Neurological syndromes driven by postinfectious processes or unrecognized persistent infections

Tory Johnson, Avindra Nath

Research output: Contribution to journalReview article

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.

Original languageEnglish (US)
Pages (from-to)318-324
Number of pages7
JournalCurrent Opinion in Neurology
Volume31
Issue number3
DOIs
StatePublished - Jun 1 2018

Fingerprint

Nervous System
Infection
Immunomodulation
Genetic Predisposition to Disease
Autoimmunity
Immune System
Inflammation
Antigens

Keywords

  • autoimmunty
  • CNS
  • persistent infection
  • postinfection

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Neurological syndromes driven by postinfectious processes or unrecognized persistent infections. / Johnson, Tory; Nath, Avindra.

In: Current Opinion in Neurology, Vol. 31, No. 3, 01.06.2018, p. 318-324.

Research output: Contribution to journalReview article

@article{aee44eec762240009f056698572dfba0,
title = "Neurological syndromes driven by postinfectious processes or unrecognized persistent infections",
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.",
keywords = "autoimmunty, CNS, persistent infection, postinfection",
author = "Tory Johnson and Avindra Nath",
year = "2018",
month = "6",
day = "1",
doi = "10.1097/WCO.0000000000000553",
language = "English (US)",
volume = "31",
pages = "318--324",
journal = "Current Opinion in Neurology",
issn = "1350-7540",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Neurological syndromes driven by postinfectious processes or unrecognized persistent infections

AU - Johnson, Tory

AU - Nath, Avindra

PY - 2018/6/1

Y1 - 2018/6/1

N2 - 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.

AB - 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.

KW - autoimmunty

KW - CNS

KW - persistent infection

KW - postinfection

UR - http://www.scopus.com/inward/record.url?scp=85046797594&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046797594&partnerID=8YFLogxK

U2 - 10.1097/WCO.0000000000000553

DO - 10.1097/WCO.0000000000000553

M3 - Review article

VL - 31

SP - 318

EP - 324

JO - Current Opinion in Neurology

JF - Current Opinion in Neurology

SN - 1350-7540

IS - 3

ER -