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[The pathogenesis of postinfectious encephalomyelitis and polyradiculoneuritis]
1Department of Microbiology, Kanazawa Medical University.
Abstract:
The neurological syndromes are known to occur following microbial infections, most of which are viral infections. Most patients recover uneventfully from such infections. Rarely, a serious postinfectious neurological syndrome develops presumably as an idiosyncratic reaction to the primary infection. The pathomechanisms of these syndromes are thought to be immune-mediated, because the etiologic microbe cannot be directly demonstrated, and because the pathological findings are highly similar to those found in experimental allergic encephalomyelitis and neuritis. The immunopathogenesis involves diverse interactions between a virus, the nervous system, and the immune response. All of the basic elements of the immune system, including humoral and cellular immunity, are involved in the pathogenesis. Novel concepts of the immune-mediated mechanisms are discussed, i.e., anti-idiotypic antibody, molecular mimicry, superantigens, heat shock proteins, and immunomodulations by viral proteins. The exact pathomechanism is, however, still to be elucidated.
Insights
Neurological syndromes can rarely follow microbial infections, leading to serious immune-mediated reactions. Research explores the complex interplay of viruses, the nervous system, and immune responses in these conditions.
Area of Science:
- Neuroimmunology
- Infectious Diseases
- Neurology
Context:
- Neurological syndromes can arise after microbial infections, particularly viral ones.
- While most infections resolve without lasting effects, rare cases develop serious post-infectious neurological syndromes.
- These syndromes are presumed to be idiosyncratic immune reactions to the initial infection.
Purpose:
- To explore the immune-mediated pathomechanisms underlying post-infectious neurological syndromes.
- To discuss novel concepts in immunopathogenesis, including anti-idiotypic antibodies, molecular mimicry, superantigens, heat shock proteins, and viral protein immunomodulation.
- To highlight the involvement of humoral and cellular immunity in the pathogenesis of these neurological conditions.
Summary:
- Post-infectious neurological syndromes are characterized by immune-mediated pathomechanisms, as the causative microbe is not directly detectable.
- Pathological findings resemble experimental allergic encephalomyelitis and neuritis, suggesting an autoimmune basis.
- The pathogenesis involves intricate interactions between viruses, the nervous system, and the host's immune response, encompassing both humoral and cellular immunity.
Impact:
- Advances understanding of the complex interplay between infections and neurological disorders.
- Provides insights into the immune system's role in rare but severe post-infectious complications.
- Lays the groundwork for future research aimed at elucidating precise pathomechanisms and potential therapeutic targets.