Alzheimer’s disease represents one of the main health problems in advanced countries. Actually, we do not have an effective therapy for disease and its cause remains unknown. For several decades, research has focused on amyloidogenesis as the primary cause of disease. However, clearly satisfactory results have not been obtained in this line of research. In recent years there has been growing evidence about the role of neuroinflammation in AD and other neurodegenerative diseases. The role of ß-Amyloid as an element of the innate immune response places it in a new position in the pathophysiology of the disease. Alterations of intestinal and oral microbiota could have a role in the generation of neuroinflammatory changes, either directly by pathogens or by bacterial endotoxins. Endotoxins are polysaccharides of gram-negative bacteria that produce a potent immune reaction. Recently, there is evidence that gingipains have a role in production of neurotoxicity and amyloidogenesis. Gingipains are endotoxins produced by a pathogen associated with chronic periodontitis, Porphyromonas gingivalis. Gingipains generate direct neurotoxicity and its effect could be reversed with various molecules that are currently under development.
pathogenesis
Bacterias, Endotoxinas y Neuroinflamación Crónica: ¿Una Etiopatogenia Para las Enfermedad de Alzheimer? Bacteria, Endotoxins And Chronic Neuroinflammation: An Etiopathogenesis For Alzheimer’s Disease?
Miositis Esporádica por Cuerpos de Inclusión
Sporadic inclusion body myositis is a common acquired inflammatory myopathy in people over 50 years of age. It presents with slowly progressive asymmetric weakness that affects preferentially the quadriceps and deep finger flexors. The pathogenesis is poorly understood. The diagnosis is made with a combination of the clinical history, physical exam, electrodiagnostic tests, imaging, serology and histopathology. There is no treatment for this condition but multiple therapies are currently being investigated.
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Tuberculous Encephalitis Associated With Basal Ganglia Lesions And Movement Disorders
An increasing number of autoimmune disorders with predominant involvement of the basal ganglia which result in movement disorders and psychiatric symptoms have been described. We report a 26 year old patient who, three weeks after initiation of treatment for tuberculous meningitis, presented with acute right hemichorea-ballism and confusion One week later the patient presented acute left hemiparkinsonism. The CSF showed oligoclonal bands. The MRI showed bilateral lesions in the basal ganglia in the T1W and FLAIR sequences. Antituberculous therapy with concomitant steroids and L dopa treatment ,resulted in clinical improvement .To our knowledge this is the first report of tuberculous encephalopathy associated with involvement of the basal ganglia and movement disorders.This case suggests involvement of the basal ganglia through an immune mediated pathogenesis.
