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
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Affiliations:
- N.P. Bechtereva Institute of the Human Brain RAS
- St. Petersburg Research Institute of Phthisiopneumology
- Molecular medicine center of I.P. Pavlov Medical University
- Military Medical Research Institute
- 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
Cite item
Full Text
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.
About the authors
J. I. Vaynshenker
N.P. Bechtereva Institute of the Human Brain RAS
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
I. M. Ivchenko
N.P. Bechtereva Institute of the Human Brain RAS
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
V. A. Zinserling
St. Petersburg Research Institute of Phthisiopneumology
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
A. D. Korotkov
N.P. Bechtereva Institute of the Human Brain RAS
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
L. A. Melucheva
N.P. Bechtereva Institute of the Human Brain RAS
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
G. V. Kataeva
N.P. Bechtereva Institute of the Human Brain RAS
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
S. V. Lapin
Molecular medicine center of I.P. Pavlov Medical University
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
I. V. Nuralova
Military Medical Research Institute
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
O. V. Khlopunova
Military Medical Research Institute
Author for correspondence.
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
L. A. Beresina
Military Medical Research Institute
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
L. B. Kulyashova
St. Petersburg Pasteur Institute
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
A. A. Vyazovaya
St. Petersburg Pasteur Institute
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
O. V. Kalinina
St. Petersburg Pasteur Institute
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
S. V. Medvedev
N.P. Bechtereva Institute of the Human Brain RAS
Email: juliavajn@mail.ru
Russian Federation, St. Petersburg
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