Respuesta neuroinmunológica en la encefalitis asociada al virus del dengue / Neuroimmunological response in dengue virus encephalitis

El virus del dengue es un virus ARN miembro de la familia Flaviviridae, la cual incluye, además, el de la fiebre amarilla, el del Nilo del Oeste y la encefalitis japonesa. Se realizó un estudio retrospectivo con tres pacientes diagnosticados de encefalitis asociada al dengue, en cuyas muestras de suero y líquido cefalorraquídeo se cuantificaron los niveles de las clases mayores de inmunoglobulinas por inmunodifusión radial y la manosa de unión a lectina, proteína de la vía de las lectinas del sistema del complemento por fluorometría. En el reibergrama se muestra la presencia de síntesis intratecal de las tres clases de inmunoglobulinas y ausencia de síntesis intratecal de lectina de unión a manosa. Existieron diferencias en cuanto al por ciento de síntesis intratecal de inmunoglobulinas, las cuales estuvieron relacionadas con el momento de la infección por el virus y la aparición de las manifestaciones neurológicas compatibles con una encefalitis. Este es el primer reporte de afectaciones neurológicas en pacientes cubanos con dengue. La respuesta inmune intratecal puede ser utilizada para el mejor conocimiento de la enfermedad y contribuir al desarrollo de posibles candidatos vacunales(AU)

Dengue virus is a RNA virus of the Flaviviridae family including also West Nile virus, Japanese encephalitis virus and yellow fever virus. A retrospective study with three patients diagnosed with encephalitis associated with dengue virus was carried out. Using their sera and cerebrospinal fluid samples the levels of high class of immunoglobulins by radial immunodiffusion and mannan binding lectin were quantified by fluorometry three classes of immunoglobulins levels were quantified by using an immunodiffusion technique. Mannose-binding lectin was quantified by fluorometry. A retrospective study with three patients diagnosed with encephalitis. The Reibergram has shown three classes of immunoglobulins intrathecal synthesis and absence of mannan binding lectin synthesis. Differences in the immunoglobulin intrathecal synthesis percent were observed, which were related with the moment of virus infection and the onset of neurological manifestations compatible with encephalitis. This is the first report of neurological affectations in Cuban patients with dengue fever. The intrathecal immune response may be used for the best knowledge of the disease and for the contribution to the development of possible candidate vaccine(AU)

Síntesis intratecal de C3c e inmunoglobulinas en niños con meningoencefalitis bacteriana / Intrathecal synthesis of C3c and immunoglobulins in children with bacterial meningoencephalitis

Las meningoencefalitis bacterianas constituyen una fuente importante de morbilidad, mortalidad y discapacidad endiferentes regiones del mundo. El objetivo del presente trabajo es conocer si el sistema de complemento puede estar involucrado en la lisis de las bacterias productoras de meningoencefalitis a través de la liberación de C3c al líquidocefalorraquídeo. Se estudiaron siete pacientes con edad promedio de 3 años, que ingresaron en el Hospital Pediátricode San Miguel del Padrón, a los que se les realizó una punción lumbar diagnóstica y se les aislaron los gérmenes siguientes: Neisseria meningitidis, Streptococcus pneumoniae y Haemophilus influenzae. La cuantificación de los niveles de C3c, albúmina e inmunoglobulinas mayores en suero y líquido cefalorraquídeo se realizó en placas de inmunodifusión radial. Los resultados obtenidos fueron recogidos en un reibergrama. El total de los pacientes estudiados mostraron síntesis intratecal del componente C3c del sistema de complemento. Este hecho evidenció la activación de este sistema en alguna de sus vías y que una vez cumplidas sus funciones biológicas, ha sufrido un proceso de degradación y liberación al LCR en forma de C3c(AU)

Bacterial meningoencephalitis is an important source of morbidity, mortality and disabilities in different regions of the world. The objective of this paper is to know if the complement system can be involved in producing-meningoencephalitis bacteriallysis through C3c release into cerebrospinal fluid. Seven patients with an average age of 3 years-old, who attended the Pediatric Hospital of San Miguel del Padrón, were studied by lumbar puncture diagnosis. Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae were isolated from the samples taken. The quantification of C3c, albumin and mainimmunoglobulins in serum and in cerebrospinal fluid were carried out by radial immunodifusion. Results were analyzed using a Reibergram. All patients showed C3c intrathecal synthesis. This fact demonstrates that the activation of this system hasoccurred in some of their three pathways and once its biological functions are fulfilled, it suffered a degradation and release process into cerebrospinal fluid as C3c(AU)

Intrathecal synthesis of IgE in children with eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis

BACKGROUND: Eosinophilic meningoencephalitis caused by the helminth Angiostrongylus cantonensis, is an emerging infectious disease in America. The objective of this paper was to determine if the intrathecal synthesis of immunoglobulin E is produced during the acute phase of the disease. METHODS: Thirteen patients, mean age 4.5 years were studied; a diagnostic lumbar puncture was performed and serum samples taken. Immunoglobulin E (IgE) in serum and in cerebrospinal fluid (CSF) was quantified by nephelometry. Control patients had other infections or other neurological diseases. RESULTS: The mean cell count in the CSF was 500 x 10-6 cells/L and of these 23 percent were eosinophils. In blood the eosinophils were 13 percent. The chief symptoms of the patients were migraine, vomiting and fever and 50 percent presented some meningeal signs. IgE intrathecal synthesis analyzed by the corresponding quotient diagram (Reibergram) was observed in all patients. No intrathecal IgE synthesis was seen in control patients. CONCLUSION: Intrathecal synthesis of IgE demonstrates the participation of this immunoglobulin in the destruction of the third stage larvae of the parasite in the CSF. The test should be considered in our environment as a tool to aid diagnosis(AU)