Infectious factors of the brain damage in the long-term unconscious states

J. I. Vaynshenker; Вайншенкер Ю. И.; I. M. Ivchenko; Ивченко И. M.; V. A. Zinserling; Зинсерлинг В. A.; A. D. Korotkov; Коротков A. Д.; L. A. Melucheva; Мелучева Л. A.; G. V. Kataeva; Катаева Г. В.; S. V. Lapin; Лапин С. В.; I. V. Nuralova; Нуралова И. В.; O. V. Khlopunova; Хлопунова O. В.; L. A. Beresina; Бересина Л. A.; L. B. Kulyashova; Куляшова Л. Б.; A. A. Vyazovaya; Вязовая A. A.; O. V. Kalinina; Калинина O. В.; S. V. Medvedev; Медведев С. В.

doi:10.17816/psaic175

Infectious factors of the brain damage in the long-term unconscious states

Authors: Vaynshenker J.I.¹, Ivchenko I.M.¹, Zinserling V.A.², Korotkov A.D.¹, Melucheva L.A.¹, Kataeva G.V.¹, Lapin S.V.³, Nuralova I.V.⁴, Khlopunova O.V.⁴, Beresina L.A.⁴, Kulyashova L.B.⁵, Vyazovaya A.A.⁵, Kalinina O.V.⁵, Medvedev S.V.¹
Affiliations:
1. N.P. Bechtereva Institute of the Human Brain RAS
2. St. Petersburg Research Institute of Phthisiopneumology
3. Molecular medicine center of I.P. Pavlov Medical University
4. Military Medical Research Institute
5. St. Petersburg Pasteur Institute
Issue: Vol 8, No 3 (2014)
Pages: 21-29
Section: Original articles
Submitted: 01.02.2017
Published: 09.02.2017
URL: https://annaly-nevrologii.com/journal/pathID/article/view/175
DOI: https://doi.org/10.17816/psaic175
ID: 175

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Abstract

Serial immunological and neurologic evaluation, and testing for infections was performed in 32 patients (m – 23, f –9, 14–58 years) with chronic non-inflammatory unconscious states. The main group of patients (n=18) received treatment for subclinical infections and other infectious agents revealed. Treatment in the control group (n=14) was targeted only on community-acquired and nosocomial microbiota. Markers of inflammatory intrathecal responce of the central nervous system (CNS) were found in 88% (28/32) patients, and this was associated with Chlamydia spp. in cerebrospinal fluid (CSF) and/or blood (р<0.01). Markers of various mmunopathological vasculites/vasсulopathies were revealed in 84% patients (27/32), and the tendency of their interrelation with Chlamydia spp. in comparison with other subclinical infections was found. In some cases clinical data was confirmed by autopsy results. In the main group of patients during treatment we found the changes of structure of immunopathological syndrome and appearance in the CSF and/or blood of previously undiagnosed subclinical infections with further sanation of latent inflammatory process. It was accompanied by neurophysiological signs of “disbalance” of a stable pathological condition with improvement of brain metabolism according to PET data. In the control group the specified changes were not found, and the short-term and long-term results of treatment were worse. The obtained data showed that in patients with chronic non-inflammatory unconscious states in the substance and in the vessels of brain develops latent inflammatory process with immunopathological component associated with Chlamydia spp. and other subclinical infections. It appears to be the factor of additional brain damage that consolidates the pathological condition in CNS. It is reasonable to consider this process during elaboration of tactics of treatment for these patients.

Keywords

vegetative state, immunopathological process in the CNS, infections in immunodeficient state, Chlamydia spp. infection of the CNS, PET

References

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Infectious factors of the brain damage in the long-term unconscious states

Full Text

Abstract

Keywords

About the authors

References

Supplementary files

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