Nhiễm trùng và viêm: những hiểu biết từ hình ảnh về các kiểu tổn thương CNS do miễn dịch ở trẻ em

Neuroradiology - Tập 65 - Trang 425-439 - 2022
Prateek Malik1, Manohar Shroff1
1Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada

Tóm tắt

Hệ thần kinh trung ương (CNS) chịu sự giám sát miễn dịch liên tục nhờ vào các cơ chế chuyên biệt theo vùng. Những cơ chế này bao gồm các rào cản cho phép chọn lọc và các sửa đổi đối với hệ thống miễn dịch bẩm sinh và miễn dịch thích ứng liên kết, giúp phát hiện và loại bỏ các tác nhân gây khởi phát. Các điểm kết thúc của chấn thương não và phù não do những tác nhân này đa dạng nhưng thường theo các mô hình nhận biết được nhờ vào các yếu tố miễn dịch nền tảng chung. Các hình ảnh cung cấp những hiểu biết về việc hiểu những mô hình này, thường xuất hiện từ những tương tác độc đáo giữa nhiễm trùng, viêm và di truyền. Chúng tôi xem xét các cập nhật hiện tại trong hiểu biết của chúng tôi về những giao điểm này và thông qua ví dụ từ các trường hợp trong thực hành của chúng tôi, làm nổi bật rằng nhiễm trùng và viêm theo các cơ chế đa dạng nhưng hội tụ có thể thách thức hệ thần kinh trung ương ở trẻ em.

Từ khóa

#nhiễm trùng #viêm #tổn thương CNS #miễn dịch #hình ảnh học #trẻ em

Tài liệu tham khảo

Galea I, Bechmann I, Perry VH (2007) What is immune privilege (not)? Trends Immunol 28:12–18. https://doi.org/10.1016/j.it.2006.11.004 Meyer C, Martin-Blondel G, Liblau RS (2017) Endothelial cells and lymphatics at the interface between the immune and central nervous systems: implications for multiple sclerosis. Curr Opin Neurol 30:222–230. https://doi.org/10.1097/WCO.0000000000000454 Ratnam NM, Gilbert MR, Giles AJ (2019) Immunotherapy in CNS cancers: the role of immune cell trafficking. Neuro Oncol 21:37–46. https://doi.org/10.1093/neuonc/noy084 Galea I (2021) The blood–brain barrier in systemic infection and inflammation. Cell Mol Immunol 18:2489–2501. https://doi.org/10.1038/s41423-021-00757-x Varatharaj A, Galea I (2017) The blood-brain barrier in systemic inflammation. Brain Behav Immun 60:1–12. https://doi.org/10.1016/j.bbi.2016.03.010 Balasa R, Barcutean L, Mosora O, Manu D (2021) Reviewing the significance of blood–brain barrier disruption in multiple sclerosis pathology and treatment. Int J Mol Sci 22:8370. https://doi.org/10.3390/ijms22168370 Louveau A, Smirnov I, Keyes TJ et al (2015) Structural and functional features of central nervous system lymphatic vessels. Nature 523:337–341. https://doi.org/10.1038/nature14432 Aspelund A, Antila S, Proulx ST et al (2015) A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules. J Exp Med 212:991–999. https://doi.org/10.1084/jem.20142290 Louveau A, Herz J, Alme MN et al (2018) CNS lymphatic drainage and neuroinflammation are regulated by meningeal lymphatic vasculature. Nat Neurosci 21:1380–1391. https://doi.org/10.1038/s41593-018-0227-9 Da Mesquita S, Fu Z, Kipnis J (2018) The Meningeal lymphatic system: a new player in neurophysiology. Neuron 100:375–388. https://doi.org/10.1016/j.neuron.2018.09.022 Sapkota D, Florian C, Doherty BM et al (2022) Aqp4 stop codon readthrough facilitates amyloid-β clearance from the brain. Brain 145:2982–2990. https://doi.org/10.1093/brain/awac199 Carlstrom LP, Eltanahy A, Perry A et al (2022) A clinical primer for the glymphatic system. Brain 145:843–857. https://doi.org/10.1093/brain/awab428 Traka M, Podojil JR, McCarthy DP et al (2016) Oligodendrocyte death results in immune-mediated CNS demyelination. Nat Neurosci 19:65–74. https://doi.org/10.1038/nn.4193 van Zwam M, Huizinga R, Heijmans N et al (2009) Surgical excision of CNS-draining lymph nodes reduces relapse severity in chronic-relapsing experimental autoimmune encephalomyelitis. J Pathol 217:543–551. https://doi.org/10.1002/path.2476 Absinta M, Ha S-K, Nair G et al (2017) Human and nonhuman primate meninges harbor lymphatic vessels that can be visualized noninvasively by MRI. eLife 6:e29738. https://doi.org/10.7554/eLife.29738 Li X, Qi L, Yang D et al (2022) Meningeal lymphatic vessels mediate neurotropic viral drainage from the central nervous system. Nat Neurosci 25:577–587. https://doi.org/10.1038/s41593-022-01063-z Da Mesquita S, Louveau A, Vaccari A et al (2018) Functional aspects of meningeal lymphatics in ageing and Alzheimer’s disease. Nature 560:185–191. https://doi.org/10.1038/s41586-018-0368-8 Kigerl KA, de Rivero Vaccari JP, Dietrich WD et al (2014) Pattern recognition receptors and central nervous system repair. Exp Neurol 258:5–16. https://doi.org/10.1016/j.expneurol.2014.01.001 Shoshkes Reiss C (2008) Neurotropic viral infections. Cambridge University Press, Cambridge Nguyen MD, Julien J-P, Rivest S (2002) Innate immunity: the missing link in neuroprotection and neurodegeneration? Nat Rev Neurosci 3:216–227. https://doi.org/10.1038/nrn752 Mørk N, Kofod-Olsen E, Sørensen KB et al (2015) Mutations in the TLR3 signaling pathway and beyond in adult patients with herpes simplex encephalitis. Genes Immun 16:552–566. https://doi.org/10.1038/gene.2015.46 Bach J-F (2018) The hygiene hypothesis in autoimmunity: the role of pathogens and commensals. Nat Rev Immunol 18:105–120. https://doi.org/10.1038/nri.2017.111 Cepon-Robins TJ, Gildner TE (2020) Old friends meet a new foe: a potential role for immune-priming parasites in mitigating COVID-19 morbidity and mortality. Evol Med Publ Health 2020:234–248. https://doi.org/10.1093/emph/eoaa037 Moltoni G, D’Arco F, Pasquini L et al (2020) Non-congenital viral infections of the central nervous system: from the immunocompetent to the immunocompromised child. Pediatr Radiol 50:1757–1767. https://doi.org/10.1007/s00247-020-04746-6 Verboon-Maciolek MA, Groenendaal F, Hahn CD et al (2008) Human parechovirus causes encephalitis with white matter injury in neonates. Ann Neurol 64:266–273. https://doi.org/10.1002/ana.21445 de Vries LS (2019) Viral Infections and the neonatal brain. Semin Pediatr Neurol 32:100769. https://doi.org/10.1016/j.spen.2019.08.005 Sarma A, Hanzlik E, Krishnasarma R et al (2019) Human Parechovirus meningoencephalitis: neuroimaging in the era of polymerase chain reaction–based testing. AJNR Am J Neuroradiol 40:1418–1421. https://doi.org/10.3174/ajnr.A6118 Khamkar A, Suryawanshi P, Pote PD, Jose GE (2022) Neonatal encephalitis and white matter injury in an early neonate: cause or association with COVID-19 infection? J Neonatol 09732179221087359. https://doi.org/10.1177/09732179221087359 Volpe JJ (2008) Neonatal encephalitis and white matter injury: more than just inflammation? Ann Neurol 64:232–236. https://doi.org/10.1002/ana.21466 Bissel SJ, Auer RN, Chiang C-H et al (2015) Human Parechovirus 3 meningitis and fatal leukoencephalopathy. J Neuropathol Exp Neurol 74:767–777. https://doi.org/10.1097/NEN.0000000000000215 Lane LM, McDermott MB, O’Connor P et al (2021) Multicystic encephalomalacia: the neuropathology of systemic neonatal parechovirus infection. Pediatr Dev Pathol 24:460–466. https://doi.org/10.1177/10935266211001645 Arrigoni F, Parazzini C, Righini A et al (2011) Deep medullary vein involvement in neonates with brain damage: an MR imaging study. AJNR Am J Neuroradiol 32:2030–2036. https://doi.org/10.3174/ajnr.A2687 Sahu PK, Hoffmann A, Majhi M et al (2021) Brain magnetic resonance imaging reveals different courses of disease in pediatric and adult cerebral malaria. Clin Infect Dis 73:e2387–e2396. https://doi.org/10.1093/cid/ciaa1647 Potchen MJ, Kampondeni SD, Seydel KB et al (2012) Acute brain MRI findings in 120 Malawian children with cerebral malaria: new insights into an ancient disease. AJNR Am J Neuroradiol 33:1740–1746. https://doi.org/10.3174/ajnr.A3035 Moghaddam SM, Birbeck GL, Taylor TE et al (2019) Diffusion-weighted MR Imaging in a prospective cohort of children with cerebral malaria offers insights into pathophysiology and prognosis. AJNR Am J Neuroradiol 40:1575–1580. https://doi.org/10.3174/ajnr.A6159 Rasalkar DD, Paunipagar BK, Sanghvi D et al (2011) Magnetic resonance imaging in cerebral malaria: a report of four cases. Br J Radiol 84:380–385. https://doi.org/10.1259/bjr/85759874 Dorovini-Zis K, Schmidt K, Huynh H et al (2011) The neuropathology of fatal cerebral malaria in malawian children. Am J Pathol 178:2146–2158. https://doi.org/10.1016/j.ajpath.2011.01.016 Muccioli L, Pensato U, Vito LD et al (2022) Teaching NeuroImage: claustrum sign in febrile infection–related epilepsy syndrome. Neurology 98:e1090–e1091. https://doi.org/10.1212/WNL.0000000000013261 Sperner J, Sander B, Lau S et al (1996) Severe transitory encephalopathy with reversible lesions of the claustrum. Pediatr Radiol 26:769–771. https://doi.org/10.1007/BF01396197 Kimura S, Nezu A, Osaka H, Saito K (1994) Symmetrical external capsule lesions in a patient with herpes simplex encephalitis. Neuropediatrics 25:162–164. https://doi.org/10.1055/s-2008-1073016 Meletti S, Slonkova J, Mareckova I et al (2015) Claustrum damage and refractory status epilepticus following febrile illness. Neurology 85:1224–1232. https://doi.org/10.1212/WNL.0000000000001996 Steriade C, Tang-Wai DF, Krings T, Wennberg R (2017) Claustrum hyperintensities: a potential clue to autoimmune epilepsy. Epilepsia Open 2:476. https://doi.org/10.1002/epi4.12077 Saito Y, Maegaki Y, Okamoto R et al (2007) Acute encephalitis with refractory, repetitive partial seizures: case reports of this unusual post-encephalitic epilepsy. Brain Develop 29:147–156. https://doi.org/10.1016/j.braindev.2006.08.005 Pensato U, Muccioli L, Cani I et al (2021) Brain dysfunction in COVID-19 and CAR-T therapy: cytokine storm-associated encephalopathy. Ann Clin Transl Neurol 8:968–979. https://doi.org/10.1002/acn3.51348 Graus F, Titulaer MJ, Balu R et al (2016) A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol 15:391–404. https://doi.org/10.1016/S1474-4422(15)00401-9 Cellucci T, Mater HV, Graus F et al (2020) Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient. Neurol - Neuroimmunol Neuroinflammation 7. https://doi.org/10.1212/NXI.0000000000000663 Hardy D (2022) Autoimmune encephalitis in children. Pediatr Neurol 132:56–66. https://doi.org/10.1016/j.pediatrneurol.2022.05.004 Saket RR, Geschwind MD, Josephson SA et al (2011) Autoimmune-mediated encephalopathy: classification, evaluation, and MR Imaging Patterns of Disease. Neurographics 1:2–16. https://doi.org/10.3174/ng.1110001 Renard D, Nerrant E, Lechiche C (2015) DWI and FLAIR imaging in herpes simplex encephalitis: a comparative and topographical analysis. J Neurol 262:2101–2105. https://doi.org/10.1007/s00415-015-7818-0 Hacohen Y, Rossor T, Mankad K et al (2018) “Leukodystrophy-like” phenotype in children with myelin oligodendrocyte glycoprotein antibody-associated disease. Dev Med Child Neurol 60:417–423. https://doi.org/10.1111/dmcn.13649 Piquet AL, Clardy SL (2018) Infection, Immunodeficiency, and inflammatory diseases in autoimmune neurology. Semin Neurol 38:379–391. https://doi.org/10.1055/s-0038-1660820 Tenembaum SN (2021) Pediatric demyelinating disease and anti-MOG antibody. Clin Exp Neuroimmunol 12:7–21. https://doi.org/10.1111/cen3.12627 Sánchez P, Chan F, Hardy TA (2021) Tumefactive demyelination: updated perspectives on diagnosis and management. Expert Rev Neurother 21:1005–1017. https://doi.org/10.1080/14737175.2021.1971077 Benarroch EE (2019) Nucleocytoplasmic transport: Mechanisms and involvement in neurodegenerative disease. Neurology 92:757–764. https://doi.org/10.1212/WNL.0000000000007305 Ohashi E, Hayakawa I, Murofushi Y et al (2021) Recurrent acute necrotizing encephalopathy in a boy with RANBP2 mutation and thermolabile CPT2 variant: The first case of ANE1 in Japan. Brain Dev 43:873–878. https://doi.org/10.1016/j.braindev.2021.04.009 La Piana R, Uggetti C, Roncarolo F et al (2016) Neuroradiologic patterns and novel imaging findings in Aicardi-Goutières syndrome. Neurology 86:28–35. https://doi.org/10.1212/WNL.0000000000002228 Malik P, Antonini L, Mannam P et al (2021) MRI patterns in pediatric cns hemophagocytic lymphohistiocytosis. Am J Neuroradiol. https://doi.org/10.3174/ajnr.A7292 Neilson DE, Adams MD, Orr CMD et al (2009) Infection-triggered familial or recurrent cases of acute necrotizing encephalopathy caused by mutations in a component of the nuclear pore, RANBP2. Am J Hum Genet 84:44–51. https://doi.org/10.1016/j.ajhg.2008.12.009 Levine JM, Ahsan N, Ho E, Santoro JD (2020) Genetic acute necrotizing encephalopathy associated with RANBP2: clinical and therapeutic implications in pediatrics. Mult Scler Relat Disord 43:102194. https://doi.org/10.1016/j.msard.2020.102194 Hutvagner G, Simard MJ (2008) Argonaute proteins: key players in RNA silencing. Nat Rev Mol Cell Biol 9:22–32. https://doi.org/10.1038/nrm2321 Palazzo AF, Joseph J, Lim M, Thakur K (2022) Workshop on RanBP2/Nup358 and acute necrotizing encephalopathy. Nucleus. https://doi.org/10.1080/19491034.2022.2069071 Shen Q, Wang YE, Truong M et al (2021) RanBP2/Nup358 enhances miRNA activity by sumoylating Argonautes. PLoS Genet 17:e1009378. https://doi.org/10.1371/journal.pgen.1009378 Sahoo MR, Gaikwad S, Khuperkar D et al (2017) Nup358 binds to AGO proteins through its SUMO-interacting motifs and promotes the association of target mRNA with miRISC. EMBO Rep 18:241–263. https://doi.org/10.15252/embr.201642386 Shen Q, Wang YE, Palazzo AF (2021) Crosstalk between nucleocytoplasmic trafficking and the innate immune response to viral infection. J Biol Chem 297:100856. https://doi.org/10.1016/j.jbc.2021.100856 Neilson DE (2010) The interplay of infection and genetics in acute necrotizing encephalopathy. Curr Opin Pediatr 22:751–757. https://doi.org/10.1097/MOP.0b013e3283402bfe Nishimura N, Higuchi Y, Kimura N et al (2016) Familial acute necrotizing encephalopathy without RANBP2 mutation: poor outcome. Pediatr Int 58:1215–1218. https://doi.org/10.1111/ped.13119 Fichtman B, Harel T, Biran N et al (2019) Pathogenic variants in NUP214 cause “plugged” nuclear pore channels and acute febrile encephalopathy. Am J Hum Genet 105:48–64. https://doi.org/10.1016/j.ajhg.2019.05.003 Kubota M, Chida J, Hoshino H et al (2012) Thermolabile CPT II variants and low blood ATP levels are closely related to severity of acute encephalopathy in Japanese children. Brain Dev 34:20–27. https://doi.org/10.1016/j.braindev.2010.12.012 Saitoh M, Shinohara M, Hoshino H et al (2012) Mutations of the SCN1A gene in acute encephalopathy. Epilepsia 53:558–564. https://doi.org/10.1111/j.1528-1167.2011.03402.x Voskoboinik I, Smyth MJ, Trapani JA (2006) Perforin-mediated target-cell death and immune homeostasis. Nat Rev Immunol 6:940–952. https://doi.org/10.1038/nri1983 de Saint BG, Ménasché G, Fischer A (2010) Molecular mechanisms of biogenesis and exocytosis of cytotoxic granules. Nat Rev Immunol 10:568–579. https://doi.org/10.1038/nri2803 Pilotto A, Masciocchi S, Volonghi I et al (2021) Severe Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encephalitis is a cytokine release syndrome: evidences from cerebrospinal fluid analyses. Clin Infect Dis 73:e3019–e3026. https://doi.org/10.1093/cid/ciaa1933 Zamani R, Pouremamali R, Rezaei N (2022) Central neuroinflammation in Covid-19: a systematic review of 182 cases with encephalitis, acute disseminated encephalomyelitis, and necrotizing encephalopathies. Rev Neurosci 33:397–412. https://doi.org/10.1515/revneuro-2021-0082 Lindan CE, Mankad K, Ram D et al (2021) Neuroimaging manifestations in children with SARS-CoV-2 infection: a multinational, multicentre collaborative study. Lancet Child Adolesc Health 5:167–177. https://doi.org/10.1016/S2352-4642(20)30362-X Matschke J, Lütgehetmann M, Hagel C et al (2020) Neuropathology of patients with COVID-19 in Germany: a post-mortem case series. Lancet Neurol 19:919–929. https://doi.org/10.1016/S1474-4422(20)30308-2 Aubart M, Roux C-J, Durrleman C et al (2022) Neuroinflammatory Disease following severe acute respiratory syndrome coronavirus 2 infection in children. J Pediatr S0022–3476(22):00426–00427. https://doi.org/10.1016/j.jpeds.2022.05.018 LaRovere KL, Riggs BJ, Poussaint TY et al (2021) Neurologic involvement in children and adolescents hospitalized in the United States for COVID-19 or multisystem inflammatory syndrome. JAMA Neurol 78:536–547. https://doi.org/10.1001/jamaneurol.2021.0504 Signa S, Brolatti N, Trincianti C et al (2022) Pediatric SARS-CoV2–related diplopia and mesencephalic abnormalities. Neurol: Clin Pract. https://doi.org/10.1212/CPJ.0000000000200076 Manzano GS, McEntire CRS, Martinez-Lage M et al (2021) Acute disseminated encephalomyelitis and acute hemorrhagic leukoencephalitis following COVID-19: systematic review and meta-synthesis. Neurol Neuroimmunol Neuroinflamm 8:e1080. https://doi.org/10.1212/NXI.0000000000001080 Paterson RW, Brown RL, Benjamin L et al (2020) The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings. Brain 143:3104–3120. https://doi.org/10.1093/brain/awaa240 Sanchez CV, Theel E, Binnicker M et al (2021) Autoimmune encephalitis after SARS-CoV-2 infection: case frequency, findings, and outcomes. Neurology 97:e2262–e2268. https://doi.org/10.1212/WNL.0000000000012931 Sa M, Mirza L, Carter M et al (2021) Systemic inflammation is associated with neurologic involvement in pediatric inflammatory multisystem syndrome associated with SARS-CoV-2. Neurol - Neuroimmunol Neuroinflammation 8. https://doi.org/10.1212/NXI.0000000000000999 Abdel-Mannan O, Eyre M, Löbel U et al (2020) Neurologic and radiographic findings associated with COVID-19 infection in children. JAMA Neurol. https://doi.org/10.1001/jamaneurol.2020.2687