Cerebritis is defined as an inflammation of the cerebrum, a structure associated with memory, speech, etc., as a result of the formation of an abscess within the brain itself, found commonly in patients with lupus.
Systemic lupus
erythematosus (SLE) or Lupus is a chronic, autoimmune
disease as as a result of the development of
autoantibodies that attack the systems and organs in the
body.researchers at the indicated that saturated fatty acid palmitate,
but not unsaturated oleate, induces the
activation of the NLRP3-ASC inflammasome, causing caspase-1, IL-1β and
IL-18 production.
Lupus
cerebritis is a disorder of nervous system problems (an autoimmune
inflammatory disorder) caused
by lupus as as a result of the development of
autoantibodies that attack the systems and organs in the body. It causes
migraine headache, if the duration of the
central nervous system involvement last for a few minutes, or causes
dementia that can lead to neurological deficits as a transient attacks
or permanently.
B. Causes
Cerebritis can be caused by an infection due to
bacteria, viruses invasion and pathogens invasion into
the brain through the sinuses or as a result of trauma
1. Gene
Research at the Oklahoma Medical Research Foundation, published in the April 6 issue of the American Journal of Human Genetics
describes three lupus genes discovered by OMRF researchers as part of a
massive international collaboration, by Using samples from a wide range
of ethnic backgrounds, scientists found
the genes IRF8 and TMEM39a were associated with lupus in
European-American, African-American, Gullah and Asian patients. A third
gene named IKZF3 was only significant in African-American and
European-American samples."Identifying and characterizing these genetic
risk factors in lupus will
undoubtedly lead to improved diagnostics and therapeutics for this
complex disease," said senior author and OMRF scientist Kathy Moser,
Ph.D.(18)
2. Klebsiella pneumoniae
Klebsiella pneumoniae is defined as a form of bacterial pneumonia associated with Klebsiella pneumoniae. In a report of a case of Klebsiella cerebritis in an adult patient with a proven extracranial focus of infection, researchers suggested considering cerebritis
as a differential diagnosis for altered level of consciousness in
patients of severe sepsis, even if an extracranial source of infection
is proven.(2)
3. Autoimmune system dysfunction
Some researchers found that the interactions between elevations of serum prolactin (PRL)[1], cytoquines[2], autoantibodies[3] and organ
involvement[4] suggest that PRL participates in local and generalized
immune and inflammatory processes and acts as a bridge between the
neuroendocrine and immune systems in SLE. Understanding the interactions between these systems in systemic lupus erythematosus (SLE), will help us to understand and treat this important autoimmune disease(3)
[1]. Elevations of serum prolactin (PRL)
In a study of conducted by Centro Medico Nacional La Raza, showed that elevated PRL and interleukin (IL)-6[5] have been found in the urine of
patients with active lupus nephritis and in cerebrospinal fluid (CSF) of
patients with active central nervous system (CNS) SLE. PRL may
therefore participate in the pathogenesis of lupus nephritis and cerebritis,
and the presence of PRL may reflect an abnormal communication between
the immune system and the neuroendocrine system in active SLE.
Lymphocytes from patients with active SLE produce increased amounts of
PRL, and this extrapituitary PRL may participate in aberrant immune
processes in SLE.(3)
[2]. Cytoquines
Cytoquines is a small protein released by cells that has a specific effect on the interactions between cells, on communications between cell, or
on the behavior of cells. There a report that the final mechanism of
lupus cerebritis involves the cytokines. The cytokines trigger edema,
endothelial thickening, and infiltration of neutrophils in brain tissue.
Two cytokines, interferon alpha and interleukin-6, have been found in
the CSF of SLE patients with psychosis(4)
[3}. Antibodies
In the study to investigate the possibility that idiotypes (Ids) defined on anti-double stranded DNA (dsDNA) antibodies during active and inactive stages of lupus (1/84 Id and 4/90 Id, respectively) were expressed on anti-DNA antibodies
during a subsequent active period (9/90) of the disease, researchers at
the St. Luke's Hospital showed that they are of related clonal origin.
The present study suggests the idiotypic heterogeneity of anti-DNA antibodies
and the shift of antigen specificity within an idiotypically related
anti-DNA population during exacerbation of the disease.(7)
[4] Organ involvement
In the report there are few data on the relationship between the onset of new organ involvement
and lupus serologies, especially in children, found that in managing two children with lupus nephritis, both developed
life-threatening extrarenal complications (cerebritis
and carditis) soon after receiving high-dose immunosuppressive therapy
and despite normalizing serologies. This lack of concordance between
serologies and the development of carditis and cerebritis
needs to be recognized so that health care professionals treating
children with SLE can promptly intensify immunosuppressive medications
and avoid life-threatening delays from seeking alternative explanations
for symptomatology.(5)
[5]. Interleukin (IL)-6
Interleukin (IL)-6 secreted by T cells and macrophages to
stimulate immune response has the function to act both a
pro-inflammatory and anti-inflammatory cytokine.[see Cytoquines]
[6]. DNA and anti-DNA complexes
Circulating immune complexes, consist of DNA
and anti-DNA, cause an inflammatory response as well as a disruption of
the blood-brain barrier. There is a report that the number of patients with the SLE manifestations was not higher in the
group with the high amount of DNA in immune complexes. Elevated levels
of DNA in immune complexes was found only in sera of SLE patients with
the active, as well as quiescent form, of the disease and not in sera of
healthy donors. The presence of increased amounts of DNA antigen in
circulating immune complexes could indicate the presence of SLE
pathology even if no manifestations of SLE are found.(6)
[7]. Etc.
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Sources
(1) http://www.cerebritis.net/
(2) http://www.ncbi.nlm.nih.gov/pubmed/19881180
(3) http://www.ncbi.nlm.nih.gov/pubmed?term=Autoimmune%20systems%20and%20Cerebritis
(4) http://www.ncbi.nlm.nih.gov/pubmed/606451
(5) http://www.ncbi.nlm.nih.gov/pubmed/12634943
(6) http://www.ncbi.nlm.nih.gov/pubmed/9802934
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