Sparing effect of hemiplegia on skin fibrosis and microvascular involvement: Reports of two cases of systemic sclerosis and review of the literature

Ughi, Nicola; Hervey, Simon; Gualtierotti, Roberta; Zeni, S.; Herrick, Ariane L.; Ingegnoli, Francesca; Meroni, Pier Luigi

doi:10.1016/j.semarthrit.2014.10.011

Cited by 4 publications

(3 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The novel concept of a selectively diminished cutaneous and subcutaneous inflammatory response due to regional poliomyelitis-related nerve damage is further supported by case reports that detail the sparing of a poliomyelitis affected limb from psoriasis, joint sparing in a patient with unilateral psoriatic arthritis with a history of hemiplegia, and sparing of limbs affected by past infection with poliomyelitis in patients with systemic sclerosis. 16 However, although our patient’s poliomyelitis infection did permanently affect the joints of his upper extremities (primarily with mild elbow contractures), there is no clear evidence that his chronologically remote polio infection contributed to his P. acnes olecranon bursitis. A link between his P. acnes olecranon bursitis/osteomyelitis also seems unlikely because he did not have any prior history of atypical or unusual infections.…”

Section: Discussionmentioning

confidence: 57%

Propionibacterium acnesandStaphylococcus epidermidisolecranon bursitis/osteomyelitis: a case involving surgical and antibiotic treatment

et al. 2018

View full text Add to dashboard Cite

This report describes a 63-year-old generally healthy male with septic olecranon bursitis caused by Propionibacterium acnes. The patient sustained a small laceration after striking the posterior aspect of his left elbow on a metal railing when he was at a public swimming pool. We concluded that P. acnes was not initially detected because cultures were only kept for 5 days. Consequently, initial antibiotic treatment failed. P. acnes and Staphylococcus epidermidis grew in a subsequent tissue culture. The infection did not respond to intravenous vancomycin although soft-tissue debridements were done. This likely reflected the presence of olecranon osteomyelitis (seen on MRI scans) in addition to inadequate treatment with this antibiotic in the setting of a polymicrobial infection. Eventually, the infection was eradicated with multiple soft-tissue debridements in addition to the continuation of vancomycin with daily intravenous piperacillin/tazobactam that was added for the final 4 weeks of antibiotic treatment.

show abstract

Section: Discussionmentioning

confidence: 57%

Propionibacterium acnesandStaphylococcus epidermidisolecranon bursitis/osteomyelitis: a case involving surgical and antibiotic treatment

et al. 2018

View full text Add to dashboard Cite

show abstract

“…It is reasonable to speculate that regional neural activity at specific vessels can modulate the development of other autoimmune diseases beyond those affecting nervous tissues. An example from clinical research suggesting the importance of neural activity in autoimmune diseases is the sparing effect of hemiplegia in several rheumatoid diseases, particularly in patients with rheumatoid arthritis, psoriatic arthritis, polymyalgia rheumatica or systemic sclerosis (Ughi et al 2015). In these rheumatic patients, paretic limbs have been shown to exhibit a marked remission of arthritic signs, including diminished erosive changes and decreased skin temperature (Keyszer et al 2004), suggesting that a loss of neural activity can protect Fig.…”

Section: Resultsmentioning

confidence: 99%

Neural activity regulates autoimmune diseases through the gateway reflex

Štofková

Murakami

2019

Bioelectron Med

View full text Add to dashboard Cite

The brain, spinal cord and retina are protected from blood-borne compounds by the blood-brain barrier (BBB), blood-spinal cord barrier (BSCB) and blood-retina barrier (BRB) respectively, which create a physical interface that tightly controls molecular and cellular transport. The mechanical and functional integrity of these unique structures between blood vessels and nervous tissues is critical for maintaining organ homeostasis. To preserve the stability of these barriers, interplay between constituent barrier cells, such as vascular endothelial cells, pericytes, glial cells and neurons, is required. When any of these cells are defective, the barrier can fail, allowing blood-borne compounds to encroach neural tissues and cause neuropathologies. Autoimmune diseases of the central nervous system (CNS) and retina are characterized by barrier disruption and the infiltration of activated immune cells. Here we review our recent findings on the role of neural activity in the regulation of these barriers at the vascular endothelial cell level in the promotion of or protection against the development of autoimmune diseases. We suggest nervous system reflexes, which we named gateway reflexes, are fundamentally involved in these diseases. Although their reflex arcs are not completely understood, we identified the activation of specific sensory neurons or receptor cells to which barrier endothelial cells respond as effectors that regulate gateways for immune cells to enter the nervous tissue. We explain this novel mechanism and describe its role in neuroinflammatory conditions, including models of multiple sclerosis and posterior autoimmune uveitis.

show abstract

“…We showed that photopic light stimulation suppresses the establishment of experimental autoimmune uveroretinitis (EAU), a model of uveroretinitis, in mice ( 51 – 53 ). We noticed a pathological difference between mice kept in photopic light and in mesopic light conditions.…”

Section: Light Gateway Reflexmentioning

confidence: 99%

Gateway Reflex and Mechanotransduction

et al. 2021

View full text Add to dashboard Cite

SummaryThe gateway reflex explains how autoreactive CD4+ T cells cause inflammation in tissues that have blood-barriers, such as the central nervous system and retina. It depends on neural activations in response to specific external stimuli, such as gravity, pain, stress, and light, which lead to the secretion of noradrenaline at specific vessels in the tissues. Noradrenaline activates NFkB at these vessels, followed by an increase of chemokine expression as well as a reduction of tight junction molecules to accumulate autoreactive CD4+ T cells, which breach blood-barriers. Transient receptor potential vanilloid 1 (TRPV1) molecules on sensory neurons are critical for the gateway reflex, indicating the importance of mechano-sensing. In this review, we overview the gateway reflex with a special interest in mechanosensory transduction (mechanotransduction).

show abstract

Sparing effect of hemiplegia on skin fibrosis and microvascular involvement: Reports of two cases of systemic sclerosis and review of the literature

Cited by 4 publications

References 56 publications

Propionibacterium acnesandStaphylococcus epidermidisolecranon bursitis/osteomyelitis: a case involving surgical and antibiotic treatment

Propionibacterium acnesandStaphylococcus epidermidisolecranon bursitis/osteomyelitis: a case involving surgical and antibiotic treatment

Neural activity regulates autoimmune diseases through the gateway reflex

Gateway Reflex and Mechanotransduction

Contact Info

Product

Resources

About