RESUMO
Inflammation and tissue infiltration by various immune cells play a significant role in the pathogenesis of neurons suffering the central nervous systems diseases. Although brachial plexus root avulsion (BPRA) leads to dramatic motoneurons (MNs) death and permanent loss of function, however, the knowledge gap on cytokines and glial reaction in the spinal cord injury is still existing. The current study is sought to investigate the alteration of specific cytokine expression patterns of the BPRA injured spinal cord during an acute and subacute period. The cytokine assay, transmission electron microscopy, and histological staining were utilized to assess cytokine network alteration, ultrastructure morphology, and glial activation and MNs loss within two weeks post-injury on a mouse unilateral BPRA model. The BPRA injury caused a progressively spinal MNs loss, reduced the alpha-(α) MNs synaptic inputs, whereas enhanced glial fibrillary acidic protein (GFAP), ionized calcium-binding adaptor molecule-1 (IBA-1), F4/80 expression in ipsilateral but not the contralateral spinal segments. Additionally, cytokine assays revealed BPRA significantly altered the level of CXCL1, ICAM1, IP10, MCP-5, MIP1-α, and CD93. Notably, the elevated MIP1-α was mainly expressed in the injured spinal MNs. While the re-distribution of CD93 expression, from the cytoplasm to the nucleus, occasionally occurred at neurons of the ipsilateral spinal segment after injury. Overall, these findings suggest that the inflammatory cytokines associated with glial cell activation might contribute to the pathophysiology of the MNs death caused by nerve roots injury.
Assuntos
Neuropatias do Plexo Braquial/imunologia , Neuropatias do Plexo Braquial/patologia , Citocinas/imunologia , Neuroglia/imunologia , Radiculopatia/imunologia , Animais , Plexo Braquial/imunologia , Plexo Braquial/lesões , Plexo Braquial/patologia , Neuropatias do Plexo Braquial/etiologia , Citocinas/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Neurônios Motores/patologia , Neuroglia/metabolismo , Radiculopatia/complicaçõesAssuntos
Neuropatias do Plexo Braquial/diagnóstico , Plexo Braquial/patologia , Hipestesia/diagnóstico , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Doença dos Neurônios Motores/diagnóstico , Debilidade Muscular/diagnóstico , Parestesia/diagnóstico , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/diagnóstico , Neuropatias do Plexo Braquial/imunologia , Diagnóstico Diferencial , Feminino , Gangliosídeos/imunologia , Humanos , Hipertrofia , Hipestesia/imunologia , Masculino , Pessoa de Meia-Idade , Doença dos Neurônios Motores/imunologia , Debilidade Muscular/imunologia , Parestesia/imunologia , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/imunologiaRESUMO
Amphiphysin, a synaptic vesicle protein, is an auto-immune target in rare cases of paraneoplastic neurological disorders. We report two additional cases with distinct neurological syndromes and paraneoplastic anti-amphiphysin antibodies. The first patient, a 59-year-old man, presented with cerebellar and cranial nerve dysfunction and small cell lung carcinoma. The second, a 77-year- old woman, presented with left brachial plexopathy followed by sensorimotor neuropathy and breast carcinoma.
Assuntos
Doenças Autoimunes/diagnóstico , Neuropatias do Plexo Braquial/diagnóstico , Encefalite/diagnóstico , Proteínas do Tecido Nervoso/imunologia , Síndromes Paraneoplásicas/diagnóstico , Rombencéfalo , Idoso , Doenças Autoimunes/imunologia , Plexo Braquial/imunologia , Plexo Braquial/patologia , Neuropatias do Plexo Braquial/imunologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/imunologia , Carcinoma de Células Pequenas/diagnóstico , Carcinoma de Células Pequenas/imunologia , Ataxia Cerebelar/diagnóstico , Ataxia Cerebelar/imunologia , Doenças dos Nervos Cranianos/diagnóstico , Doenças dos Nervos Cranianos/imunologia , Encefalite/imunologia , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/imunologia , Metástase Linfática/diagnóstico , Metástase Linfática/imunologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Síndromes Paraneoplásicas/imunologia , Rombencéfalo/imunologia , Rombencéfalo/patologia , Tomografia Computadorizada por Raios XRESUMO
The authors report four patients with a syndrome of painless bilateral isolated phrenic neuropathy. Electrophysiologic testing demonstrated active denervation restricted to the diaphragm. Long-term recovery was poor. The authors conclude that bilateral isolated phrenic neuropathy is a cause of painless diaphragmatic paralysis distinguishable from immune brachial plexus neuropathy and other neuromuscular disorders with similar clinical presentation.
Assuntos
Doenças do Sistema Nervoso Periférico/complicações , Doenças do Sistema Nervoso Periférico/fisiopatologia , Nervo Frênico/fisiopatologia , Paralisia Respiratória/fisiopatologia , Adulto , Idoso , Anti-Inflamatórios/uso terapêutico , Doenças Autoimunes do Sistema Nervoso/complicações , Doenças Autoimunes do Sistema Nervoso/imunologia , Doenças Autoimunes do Sistema Nervoso/fisiopatologia , Neuropatias do Plexo Braquial/imunologia , Neuropatias do Plexo Braquial/fisiopatologia , Diagnóstico Diferencial , Dispneia/diagnóstico , Dispneia/imunologia , Dispneia/fisiopatologia , Eletromiografia , Feminino , Lateralidade Funcional/fisiologia , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Masculino , Pessoa de Meia-Idade , Condução Nervosa/imunologia , Dor/imunologia , Dor/fisiopatologia , Doenças do Sistema Nervoso Periférico/imunologia , Nervo Frênico/imunologia , Nervo Frênico/patologia , Prednisona/uso terapêutico , Paralisia Respiratória/diagnóstico , Paralisia Respiratória/imunologia , Falha de TratamentoAssuntos
Neuropatias do Plexo Braquial/complicações , Meningoencefalite/complicações , Febre do Nilo Ocidental/complicações , Vírus do Nilo Ocidental/isolamento & purificação , Animais , Anticorpos Antivirais/imunologia , Neuropatias do Plexo Braquial/imunologia , Humanos , Imunoglobulina M/imunologia , Masculino , Pessoa de Meia-Idade , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/imunologia , Vírus do Nilo Ocidental/imunologiaRESUMO
BACKGROUND: Amyloidomas of the peripheral nervous system are rare lesions. Most commonly, they involve the gasserian ganglion and the branches of the fifth cranial nerve. No association with systemic amyloidosis has been reported. CASE DESCRIPTION: We describe an amyloidoma of the lower trunk of the right brachial plexus. At the age of 34 years, this 71-year-old female had undergone radical right mastectomy for breast cancer with axillary lymph node dissection followed by radiotherapy. On admission, she presented with burning pain to the right hand and mild motor deficit to the ulnar-innervated intrinsic hand muscles. A palpable lesion was found in the supraclavicular region. On surgical inspection, the lesion appeared to originate from the lower trunk of the right brachial plexus. The middle and upper trunks were dislocated. Histologically, fibrous connective tissue embedded small nerve bundles featuring perineurial and endoneurial fibrosis as well as amyloid. Amyloid featured immunoreactivity for both lambda and kappa chains. DISCUSSION: Localized amyloidoma of brachial plexus has never been reported. Because of compressive rather than infiltrative growth of the present lesion, a conservative surgery was achieved. Our immunohistochemical findings indicated that peripheral nerve amyloidomas are not, by definition, monoclonal in nature.