PATHOGENESIS OF ENCEPHALITIS Edited by Daisuke Hayasaka Pathogenesis of Encephalitis Edited by Daisuke Hayasaka Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. 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Used under license from Shutterstock.com First published December, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Pathogenesis of Encephalitis, Edited by Daisuke Hayasaka p. cm. ISBN 978-953-307-741-3 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Diagnosis and Clinical Symptoms of Encephalitis 1 Chapter 1 Biomarkers of Encephalitis 3 Dafna Bonneh-Barkay Chapter 2 Neuropathologic Diagnosis of Central Nervous System Viral Diseases 19 Kymberly A. Gyure Chapter 3 The Neuropsychiatric Consequences of Childhood Encephalitis: A Review of Cases from Middle-Eastern Countries 39 Ali Evren Tufan, Tugba Guven, Banu Aslantas-Ertekin and Irem Yalug Ulubil Chapter 4 Encephalitis in Elderly Population 47 Şerefnur Öztürk and Fahrettin Ege Chapter 5 Language and Cognitive Impairments Associated with Encephalitis 61 Raphiq Ibrahim Chapter 6 The Value of Standardized Case Definitions in Encephalitis Clinical Research 69 Barbara Rath Part 2 Virus Infections 93 Chapter 7 The Inflammatory Response to Viral Infection of the Central Nervous System 95 Nicholas Johnson and Adam F. Cunningham Chapter 8 Chemokines and Viral Infections of the CNS 117 Douglas M. Durrant and Robyn S. Klein VI Contents Chapter 9 Subacute Sclerosing Pan-Encephalitis (SSPE) – Past and Present 135 Natan Gadoth Chapter 10 Herpes Simplex Myelitis: Differences in Clinical Manifestations Between Herpes Simplex Virus Type 1 and Type 2 153 Hideto Nakajima and Hiroshi Shoji Chapter 11 Astrocyte CD38: Links to Neuroinflammation in HAND 169 Sugato Banerjee and Anuja Ghorpade Part 3 Other Agents 183 Chapter 12 Encephalitic Angiostrongyliasis 185 Kittisak Sawanyawisuth Chapter 13 Clinical and Therapeutic Aspects of Cryptococcal Meningitis in West Africa 195 A.A. Oumar, A.S. Hammond, B. Diarra, A.I. Maiga, G.K. Taboue, S. Dao and A. Tounkara Chapter 14 Clostridium Septicum Encephalitis: A Case Report 209 Bernadette Calabek, Georg Hinterholzer, Gabriele Neuwirth-Senautka, Harald Kirschner, Barbara Horvath-Mechtler and Wolfgang Grisold Chapter 15 Superantigen-Mediated Encephalitis 213 A. Emmer, K. Gerlach, M. S. Staege and M. E. Kornhuber Chapter 16 Rasmussen’s Encephalitis: An Overview 235 Mayowa Owolabi Chapter 17 Clinical Aspects of Anti-NMDA Receptor Encephalitis 255 Haruo Shimazaki Chapter 18 Non-Herpetic Acute Limbic Encephalitis: A New Subgroup of Limbic Encephalitis? 267 Hiroshi Shoji, Noriyuki Kimura, Toshihide Kumamoto, Takashi Ichiyama and Yukitoshi Takahashi Part 4 Experimental Model of Encephalitis 279 Chapter 19 Experimental Model Systems to Define Mechanisms of Immune-Mediated Blood Brain Barrier Disruption in Acute Disseminated Encephalomyelitis (ADEM) and Acute Hemorrhagic Leukoencephalitis (AHLE) 281 Holly L. Johnson, Istvan Pirko and Aaron J. Johnson Contents VII Chapter 20 Development of Human and Macaque Antibodies Using Antibody Phage Display for the Detection of Equine Encephalitis Viruses 309 Philippe Thullier, Birgit Hülseweh, Thibaut Pelat, Torsten Rülker, Sebastian Miethe, Stefan Dübel and Michael Hust Chapter 21 Modelling of Autoimmune Encephalomyelitis in a Non-Human Primate 323 S. Anwar Jagessar, Nicole Heijmans, Nikki van Driel, Bert A. ‘t Hart and Yolanda S. Kap Chapter 22 Alternative Medicines for Encephalitis 341 Kenji Sorimachi and Takaaki Nakamoto Preface Many infectious agents, including viruses, bacteria, and parasites, can cause central nervous system (CNS) inflammation. Encephalitis is an inflammation of the brain parenchyma, and those cases with more serious and advanced symptoms usually result in meningoencephalitis. In order to overcome encephalitis, it is a priority to elucidate the mechanism of pathogenesis, to establish accurate diagnosis, and develop effective vaccines and drugs. This book provides comprehensive commentaries on encephalitis. The first section covers diagnoses and clinical symptoms: the topics on biomarkers, diagnosis, childhood and elderly population, limbic encephalitis, language and cognitive impairment, and standardized case. The second section reviews some virus infections concerning SSPE, HSV, and HIV, while providing outlines of inflammatory and chemokine responses. The third section addresses the other agents of encephalitis, such as angiostrongyliasis, cryptococcal meningitis, and clostridium, and describes superantigen-mediated encephalitis, Rasmussen’s encephaliti, anti-NMDA receptor encephalitis, and non-herpetic acute limbic encephalitis. The last section discusses the experimental model of encephalitis, including topics on the mechanism of ADEM and AHLE, autoimmune encephalitis in a non-human primate, antibody phage display, and alternative medicines for encephalitis. These chapters provide valuable and important information not only to researchers, but also to physician and health care workers. I am deeply grateful to all of the authors for preparing the chapter assigned to them, and for doing a great job. Also, I would like to thank Masa Vidovic and Ana Nikolic, from InTech Open Access, for kind and helpful support during the completion of this book. Daisuke Hayasaka Department of Virology, Institute of Tropical Medicine, Nagasaki University, Japan [...]... monitoring of patients with encephalitis These biomarkers are increasingly important in the recognition and treatment of inflammatory and autoimmune central nervous system (CNS) disorders This chapter will review the current literature of emerging biomarkers in the different types of encephalitis 2 Infectious encephalitis 2.1 HIV encephalitis HIV encephalitis (HIVE) is characterized by the presence of microglial...Part 1 Diagnosis and Clinical Symptoms of Encephalitis 1 Biomarkers of Encephalitis Dafna Bonneh-Barkay Department of Pathology, University of Pittsburgh, USA 1 Introduction The development of encephalitis presents a dilemma to the clinician as during the early stages, when treatment would be most effective, the symptoms... Rasmussen’s encephalitis patients with and without EPC (Pleasure 2008; Takahashi et al 2003; Takahashi et al 2005) This suggests that autoantibodies against GluRε2 are important for the diagnosis of both subtypes of Rasmussen’s encephalitis, independent of EPC 4 Conclusion Viral and autoimmune disorders of the CNS are a heterogeneous group of disorders Many viruses are known to cause acute viral encephalitis. .. system 20 Pathogenesis of Encephalitis (A) (B) Fig 1 Viral encephalitis Perivascular chronic inflammation (A) and microglial nodules (B) are characteristic findings 3.1.1 Herpes Simplex Virus type 1 Herpes simplex virus (HSV) is the most common cause of sporadic, nonseasonal encephalitis and is most often caused by HSV type 1 (herpes labialis) It produces a clinical picture consisting of fever, headache,... symptoms of flu (Wang et al 2010) 8 Pathogenesis of Encephalitis The influenza-virus usually can not be detected in the CNS of IAE patients and thus the pathophysiology of IAE remains unclear The early studies reported that thrombocytopenia and severely elevated serum aspartate aminotransaminase levels were associated with a poor prognosis (Morishima et al 2002) High concentration levels of various... 2004) A variety of autoantibody markers are associated with limbic encephalitis like anti-Hu and anti-CV2/CRMP5 (Gultekin et al 2000; Voltz 2002) In recent years different subtypes of this disorder have been discovered as well as new antigens Anti-N-Methyl-D-aspartate receptor (NMDAR) encephalitis was identified as a subtype of limbic encephalitis This disease usually starts with an episode of fever, headache,... hippocampus and amygdala Examination of the CSF revealed occasional mild pleocytosis, and increased IL-6 10 Pathogenesis of Encephalitis levels (Ichiyama et al 2008; Shoji 2010) Recent reports associate the disease with the presence of anti-glutamate receptor epsilon 2 antibodies (Shoji 2010) Takahashi et al reported the presence of those antibodies in the serum and CSF of patients in acute and chronic... and astrocytes appears as yellow and colocalization of YKL-40 and CD68 positive macrophages is evident as aqua signal (arrowheads); scale bar=50m (Bonneh-Barkay et al 2008) 6 Pathogenesis of Encephalitis versus patients without encephalitis (Figure 1B) Previous studies have shown that high viral load in the CSF correlates with the severity of SIV encephalitis (SIVE) (Bissel et al 2006; Zink et al... recognition and treatment of viral and autoimmune CNS disorders (Dale & Brilot 2010) Many of the viral encephalitides are accompanied by CSF markers for immune activation like β2 microglobulin and neopterin or elevated levels of cytokines and chemokines in Biomarkers of Encephalitis 11 addition to the presence of the virus or viral antigens Many studies also tried to predict the progression of the disease and... acidic protein in the cerebrospinal fluid: a possible indicator of prognosis in full-term asphyxiated newborn infants? Pediatr Res 37:260-4 12 Pathogenesis of Encephalitis Bonneh-Barkay D, Bissel SJ, Wang G, Fish KN, Nicholl GC, et al 2008 YKL-40, a marker of simian immunodeficiency virus encephalitis, modulates the biological activity of basic fibroblast growth factor Am J Pathol 173:130-43 Bonneh-Barkay . literature of emerging biomarkers in the different types of encephalitis. 2. Infectious encephalitis 2.1 HIV encephalitis HIV encephalitis (HIVE) is characterized by the presence of microglial. Encephalitis 1 Biomarkers of Encephalitis Dafna Bonneh-Barkay Department of Pathology, University of Pittsburgh, USA 1. Introduction The development of encephalitis presents a dilemma. PATHOGENESIS OF ENCEPHALITIS Edited by Daisuke Hayasaka Pathogenesis of Encephalitis Edited by Daisuke Hayasaka Published