Tory P Johnson1, Avindra Nath2. 1. Richard T Johnson Division of Neuroimmunology and Neurological Infections, Department of Neurology, Johns Hopkins University, Baltimore. 2. Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
Abstract
PURPOSE OF REVIEW: The immune system serves a critical role in protecting the host against various pathogens. However, under circumstances, once triggered by the infectious process, it may be detrimental to the host. This may be as a result of nonspecific immune activation or due to a targeted immune response to a specific host antigen. In this opinion piece, we discuss the underlying mechanisms that lead to such an inflammatory or autoimmune syndrome affecting the nervous system. We examine these hypotheses in the context of recent emerging infections to provide mechanistic insight into the clinical manifestations and rationale for immunomodulatory therapy. RECENT FINDINGS: Some pathogens endure longer than previously thought. Persistent infections may continue to drive immune responses resulting in chronic inflammation or development of autoimmune processes, resulting in damage to the nervous system. Patients with genetic susceptibilities in immune regulation may be particularly vulnerable to pathogen driven autoimmune responses. SUMMARY: The presence of prolonged pathogens may result in chronic immune stimulations that drives immune-mediated neurologic complications. Understanding the burden and mechanisms of these processes is challenging but important.
PURPOSE OF REVIEW: The immune system serves a critical role in protecting the host against various pathogens. However, under circumstances, once triggered by the infectious process, it may be detrimental to the host. This may be as a result of nonspecific immune activation or due to a targeted immune response to a specific host antigen. In this opinion piece, we discuss the underlying mechanisms that lead to such an inflammatory or autoimmune syndrome affecting the nervous system. We examine these hypotheses in the context of recent emerging infections to provide mechanistic insight into the clinical manifestations and rationale for immunomodulatory therapy. RECENT FINDINGS: Some pathogens endure longer than previously thought. Persistent infections may continue to drive immune responses resulting in chronic inflammation or development of autoimmune processes, resulting in damage to the nervous system. Patients with genetic susceptibilities in immune regulation may be particularly vulnerable to pathogen driven autoimmune responses. SUMMARY: The presence of prolonged pathogens may result in chronic immune stimulations that drives immune-mediated neurologic complications. Understanding the burden and mechanisms of these processes is challenging but important.
Authors: Elizabeth Matthews; Luisa A Diaz-Arias; Susan E Beekmann; Philip Polgreen; Greer Waldrop; Vivian Yang; Kathryn Rimmer; Arun Venkatesan; Kiran T Thakur Journal: Open Forum Infect Dis Date: 2020-05-09 Impact factor: 3.835
Authors: Elvia Ramírez-Carrillo; Osiris Gaona; Javier Nieto; Andrés Sánchez-Quinto; Daniel Cerqueda-García; Luisa I Falcón; Olga A Rojas-Ramos; Isaac González-Santoyo Journal: Sci Rep Date: 2020-02-28 Impact factor: 4.379