scholarly journals Matrix Metalloproteinases in Pulmonary and Central Nervous System Tuberculosis—A Review

2019 ◽  
Vol 20 (6) ◽  
pp. 1350 ◽  
Author(s):  
Ursula Rohlwink ◽  
Naomi Walker ◽  
Alvaro Ordonez ◽  
Yifan Li ◽  
Elizabeth Tucker ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Matrix Metalloproteinases ◽  
Immune Reconstitution ◽  
Proteolytic Enzymes ◽  
Key Factors ◽  
Adults And Children ◽  
Inflammatory Syndrome ◽  
The Brain ◽  
Cns Tuberculosis

Tuberculosis (TB) remains the single biggest infectious cause of death globally, claiming almost two million lives and causing disease in over 10 million individuals annually. Matrix metalloproteinases (MMPs) are a family of proteolytic enzymes with various physiological roles implicated as key factors contributing to the spread of TB. They are involved in the breakdown of lung extracellular matrix and the consequent release of Mycobacterium tuberculosis bacilli into the airways. Evidence demonstrates that MMPs also play a role in central nervous system (CNS) tuberculosis, as they contribute to the breakdown of the blood brain barrier and are associated with poor outcome in adults with tuberculous meningitis (TBM). However, in pediatric TBM, data indicate that MMPs may play a role in both pathology and recovery of the developing brain. MMPs also have a significant role in HIV-TB-associated immune reconstitution inflammatory syndrome in the lungs and the brain, and their modulation offers potential novel therapeutic avenues. This is a review of recent research on MMPs in pulmonary and CNS TB in adults and children and in the context of co-infection with HIV. We summarize different methods of MMP investigation and discuss the translational implications of MMP inhibition to reduce immunopathology.

Central nervous system immune reconstitution inflammatory syndrome in AIDS: Experience of a Mexican neurological centre

2012 ◽  
Vol 114 (7) ◽  
pp. 852-861 ◽  
Author(s):  
Erik A. Guevara-Silva ◽  
María A. Ramírez-Crescencio ◽  
José Luís Soto-Hernández ◽  
Graciela Cárdenas
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Inflammatory Syndrome

scholarly journals MRI imaging features of HIV-related central nervous system diseases: diagnosis by pattern recognition in daily practice

2021 ◽  
Author(s):  
Mio Sakai ◽  
Masahiro Higashi ◽  
Takuya Fujiwara ◽  
Tomoko Uehira ◽  
Takuma Shirasaka ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Pattern Recognition ◽  
Nervous System ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Opportunistic Infections ◽  
Primary Cns Lymphoma ◽  
Imaging Features ◽  
Cns Diseases ◽  
Inflammatory Syndrome

AbstractWith the advent of antiretroviral therapy (ART), the prognosis of people infected with human immunodeficiency virus (HIV) has improved, and the frequency of HIV-related central nervous system (CNS) diseases has decreased. Nevertheless, mortality from HIV-related CNS diseases, including those associated with ART (e.g., immune reconstitution inflammatory syndrome) remains significant. Magnetic resonance imaging (MRI) can improve the outlook for people with HIV through early diagnosis and prompt treatment. For example, HIV encephalopathy shows a diffuse bilateral pattern, whereas progressive multifocal leukoencephalopathy, HIV-related primary CNS lymphoma, and CNS toxoplasmosis show focal patterns on MRI. Among the other diseases caused by opportunistic infections, CNS cryptococcosis and CNS tuberculosis have extremely poor prognoses unless diagnosed early. Immune reconstitution inflammatory syndrome shows distinct MRI findings from the offending opportunistic infections. Although distinguishing between HIV-related CNS diseases based on imaging alone is difficult, in this review, we discuss how pattern recognition approaches can contribute to their early differentiation.

scholarly journals The predictive power of MRI criteria in the diagnosis of immune reconstitution inflammatory syndrome by the comparison of classification using the decision tree method and ROC analysis

2021 ◽  
Vol 12 (3) ◽  
pp. 16-25
Author(s):  
E. G. Bakulina ◽  
G. V. Kataeva ◽  
T. N. Trofimova
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Decision Tree ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Roc Analysis ◽  
Brain Mri ◽  
Predictive Values ◽  
The Central Nervous System ◽  
Inflammatory Syndrome

Introduction. Immune reconstitution inflammatory syndrome involving the central nervous system (CNS-IRIS) is a dangerous complication in HIV-infected patients on antiretroviral therapy (ART). The radiologic features of this syndrome have been little studied and are presented in isolated works. The diagnosis is difficult because there are no generally accepted criteria for IRIS. Our study is devoted to radiology of IRIS. Based on the results of brain MRI, together with clinical and laboratory data, MRI criteria for IRIS were formulated.Purpose and goals. To determine the prognostic value of MRI signs of CNS-IRIS using in a cohort of HIV-positive patients with neurological symptoms.Materials and methods. The analysis includes data from 68 HIV-infected patients who underwent brain MRI. In 14 of them were diagnosed IRIS with involvement of the central nervous system. To determine the diagnostic efficiency of the formulated MRI criteria, the STATISTICA program was used, decision trees were built, and a ROC analysis was performed.Results. Five decision tree models were built with different predictive values. The models took into account the categorical predictors (MRI criteria) in different order and quantity. The best performance has model #5, which can be considered a clinically useful predictive model.Conclusion. Brain MRI is an essential diagnostic step in HIV-infected patients on ART. It is necessary to expand the indications and conditions for radiological studies of the brain in patients with suspected immune reconstitution inflammatory syndrome.

scholarly journals CNS tuberculosis: diagnostic challenges and review of recent laboratory investigations

2017 ◽  
Vol 5 (1) ◽  
pp. 56
Author(s):  
Vinod Gautam ◽  
Renu Gupta
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Biochemical Tests ◽  
Eloquent Area ◽  
The Central Nervous System ◽  
Laboratory Investigations ◽  
Brain And Spinal Cord ◽  
The Brain ◽  
Recent Laboratory ◽  
Cns Tuberculosis

Tuberculosis of the central nervous system poses a diagnostic and therapeutic challenge to the physicians. Early diagnosis is warranted to reduce morbidity and mortality associated with this disease. Microbiological investigations for the diagnosis of tuberculosis of central nervous system are of paramount significance. However, due to relative inaccessibility of approaching infected lesions in eloquent area of brain and difficulty in retrieving pathological sample from deep located regions of the brain and spinal cord without causing any neurological deficit, there is need to review the relevance of available microbiological and biochemical tests. Some tests which may be very specific like AFB microscopy and culture may not be positive in many cases due to paucibacillary CSF sample or pus or granulation tissue from the brain or spine. So, authors have reviewed different biochemical and microbiological tests and suggested a pragmatic and step wise practical approach for use of laboratory investigations in clinical management of CNS TB patients.

scholarly journals Central nervous system immune reconstitution inflammatory syndrome (IRIS) after hematopoietic SCT

2009 ◽  
Vol 45 (3) ◽  
pp. 593-596 ◽  
Author(s):  
L Airas ◽  
M Päivärinta ◽  
M Röyttä ◽  
J Karhu ◽  
M Kauppila ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Inflammatory Syndrome

scholarly journals Extensive central nervous system cryptococcal disease presenting as immune reconstitution syndrome in a patient with advanced HIV: report of a case and review of management dilemmas and strategies

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Onyema Ogbuagu ◽  
Merceditas Villanueva
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Immune Reconstitution ◽  
Treatment Guidelines ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Cryptococcal Disease ◽  
Intracranial Cysts ◽  
Inflammatory Syndrome ◽  
Acquired Immune Deficiency

One of the complications of the use of anti-retroviral therapy (ART), immune reconstitution inflammatory syndrome (IRIS), is particularly problematic in the management of cryptococcal meningitis. We present the case of a 35- year-old male with acquired immune deficiency syndrome diagnosed with extensive central nervous system (CNS) cryptococcal disease, including meningitis and multiple intracranial cysts, diagnosed eight weeks after the initiation of ART. The patient experienced a relapsing and remitting clinical course despite repeated courses of potent antifungal therapy and aggressive management of raised intracranial pressure. This review highlights therapeutic dilemmas and strategies in the management of CNS cryptococcosis complicated with IRIS and highlights gaps in available treatment guidelines.

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