, microglia differentiate into specialized antigen-presenting subsets expressing Cd74 and major histocompatibility complex class II molecules, supported by tissue repair programs governed by Spp1 and Tgm2. Infiltrating myeloid populations promote chemokine signaling and coordinated leukocyte recruitment rather than inflammatory destruction. Natural killer cells maintain robust cytotoxicity, while CD4 and CD8 T cells undergo complete effector and memory differentiation without transitioning into exhausted states. Dense intercellular signaling networks and balanced immune synapses preserve neural tissue while achieving sterile immunity. These distinct molecular divergence markers, particularly Fkbp5, Apod, Klf2, and Socs3, provide novel therapeutic targets for post-exposure management and guide rational vaccine development for rabies virus infection.
Reference
Wang X et al. Single-cell immune landscape of the central nervous system of mice infected with rabies virus. Front Immunol. 2026;17:1850356.
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