Đặc điểm sinh lý bệnh của viêm màng não cấp do Streptococcus pneumoniae và các phương pháp điều trị bổ trợ
Tóm tắt
Viêm màng não do phế cầu là một bệnh đe dọa tính mạng, được đặc trưng bởi nhiễm trùng mủ cấp tính ảnh hưởng đến lớp màng mềm, màng nhện và không gian dưới nhện. Phản ứng viêm mạnh mẽ của cơ thể có khả năng gây tử vong và góp phần vào các di chứng thần kinh. Streptococcus pneumoniae cư trú ở vùng họng mũi, tiếp theo là tình trạng nhiễm khuẩn máu, xâm nhập vi khuẩn và vượt qua hàng rào máu-não. S. pneumoniae được nhận diện bởi các tế bào trình diện kháng nguyên thông qua việc gắn kết với các thụ thể giống Toll, gây ra sự kích hoạt của các con đường yếu tố nhân kappa B hoặc protein kinase được kích hoạt bởi mitogen và sau đó tăng cường sự phát triển của các quần thể lympho và biểu hiện của nhiều protein liên quan đến viêm và phản ứng miễn dịch. Nhiều tế bào não có thể sản xuất cytokine, chemokine và các phân tử gây viêm khác để đáp ứng với các tác nhân vi khuẩn, do đó, bạch cầu đa nhân được thu hút, kích hoạt và thải ra lượng lớn anion superoxide và oxit nitric, dẫn đến sự hình thành peroxynitrite, tạo ra stress oxy hóa. Chuỗi phản ứng này dẫn đến quá trình peroxy hóa lipid, tổn thương ty thể và sự phân hủy của hàng rào máu-não, góp phần vào tổn thương tế bào trong quá trình viêm màng não do phế cầu.
Từ khóa
Tài liệu tham khảo
2004, Clinical features and prognostic factors in adults with bacterial meningitis, N Eng J Med, 351, 1849, 10.1056/NEJMoa040845
Weisfeld M, 2006, Pneumococcal meningitis in adults: new approaches to management and prevention, Lancet Neurol, 5, 332, 10.1016/S1474-4422(06)70409-4
Malipiero U, 2006, TGF-beta receptor II gene deletion in leucocytes prevents cerebral vasculitis in bacterial meningitis, Brain, 129, 2404, 10.1093/brain/awl192
Hoogman M, 2007, Cognitive outcome in adults after bacterial meningitis, J Neurol Neurosurg Psychiatry, 78, 1092, 10.1136/jnnp.2006.110023
Grimwood K, 2000, Twelve year outcomes following bacterial meningitis: further evidence for persisting effects, Arch Dis Child, 83, 111, 10.1136/adc.83.2.111
Brugger SD, 2009, Detection of Streptococcus pneumoniae strain colonization in the nasopharynx, J Clin Microbiol, 47, 1750, 10.1128/JCM.01877-08
Mook-Kanamori BB, 2011, Pathogenesis and pathophysiology of pneumococcal meningitis, Clin Microbiol Rev, 24, 557, 10.1128/CMR.00008-11
Aas JA, 2005, Defining the normal bacterial flora of the oral cavity, J Clin Microbiol, 43, 5721, 10.1128/JCM.43.11.5721-5732.2005
Burnaugh AM, 2008, Growth of Streptococcus pneumoniae on human glycoconjugates is dependent upon the sequential activity of bacterial exoglycosidases, J Bacteriol, 190, 221, 10.1128/JB.01251-07
Feldman C, 1990, The effect of Streptococcus pneumoniae pneumolysin on human respiratory epithelium in vitro, Microb Pathog, 9, 275, 10.1016/0882-4010(90)90016-J
Davis K, 2008, Resistance to mucosal lysozyme compensates for the fitness deficit of peptidoglycan modifications by Streptococcus pneumoniae, PLoS Pathog, 4, e1000241, 10.1371/journal.ppat.1000241
Weiser JN, 2003, Antibody-enhanced pneumococcal adherence requires IgA1 protease, Proc Natl Acad Sci U S A, 100, 4215, 10.1073/pnas.0637469100
Cundell DR, 1995, Streptococcus pneumoniae anchor to activate human cells by the receptor for platelet-activating factor, Nature, 377, 435, 10.1038/377435a0
Sellner J, 2010, Pathogenesis and pathophysiology of bacterial CNS infections, Handb Clin Neurol, 96, 1, 10.1016/S0072-9752(09)96001-8
Kim KS, 2008, Mechanisms of microbial traversal of the blood-brain barrier, Nat Rev Microbiol, 6, 625, 10.1038/nrmicro1952
Schröder NW, 2003, Lipoteichoic acid (LTA) of Streptococcus pneumoniae and Staphylococcus aureus activates immune cells via Toll-like receptor (TLR)-2, lipopolysaccharide-binding protein (LBP), and CD14, whereas TLR-4 and MD-2 are not involved, J Biol Chem, 278, 15587, 10.1074/jbc.M212829200
Malley R, 2003, Recognition of pneumolysin by Toll-like receptor 4 confers resistance to pneumococcal infection, Proc Natl Acad Sci U S A, 100, 1966, 10.1073/pnas.0435928100
Kersse K, 2011, NOD-like receptors and the innate immune system: coping with danger, damage and death, Cytokine Growth Factor Rev, 22, 257, 10.1016/j.cytogfr.2011.09.003
Opitz B, 2009, Role of Toll-like receptors, NOD-like receptors and RIG-I-like receptors in endothelial cells and systemic infections, Thromb Haemost, 102, 1103, 10.1160/TH09-05-0323
Koedel U, 2004, MyD88 is required for mounting a robust host immune response to Streptococcus pneumoniae in the CNS, Brain, 127, 1437, 10.1093/brain/awh171
Klein M, 2007, My D88 dependent immune response contributes to hearing loss in experimental pneumococcal meningitis, J Infect Dis, 195, 1189, 10.1086/512859
Tato CM, 2002, Host-pathogen interactions: subversion and utilization of the NF-kappa B pathway during infection, Infect Immun, 70, 3311, 10.1128/IAI.70.7.3311-3317.2002
Koedel U, 2000, Pharmacologic interference with NF-kappaB activation attenuates central nervous system complication in experimental pneumococcal meningitis, J Infect Dis, 182, 1437, 10.1086/315877
Kastenbauer S, 2004, Protective role of NF-kappaB1 (p50) in experimental pneumococcal meningitis, Eur J Pharmacol, 498, 315, 10.1016/j.ejphar.2004.07.081
Moreillon P, 2003, Proinflammatory activity of cell-wall constituents from gram-positive bacteria, Scand J Infect Dis, 35, 632, 10.1080/00365540310016259
Kronfol Z, 2000, Cytokines and the brain: implications for clinical psychiatry, Am J Psychiatry, 157, 683, 10.1176/appi.ajp.157.5.683
Ichiyama T, 2002, NF-kappaB activation in cerebrospinal fluid cells from patients with meningitis, Neurol Res, 24, 709
Barichello T, 2010, TNF-alpha, IL-1beta, IL-6, and cinc-1 levels in rat brain after meningitis induced by Streptococcus pneumoniae, J Neuroimmunol, 221, 42, 10.1016/j.jneuroim.2010.02.009
Rosenberg GA, 1995, Tumor necrosis factor-alpha-induced gelatinase B causes delayed opening of the blood-brain barrier: an expanded therapeutic window, Brain Res, 703, 151, 10.1016/0006-8993(95)01089-0
Gerber J, 2004, Increased mortality and spatial memory deficits in TNF-alpha-deficient mice in ceftriaxone-treated experimental pneumococcal meningitis, Neurobiol Dis, 16, 133, 10.1016/j.nbd.2004.01.013
Østergaard C, 2004, Differences in survival, brain damage, and cerebrospinal fluid cytokine kinetics due to meningitis caused by 3 different Streptococcus pneumoniae serotypes: evaluation in humans and in 2 experimental models, J Infect Dis, 190, 1212, 10.1086/423852
Saukkonen K, 1990, The role of cytokines in the generation of inflammation and tissue damage in experimental gram-positive meningitis, J Exp Med, 171, 439, 10.1084/jem.171.2.439
Zwijnenburg PJ, 2003, Interleukin-10 negatively regulates local cytokine and chemokine production but does not influence antibacterial host defense during murine pneumococcal meningitis, Infect Immun, 71, 2276, 10.1128/IAI.71.4.2276-2279.2003
Rusconi F, 1991, Interleukin 6 activity in infants and children with bacterial meningitis: The Collaborative Study on Meningitis, Pediatr Infect Dis J, 10, 117, 10.1097/00006454-199102000-00008
Gruol DL, 1997, Physiological and pathological roles of interleukin-6 in the central nervous system, Mol Neurobiol, 15, 307, 10.1007/BF02740665
Paul R, 2003, Lack of IL-6 augments inflammatory response but decreases vascular permeability in bacterial meningitis, Brain, 126, 1873, 10.1093/brain/awg171
van der Poll T, 1997, Interleukin-6 gene-deficient mice show impaired defense against pneumococcal pneumonia, J Infect Dis, 176, 439, 10.1086/514062
Howard M, 1992, Biological properties of interleukin 10, Immunol Today, 13, 198, 10.1016/0167-5699(92)90153-X
Kornelisse RF, 1996, Interleukin-10 and soluble tumor necrosis factor receptors in cerebrospinal fluid of children with bacterial meningitis, J Infect Dis, 173, 1498, 10.1093/infdis/173.6.1498
Koedel U, 1996, Systemically (but not intrathecally) administered IL-10 attenuates pathophysiologic alterations in experimental pneumococcal meningitis, J. Immunol, 157, 5185, 10.4049/jimmunol.157.11.5185
Li MO, 2008, Contextual regulation of inflammation: a duet by transforming growth factor-beta and interleukin-10, Immunity, 28, 468, 10.1016/j.immuni.2008.03.003
Suzumura A, 1993, Transforming growth factor-beta suppresses activation and proliferation of microglia in vitro, J Immunol, 151, 2150, 10.4049/jimmunol.151.4.2150
Østergaard C, 2000, Inhibition of leukocyte entry into the brain by the selectin blocker fucoidin decreases interleukin-1 (IL-1) levels but increases IL-8 levels in cerebrospinal fluid during experimental pneumococcal meningitis in rabbits, Infect Immun, 68, 3153, 10.1128/IAI.68.6.3153-3157.2000
Leppert D, 2000, Matrix metalloproteinase (MMP)-8 and MMP-9 in cerebrospinal fluid during bacterial meningitis: association with blood-brain barrier damage and neurological sequelae, Clin Infect Dis, 31, 80, 10.1086/313922
Rosenberg GA, 1992, TIMP-2 reduces proteolytic opening of blood-brain barrier by type IV collagenase, Brain Res, 576, 203, 10.1016/0006-8993(92)90681-X
Liu X, 2008, Dexamethasone regulation of matrix metalloproteinase expression in experimental pneumococcal meningitis, Brain Res, 1207, 237, 10.1016/j.brainres.2008.01.106
Leib SL, 2001, Inhibition of matrix metalloproteinases and tumor necrosis factor alpha converting enzyme as adjuvant therapy in pneumococcal meningitis, Brain, 124, 1734, 10.1093/brain/124.9.1734
Klein M, 2006, Oxidative stress in pneumococcal meningitis: a future target for adjunctive therapy?, Prog Neurobiol, 80, 269, 10.1016/j.pneurobio.2006.11.008
Pfister HW, 1990, Superoxide dismutase inhibits brain oedema formation in experimental pneumococcal meningitis, Acta Neurochir Supll (Wien), 51, 378
Pfister HW, 1992, Effect of catalase on regional cerebral blood flow and brain edema during the early phase of experimental pneumococcal meningitis, J Infect Dis, 166, 1442, 10.1093/infdis/166.6.1442
Barichello T, 2010, Antibiotic therapy prevents, in part, the oxidative stress in the rat brain after meningitis induced by Streptococcus pneumoniae, Neurosci Lett, 478, 93, 10.1016/j.neulet.2010.04.072
Braun JS, 2002, Pneumococcal pneumolysin and H2O2 mediate brain cell apoptosis during meningitis, J Clin Invest, 109, 19, 10.1172/JCI12035
Scheld WM, 2002, Pathophysiology of bacterial meningitis: mechanism(s) of neuronal injury, J Infect Dis, 186, S225, 10.1086/344939
Nau R, 1999, Apoptosis of neurons in the dentate gyrus in humans suffering from bacterial meningitis, J Neuropathol Exp Neurol, 58, 265, 10.1097/00005072-199903000-00006
Mitchell L, 2004, Dual phases of apoptosis in pneumococcal meningitis, J Infect Dis, 190, 2039, 10.1086/425520
Kastenbauer S, 2003, Pneumococcal meningitis in adults: spectrum of complications and prognostic factors in a series of 87 cases, Brain, 126, 1015, 10.1093/brain/awg113
Østergaard C, 2005, Clinical presentation and prognostic factors of Streptococcus pneumoniae meningitis according to the focus of infection, BMC Infect Dis, 5, 93, 10.1186/1471-2334-5-93
Pelkonen T, 2011, Slow initial ß-lactam infusion and oral paracetamol to treat childhood bacterial meningitis: a randomized controlled trial, Lancet Infect Dis, 11, 613, 10.1016/S1473-3099(11)70055-X
Koedel U, 2010, Modulation of brain injury as a target of adjunctive therapy in bacterial meningitis, Curr Infect Dis Rep, 12, 266, 10.1007/s11908-010-0116-1
Tunkel AR, 1993, Bacterial meningitis non-antibiotic modes of therapy, Curr Opin Infect Dis, 6, 638, 10.1097/00001432-199310000-00004
Peterson PK, 1995, Thalidomide inhibits tumor necrosis factor α production by lipopolysaccharide- and lipoarabinomannan-stimulated human microbial cells, J Infect Dis, 172, 1137, 10.1093/infdis/172.4.1137
Cooper DD, 2012, Is adjunctive dexamethasone beneficial in patients with bacterial meningitis, Ann Emerg Med, 59, 225, 10.1016/j.annemergmed.2011.10.014
Peterkovic V, 2012, Dexamethasone for adult community-acquired bacterial meningitis: 20 years of experience in daily practice, J Nerol, 259, 225, 10.1007/s00415-011-6150-6
Burroughs MH, 1995, Effect of thalidomide on the inflammatory response in cerebrospinal fluid in experimental bacterial meningitis, Microb Pathog, 19, 245, 10.1016/S0882-4010(95)90299-6
Marby D, 2001, Anti interleukin-6 antibodies attenuate inflammation in a rat meningitis model, Acad Emerg Med, 8, 946, 10.1111/j.1553-2712.2001.tb01090.x
Gianinazzi C, 2003, Caspase-3 mediates hippocampal apoptosis in pneumococcal meningitis, Acta Neuropathol, 105, 499, 10.1007/s00401-003-0672-7
Koedel U, 2002, Role of Caspase-1 in experimental pneumococcal meningitis: Evidence from pharmacologic Caspase inhibition and Caspase-1-deficient mice, Ann Neurol, 51, 319, 10.1002/ana.10103