Spinal neuroschistosomiasis

Palin, Martin S.; Mathew, Ryan; Towns, Gerry

doi:10.3109/02688697.2015.1016890

Cited by 8 publications

(8 citation statements)

References 4 publications

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“…It is hypothesized by some researchers that the eggs can invade the CNS from the portal mesenteric and pelvic system through two routes: Batson’s venous plexus and the arterial system [2, 18]. The trapped eggs can induce a host’s immune response and cause the formation of granulomas whose mass effect and intrinsic immune properties are thought to be the basis of clinical symptoms [2–4, 18, 19]. Although there is a lack of study thoroughly demonstrating the microenvironment of the granuloma formation in encephalic Schistosomiasis japonicum, researches focusing on Schistosomiasis mansoni (another species of genus Schistosoma , mainly prevalent in Africa and Brazil) revealed the involvement of monocytes, lymphocytes and eosinophils along with soluble factors in CNS infection [5].…”

Section: Discussionmentioning

confidence: 99%

Identification and characterization of microglia/macrophages in the granuloma microenvironment of encephalic schistosomiasis japonicum

et al. 2019

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BackgroundEgg-induced immune response and granuloma formation are thought to be the basis of central nervous system (CNS)-related clinical symptoms of Schistosoma japonicum. Microglia/macrophages are the major immune cells involved in detection and subsequent elimination of pathogens and injured tissue in the brain. However, little is known about their role in the pathogenesis of neuroschistosomiasis. The main purpose of the study is to clarify the pathological involvement of microglia/macrophages in the pathogenesis of neuroschistosomiasis (NS).MethodsStaining techniques were applied to the granuloma tissues excised from 4 patients, as well as mice model which was established by microinjecting viable S. japonicum eggs into the brain. Clinical features of the patients and neurological symptoms in mice were also collected and analyzed in terms of their correlation with microglia/macrophages.ResultsMicroglia/macrophages constituted the major portions of the granulomas surrounding the eggs in both all human cases and S. japonicum egg-injected mice. Granuloma persisted in all patients accompanied by unremitted neurological symptoms, while in mice granuloma formation initiated on day 3, peaked on day 7 and subsided on day 30 post injection with S. japonicum eggs. No neurological abnormalities were observed in egg-injected mice except for significant weight decrease on day 3 compared with saline-injected control. M1 polarization of microglia/macrophages was confirmed in egg-injected mice 3 days post injection and in all human cases. M2 polarization was absent in human patients despite the duration of complaints but dominated in the whole progression of egg-induced pathology in mice until the elimination of eggs and subsidence of neuroinflammation on day 30 post injection.ConclusionsMicroglia/macrophages participated actively in the granuloma microenvironment of encephalic schistosomiasis japonicum in both human and mice. The polarization pattern of microglia/macrophages coincided with the symptomatic features in human cases and S. japonicum egg-injected mice, indicating M2 instead of M1 activation as a probably more important mediator in the battle against egg-induced pathology and concomitant manifestations. These new findings will shed light on the pathogenesis of NS from a brand-new perspective, and may contribute to the immunotherapy development for such disease, favoring perhaps M2 polarization of microglia/macrophages as a feasible strategy.

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Section: Discussionmentioning

confidence: 99%

Identification and characterization of microglia/macrophages in the granuloma microenvironment of encephalic schistosomiasis japonicum

et al. 2019

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“…Schistosoma mansoni and Schistosoma haematobium are the most common causes of spinal schistosomiasis [2]. Spinal schistosomiasis usually presents as symptoms of spinal cord compression, transverse myelopathy, and painful lumbosacral radiculopathy with low back pain or cauda equina or conus medullaris syndrome [4,[6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…e diagnosis of SCS is based upon the presentation of neurological symptoms resulting from lesions of the spinal cord, the demonstration of schistosomal infection using microscopy and serological techniques, and the exclusion of other causes of myelopathy [4,5]. Treatment usually includes antischistosomal drugs with corticosteroids [2,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Longitudinally Extensive Transverse Myelitis: A Sub-Saharan Conundrum

Obayo

Mbugua

Ali

2020

Case Reports in Neurological Medicine

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Spinal cord schistosomiasis is a rare, underdiagnosed manifestation of schistosomiasis. We present the case of a 36-year-old male who presented to our institution with a one-week history of low back pain with rapidly progressive lower limb weakness, loss of sensation, and flaccid paraparesis. An MRI of the spine showed a longitudinally extensive transverse myelitis from T6 to L1, with enhancement at the cauda equina region. Further review of the images and serological tests eventually led to diagnosis of spinal schistosomiasis. He was treated with praziquantel and high-dose steroids, with minimal improvement in his symptoms.

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“…A common finding that can be seen is enlargement of the spinal cord, specifically in the lower spinal cord and conus medullaris region. 23,43,50,53,56 This is due to intramedullary granuloma formation. Saleem et al noted moderate expansion of distal spinal cord in all 8 of their patients presenting with spinal cord schistosomiasis.…”

Section: Neuroschistosomiasismentioning

confidence: 99%

Parasitic infections of the spine: case series and review of the literature

Majmundar¹,

Patel²,

Dodson³

et al. 2019

Neurosurgical Focus

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OBJECTIVEAlthough parasitic infections are endemic to parts of the developing world and are more common in areas with developing economies and poor sanitary conditions, rare cases may occur in developed regions of the world.METHODSArticles eligible for the authors’ literature review were initially searched using PubMed with the phrases “parasitic infections” and “spine.” After the authors developed a list of parasites associated with spinal cord infections from the initial search, they expanded it to include individual diagnoses, using search terms including “neurocysticercosis,” “schistosomiasis,” “echinococcosis,” and “toxoplasmosis.”RESULTSTwo recent cases of parasitic spinal infections from the authors’ institution are included.CONCLUSIONSKey findings on imaging modalities, laboratory studies suggestive of parasitic infection, and most importantly a thorough patient history are required to correctly diagnose parasitic spinal infections.

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Spinal neuroschistosomiasis

Cited by 8 publications

References 4 publications

Identification and characterization of microglia/macrophages in the granuloma microenvironment of encephalic schistosomiasis japonicum

Identification and characterization of microglia/macrophages in the granuloma microenvironment of encephalic schistosomiasis japonicum

Longitudinally Extensive Transverse Myelitis: A Sub-Saharan Conundrum

Parasitic infections of the spine: case series and review of the literature

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