Modeling Cerebral Tuberculosis: Hope for Research on a Global Disease

| Posted in: Science

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Modelling of Cerebral Tuberculosis: Hope for Continuous Research in Solving the Enigma of the Bottom Billion’s Disease
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Author:

Rogelio Hernández Pando


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Modelling of Cerebral Tuberculosis: Hope for Continuous Research in Solving the Enigma of the Bottom Billion’s Disease

Year: 2011

Copyright (license): CC BY 4.0


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Summary of article contents:

Introduction

Cerebral tuberculosis, particularly prevalent in children in developing countries, represents a severe form of extrapulmonary tuberculosis, accounting for approximately 5%-15% of the cases. The most common manifestation of this condition is tuberculous meningitis. This type of cerebral tuberculosis is believed to develop following respiratory infection and subsequent dissemination through the bloodstream to the central nervous system (CNS). Various host genetic factors and specific mycobacterial substrains may contribute to the occurrence of this serious disease. Recent advancements in animal models, particularly a murine model using BALB/c mice, provide new insights into understanding the transmission dynamics and pathogenesis associated with cerebral tuberculosis.

Mechanisms of CNS Infection

A recent study highlights a novel murine model where BALB/c mice, infected via the intratracheal route with clinical Mycobacterium tuberculosis isolates from patients with meningeal tuberculosis, demonstrated rapid dissemination and infection of the brain. These clinical isolates exhibited distinct genotypes and were able to produce significant CNS lesions, emphasizing that particular strains may possess enhanced neurovirulence and neurotropism. The study also revealed that the ability of certain mycobacterial strains to traverse the blood-brain barrier (BBB) is crucial to their pathogenesis, representing a key factor in how cerebral tuberculosis affects individuals. Understanding the interaction between these specific isolates and the immune response within the CNS could unveil essential mechanisms leading to effective therapeutic strategies for this elusive disease.

Conclusion

The findings from this experimental study underscore the significance of developing an accurate animal model to simulate human cerebral tuberculosis more closely. This model paves the way for better understanding host-pathogen interactions, particularly in the context of varying virulence among different mycobacterial strains. As research continues to unravel the complex mechanisms underlying CNS infection by mycobacteria, it may ultimately lead to the identification of novel therapeutic targets and improve outcomes for patients suffering from this severe condition.

FAQ section (important questions/answers):

What is cerebral tuberculosis and its main form?

Cerebral tuberculosis is a severe form of extrapulmonary tuberculosis, predominantly seen in children. The most common type is tuberculous meningitis, which often begins with a respiratory infection followed by dissemination to the central nervous system.

How do bacteria reach the central nervous system in tuberculosis?

Bacteria typically reach the central nervous system via hematogenous dissemination after a primary tuberculosis infection. This is facilitated by specific viral factors that allow them to penetrate the blood-brain barrier.

What are the key findings from the recent murine model study?

The recent murine model study demonstrated that specific clinical isolates from patients with meningeal tuberculosis could rapidly disseminate and infect the brain, highlighting the strain's role in neurovirulence and pathogenesis.

What role do host genetics play in meningeal tuberculosis?

Host genetic susceptibility factors, including single nucleotide polymorphisms in specific genes, have been associated with the development of meningeal tuberculosis, indicating a significant interplay between the host's genetic background and Mycobacterium strains.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Modeling Cerebral Tuberculosis: Hope for Research on a Global Disease”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Tuberculosis:
Tuberculosis is a contagious disease primarily caused by Mycobacterium tuberculosis, significantly affecting the lungs but also manifesting as extrapulmonary forms, including cerebral tuberculosis. Its severity in children highlights the need for understanding its mechanism, especially as it can lead to severe complications, including neurological damage and even death.

2) Study (Studying):
The editorial emphasizes the importance of studying cerebral tuberculosis using experimental models, particularly in mice. Such studies help elucidate the pathogenesis, host responses, and the role of specific Mycobacterium strains. This knowledge is essential for developing effective therapeutic strategies and understanding risk factors associated with the disease.

3) Disease:
Cerebral tuberculosis represents a severe and often fatal extrapulmonary disease affecting the central nervous system. Understanding this disease is crucial, especially in vulnerable populations such as children and immunocompromised individuals. Studying its multifaceted manifestations can help in early diagnosis and intervention to reduce mortality.

4) Rich (Ṛch):
Rich and McCordock were pivotal in describing the two-stage development process of cerebral tuberculosis. Their work laid the groundwork for understanding how initial tuberculous lesions can form in the brain and eventually progress to more severe manifestations, highlighting the importance of historical research in current studies.

5) Inflammation:
Inflammation is a key biological response in infections, including cerebral tuberculosis. The study shows that while mycobacterial infections induce inflammation, effective modulation mechanisms may prevent excessive tissue damage. Understanding how inflammation is regulated could inform therapeutic strategies to protect the brain during infection.

6) Animal:
Animal models, particularly murine models, play a significant role in understanding cerebral tuberculosis. These models simulate human disease processes and help researchers explore pathogenic mechanisms, immune responses, and potential interventions, thereby contributing to the advancement of knowledge and treatment of this serious condition.

7) Blood:
The bloodstream is a critical route for Mycobacterium tuberculosis to disseminate to the central nervous system following a respiratory infection. Understanding the role of blood in this process is vital for identifying vulnerabilities in the pathogenesis of cerebral tuberculosis, particularly regarding how bacteria infiltrate the brain.

8) Observation:
Observations made during experimental studies are fundamental to understanding the pathology of cerebral tuberculosis. These observations guide researchers in identifying key factors that affect disease progression, immune response, and potential therapeutic targets, ensuring a more effective approach to managing the disease.

9) Activity:
The activity of immune cells is crucial in the response to mycobacterial infections, including cerebral tuberculosis. The interplay between immune activity and the pathogen's virulence determines the outcome of the infection, making it essential to study how different strains elicit varying immune responses.

10) Surface:
The surface properties of host cells, particularly in the blood-brain barrier, are vital for the entry of Mycobacterium tuberculosis into the central nervous system. Understanding how bacteria interact with these cell surfaces is crucial for developing strategies to prevent CNS infections and improve patient outcomes.

11) Death:
Cerebral tuberculosis can lead to death, predominantly in untreated cases. Understanding the mechanisms behind mortality in this disease emphasizes the urgency for effective treatments and informs public health strategies to combat tuberculosis, especially in high-risk populations like children and immunocompromised individuals.

12) Sign:
Signs of cerebral tuberculosis include neurological symptoms such as seizures and cognitive disturbances. Recognizing these signs early can facilitate prompt diagnosis and treatment, ultimately improving patient outcomes and reducing the loss of quality of life associated with this debilitating disease.

13) Transformation (Transform, Transforming):
Transforming growth factor beta (TGFβ) plays a significant role in moderating inflammatory responses in mycobacterial infections. The study highlights TGFβ's expression in the brain, suggesting its potential role in neuroprotection during cerebral tuberculosis, a timely focus for future therapeutic applications.

14) Developing:
Developing a deeper understanding of cerebral tuberculosis is paramount for creating effective treatments and preventive strategies. Research into the genetic, immunological, and microbial aspects of this disease can facilitate the identification of high-risk patients and pave the way for targeted interventions.

15) Antibiotic (Antibacterial):
Antibiotics are critical in treating tuberculosis, including its extrapulmonary forms like cerebral tuberculosis. Understanding the efficacy of different antibiotics against various Mycobacterium strains can lead to improved treatment protocols, reducing morbidity and mortality related to this severe infection.

16) Chang:
Chang's work contributes to the body of knowledge on central nervous system infections caused by Mycobacterium. His research helps clarify the pathogenic mechanisms and highlights the importance of studying specific strains to better understand their virulence and the potential for cerebral involvement.

17) Katti (Kattī, Kāṭṭi, Kaṭṭī):
Katti's research emphasizes various aspects of cerebral tuberculosis, including pathogenesis, diagnosis, and treatment. His contributions underscore the multifaceted nature of the disease and the importance of comprehensive studies to improve management strategies and outcomes for affected individuals.

18) Beta (Bēṭa, Beṭa):
Beta, in the context of transforming growth factor beta (TGFβ), plays a crucial role in regulating immune responses during mycobacterial infections. Its presence and activity in the brain provide insights into potential neuroprotective mechanisms that could mitigate inflammation and neuronal damage during cerebral tuberculosis.

19) Viru (Vīṟu):
The virulence of Mycobacterium tuberculosis strains influences the severity and outcome of cerebral tuberculosis. Understanding the molecular mechanisms behind the virulence of specific strains aids researchers in identifying high-risk infections and tailoring therapies to combat the more aggressive forms of the disease.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Modeling Cerebral Tuberculosis: Hope for Research on a Global Disease’. Further sources in the context of Science might help you critically compare this page with similair documents:

Central nervous system, Infectious disease, Physiological condition, Experimental model, Experimental study, Animal model, Blood brain barrier, Innate immunity, Immune response, HIV infection, Single nucleotide polymorphism, Cytokine expression, Mice, Tumor necrosis factor-alpha, Cerebrospinal Fluid, Clinical sign, Intravenous route, Bacteraemia, Mycobacterium tuberculosis, Clinical isolate, Transforming growth factor beta, M. tuberculosis, In vitro model, Innate immune response, Histological Observation, Pulmonary infection, Neuroprotection, Virulence factor, Respiratory infection, Tuberculous meningitis, C57BL mice, Acid-fast bacilli, Histological features, Murine model, Capillary endothelial cells, Inflammatory infiltrate, Microglia cells, Tuberculous abscess, Tuberculoma, Tuberculous encephalopathy, Anti-inflammatory cytokine, Tuberculous lesions, IL-4 expression, Histological damage, Clinical strain, CNS infection.

Concepts being referred in other categories, contexts and sources.

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