The relationship between Moyamoya disease and bacterial infection

Yamada, Hideaki; Deguchi, Kazuki; Tanigawara, Tetsuya; Takenaka, Katsunobu; Nishimura, Yasuaki; Shinoda, Jun; Hattori, Taku; Andoh, Takashi; Sakai, Noboru

doi:10.1016/s0303-8467(97)00048-6

Cited by 56 publications

(33 citation statements)

References 6 publications

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“…8,19,42,45,66,68,70) Among these sporadic case reports, Yamada et al have systematically studied the serum of 85 patients suffering moyamoya disease, and revealed that Propionibacterium acnes antibody and immunoglobulin M, transferrin, and a2-macroglobulin levels are significantly higher in cases of moyamoya disease. 74) However, there are few systemic studies on subsequent infection and moyamoya disease.…”

Section: Proteomicsmentioning

confidence: 99%

Review of Past Research and Current Concepts on the Etiology of Moyamoya Disease

Houkin

Ito

Sugiyama

et al. 2012

Neurol. Med. Chir.(Tokyo)

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Research on moyamoya disease has progressed remarkably in the past several decades. Indeed, many new facts concerning the epidemiology of the disease have been revealed and surgical treatments have been drastically improved. However, despite extensive research, the mechanism of moyamoya disease is still unknown. Consequently, the cardinal treatment of this disease has not yet been developed. For further clarification of its etiology, innovative studies are therefore indispensable. The aim of this paper is to review research on the pathogenesis of moyamoya disease to identify milestones in the direction of its true solution. Many hypotheses of the pathogenesis of moyamoya disease have been proposed in the past half century, including infection (viral and bacterial), autoimmune disorders, proteins abnormality, and gene abnormality. Some of these are now considered to be historical achievements. Others, however, can be still subjected to contemporary research. Currently, several genetic abnormalities are considered to offer the most probable hypothesis. In addition, interesting papers have been presented on the role of the endothelial progenitor cell on the pathogenesis of moyamoya disease. Intuitively, however, it appears that a single theory cannot always explain the pathogenesis of this disease adequately. In other words, the complex mechanism of several factors may comprehensively explain the formation of moyamoya disease. The``double hit hypothesis'' is probably the best explanation for the complicated pathology and epidemiology of this disease.

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Section: Proteomicsmentioning

confidence: 99%

Review of Past Research and Current Concepts on the Etiology of Moyamoya Disease

Houkin

Ito

Sugiyama

et al. 2012

Neurol. Med. Chir.(Tokyo)

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show abstract

“…Moreover, cases with previous infection in the head and neck region have been reported to be at higher risk of developing MMD. 18 More recently, genetic approaches have become increasingly utilized to shed light on the disease pathogenesis. Evidence for a genetic contribution to MMD is suggested by the highly variable incidence rates between different ethnic groups, as described above, as well as the many familial occurrences described in the literature.…”

Section: Etiologymentioning

confidence: 99%

Genetics of Moyamoya disease

et al. 2010

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“…Macrophages and T cells have also been found in moyamoya vessels, but they may be a response to and not a cause of MMD. One novel hypothesis is a possible infectious pathogen preceding the development of MMD, 70 but no infectious pathogen has been implicated. Epidemiological studies have indicated though that infection in the head and neck might be implicated in the development of MMD.…”

Section: Pathophysiologymentioning

confidence: 99%

Moyamoya disease: a summary

Burke

Burke²,

Sherma

et al. 2009

FOC

185

150

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Moyamoya, meaning a “hazy puff of smoke” in Japanese, is a chronic, occlusive cerebrovascular disease involving bilateral stenosis or occlusion of the terminal portion of the internal carotid arteries (ICAs) and/or the proximal portions of the anterior cerebral arteries and middle cerebral arteries (MCAs). The Ministry of Health and Welfare of Japan has defined 4 types of moyamoya disease (MMD): ischemic, hemorrhagic, epileptic, and “other.” The ischemic type has been shown to predominate in childhood, while the hemorrhagic type is more often observed in the adult population. The highest prevalence of MMD is found in Japan, with a higher female to male ratio. Studies have shown a possible genetic association of MMD linked to chromosome 17 in Japanese cases as well as in cases found in other demographics. During autopsy, intracerebral hematoma is found and most commonly serves as the major cause of death in patients with MMD. Moyamoya vessels at the base of the brain are composed of medium-sized or small muscular arteries emanating from the circle of Willis, mainly the intracranial portions of ICAs, anterior choroidal arteries, and posterior cerebral arteries, forming complex channels that connect with distal positions of the MCAs. Off of these channels are small tortuous and dilated vessels that penetrate into the base of the brain at the site of the thalamoperforate and lenticulostriate arteries. On angiography, there is the characteristic stenosis or occlusion bilaterally at the terminal portion of the ICAs as well as the moyamoya vessels at the base of the brain. Six angiographic stages have been described, from Stage 1, which reveals a narrowing of the carotid forks, to Stage 6, in which the moyamoya vessels disappear and collateral circulation is produced solely from the external carotid arteries. Cases with milder symptoms are usually treated conservatively; however, more severe symptomatic cases are treated using revascularization procedures. Surgical treatments are divided into 3 types: direct, indirect, and combined/other methods. Direct bypass includes superficial temporal artery-MCA bypass or use of other graft types. Indirect procedures bring in circulation to the intracranial regions by introducing newly developed vasculature from newly approximated tissues. These procedures may not be enough to prevent further ischemia; therefore, a combination of direct and indirect procedures is more suitable. This article will give a review of the epidemiology, natural history, pathology, pathophysiology, and diagnostic criteria, including imaging, and briefly describe the surgical treatment of MMD.

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The relationship between Moyamoya disease and bacterial infection

Cited by 56 publications

References 6 publications

Review of Past Research and Current Concepts on the Etiology of Moyamoya Disease

Review of Past Research and Current Concepts on the Etiology of Moyamoya Disease

Genetics of Moyamoya disease

Moyamoya disease: a summary

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