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Internal Medicine British Journal of Medical Practitioners.Authors.Article Citation and PDF Link.Family Medicine Ambulatory Care And Prevention Sixth Edition Interactions' title='Family Medicine Ambulatory Care And Prevention Sixth Edition Interactions' />Abstract.Bacterial infections are associated with many autoimmune diseases involving chronic inflammation and demyelination.The possible mechanisms of bacterial involvement as aetiological agents or in the exacerbation of these diseases have been investigated intensively.This review focuses the role of bacterial infections in the pathogenesis of autoimmune, inflammatory and demyelinating diseases.Possible modes of pathogenic action of bacteria are discussed, viz.Toll like receptor signalling, the interaction of heat shock proteins with the immune system, and the role of nitric oxide.Special Article.Shattuck Lecture.Chronic Infectious Disease and the Future of Health Care Delivery.Paul E.Farmer, M.D., Ph.D. N Engl J Med 2013 36924242436.More than 4,500 ebooks and many book collections, including archive collections of critical historical material, as well as publisher and topical collections.We would like to show you a description here but the site wont allow us.An auto regulatory loop might exist in the interaction of bacteria with the host and in pathogenic signal processing.These studies reveal potential therapeutic targets.Abbreviations AQP4 Aquaporin 4 AS ankylosing spondylitis CSF cerebrospinal fluid EAE autoimmune encephalomyelitis GB Guillain Barre syndrome HLA human leukocyte antigens HSP heat shock protein IL interleukin LPS lipopolysaccharides MAM Mycoplasma arthritidis antigen MHC proteins encoded by major histocompatibility gene complex MS multiple sclerosis NK natural killer cells NMO neuromyelitis optica NO nitric oxide NOS nitirc oxide synthase PCR polymerase chain reaction RA rheumatoid arthritis SLE systemic lupus erythematosus TLR Toll like receptors TNF tumour necrosis factor.Introduction.Bacterial and viral infections are commonplace in a variety of autoimmune and chronic illnesses such as the chronic fatigue syndrome myalgic encephalomyelitis, fibromyalgia syndrome, Gulf War illnesses and rheumatoid conditions.Family Medicine Ambulatory Care And Prevention Sixth Edition Interactions' title='Family Medicine Ambulatory Care And Prevention Sixth Edition Interactions' />Much attention is focused at present on the role of bacteria and the possible mechanisms of their involvement in the pathogenesis of several diseases.The route of infection and penetration and the immune responses of the host can not only make any bacterial infection pathogenic but probably can also determine the aggressiveness of the disease and the chance for full recovery.Therefore the two basic elements addressed here are the association between bacterial infection and autoimmune disease and the involvement of the immune system in the disease process.Bacterial infections in rheumatoid conditions.A wide variety of bacterial infections have been associated with rheumatoid conditions.Rheumatic diseases might have a manifold aetiology with varying genetic susceptibility, but bacteria related autoimmunity might be an important factor.Mycoplasma infection, e.M.M.M. fermentans, has been strongly associated with RA rheumatoid arthritis5 8.There is often systemic infection of more than one species.Mycoplasma antigens induce both cell mediated and humoral immune responses.Enhanced levels of antibodies against MAM Mycoplasma arthritidis antigen have been found in sera from RA patients in comparison with antibodies against Staphylococcal enterotoxins A and B.Also antibody titers were higher in RA serum than in systemic lupus erythematosus, ankylosing spondylitis, psoriatic arthritis, Reiters syndrome, or healthy controls.The mycoplasma antigen MAM can activate T cells.MAM contains two domains, one of which can inhibit lymphocyte proliferation the second domain, which contains concanavalin A motif, is required for T cell activation.It can also up regulate natural killer cell activity.Furthermore, synovial tissues of RA patients contain T cells, which bear the same T cell receptors as used by MAM.The mitogen seems to be capable of initiating and exacerbating arthritic changes.MAM is a zinc dependent antigen that binds to MHC class II molecules.Zinc induces MHC protein dimerisation required for MAM binding, MHC induced cell cell adhesion, and efficient T cell activation.As discussed in later sections, MAM can alter cytokine expression profiles and activate and modulate nitric oxide synthase NOS signalling pathways.Bacterial DNA isolated from rheumatoid arthritis RA and juvenile arthritis has included Haemophilus influenzae, Bordatella and Yersinia as possible infecting organisms.Lyme arthritis, which resembles rheumatoid synovial infiltration by Borrelia burgdorferi, has often been suggested to be an autoimmune condition.The B.A Osp.A1. 61 1.T cells and HLA human leukocyte antigen DR molecules that bind this T cell epitope and to these events is attributed the development of autoimmunity following B.However, these decline with antibiotic therapy.Therefore, in spite of the perceived association, Drouin et al.Osp.A 1. 65 1.The epitope Osp.A 1.Lyme disease.Serum reactivity against Osp.A is also found in RA patients.Our knowledge concerning the interaction of B.Ghosh et al.Gavanescu et al. 2.It is not known if this cellular organelle is involved with autoimmunity in RA.B.T helper cell 1 Th 1 type.Beermann et al.LV from this bacterium and incorporated them into peripheral blood mononuclear cells.The resultant LV T cells were predominantly the immune effector CD8.Furthermore, these cells destroyed autologous T cells carrying LV.These data do indeed support the existence of an autoimmune condition.Overall, a conservative conclusion would be that the molecular mimicry and autoimmunity thesis is yet to be fully tested.Proteus mirabilis has been implicated in the pathogenesis of RA2.OA2.Again, the HLA DRB1 alleles appear to be the major genetic susceptibility factors as postulated some years ago.Bacterial infection associated with other autoimmune conditions Bacterial infections have been identified in association with other autoimmune conditions besides RA.Members of the Enterobacteriaceae family are associated with autoimmune conditions such as Kawasaki syndrome and Graves disease.Demyelinating diseases have been a focus of active investigation in the past few years.Kollef et al.M.Since then patients with the autoimmune condition SLE systemic lupus erythematosus have been investigated for mycoplasma infections.Early studies revealed differences between SLE patients and control subjects in respect of genitourinary mycoplasma infections.However, the deployment of more sensitive methods of detection has not supported these early claims.Runge et al. 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Ureaplasma urealyticum in SLE patients, and they discount the notion that this mycoplasma species has any role to play in the pathogenesis of SLE.Nonetheless, there should be no serious doubts that mycoplasma infection can lead to demyelination.The demyelinating neuropathy known as Guillain Barre GB syndrome often has pathogenic association with bacterial infections.Campylobacter jejuni, Haemophilus influenzae and M pneumoniae have been implicated as possible causative agents of GB.Force Windows Update Install Command Line there.C. jejuni is the major infecting organism here together with M.GB is associated with the presence of antibodies against galactocerebroside, which is a major component of myelin.Some bacterial LPS lipopolysaccharides apparently bear molecular similarity to the human gangliosides GM1, GM1b, GD1a, and Gal.NAc GD1a of the motor axolemma and are said to be the target epitopes for antibodies occurring in the GB subtype acute motor axonal neuropathy.The antiganglioside antibodies cause axonal neuropathy.The host immune response to LPS moieties of the HB9.C. 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Hippocampal sclerosis Wikipedia.Hippocampal sclerosis HS is a neuropathological condition with severe neuronal cell loss and gliosis in the hippocampus, specifically in the CA 1 Cornu Ammonis area 1 and subiculum of the hippocampus.It was first described in 1.Wilhelm Sommer. 1 Hippocampal sclerosis is a frequent pathologic finding in community based dementia.Hippocampal sclerosis can be detected with autopsy or MRI.Individuals with hippocampal sclerosis have similar initial symptoms and rates of dementia progression to those with Alzheimers disease AD and therefore are frequently misclassified as having Alzheimers Disease. Captain Rodney S Crack Dip Pinterest . But clinical and pathologic findings suggest that hippocampal sclerosis has characteristics of a progressive disorder although the underlying cause remains elusive.A diagnosis of hippocampal sclerosis has a significant effect on the life of patients because of the notable mortality, morbidity and social impact related to epilepsy, as well as side effects associated with antiepileptic treatments.ClassificationeditMesial temporal sclerosis is a specific pattern of hippocampalneuron cell loss.There are 3 specific patterns of cell loss.Cell loss might involve sectors CA1 and CA4, CA4 alone, or CA1 to CA4.Associated hippocampal atrophy and gliosis is common.MRI scan commonly displays increased T2 signal and hippocampal atrophy.Mesial temporal sclerosis might occur with other temporal lobe abnormalities dual pathology.Mesial temporal sclerosis is the most common pathological abnormality in temporal lobe epilepsy.It has been linked to abnormalities in TDP 4.SymptomseditHistopathological hallmarks of hippocampal sclerosis include segmental loss of pyramidal neurons, granule celldispersion and reactive gliosis.This means that pyramidal neuronal cells are lost, granule cells are spread widely or driven off, and glial cells are changed in response to damage to the central nervous system CNS.Generally, hippocampal sclerosis may be seen in some cases of epilepsy.It is important to clarify the nature of insults that most likely have caused the hippocampal sclerosis and have initiated the epileptogenic process.Presence of hippocampal sclerosis and duration of epilepsy longer than 1.Apart from its association with the chronic nature of epilepsy, hippocampal sclerosis was shown to have an important role in internal cardiac autonomic dysfunction.Patients with left hippocampal sclerosis had more severe parasympathetic dysfunction as compared with those with right hippocampal sclerosis.In young individuals, mesial temporal sclerosis is commonly recognized with temporal lobe epilepsy TLE.On the other hand, it is an often unrecognized cause of cognitive decline, typically presenting with severe memory loss.Temporal lobe epilepsyeditAmmons horn or hippocampal sclerosis AHS is the most common type of neuropathological damage seen in individuals with temporal lobe epilepsy.This type of neuron cell loss, primarily in the hippocampus, can be observed in approximately 6.Sclerotic hippocampus is pointed to as the most likely origin of chronic seizures in temporal lobe epilepsy patients, rather than the amygdala or other temporal lobe regions.Although hippocampal sclerosis has been identified as a distinctive feature of the pathology associated with temporal lobe epilepsy, this disorder is not merely a consequence of prolonged seizures as argued.A long and ongoing debate addresses the issue of whether hippocampal sclerosis is the cause or the consequence of chronic and pharmaceutically resistant seizure activity.Temporal lobectomy is a common treatment for TLE, surgically removing the seizure focal area, though complications can be severe.Other variants of temporal lobe epilepsy include mesial temporal lobe epilepsy MTLE,1.MTLE due to hippocampal sclerosis,1.Possible causeseditAlthough hippocampal sclerosis is relatively commonly found among elderly people 1.Vascular risk factorseditThere were also observations that hippocampal sclerosis was associated with vascular risk factors.Hippocampal sclerosis cases were more likely than Alzheimers disease to have had a history of stroke 5.Socioeconomic statuseditSocioeconomic correlates of health have been well established in the study of heart disease, lung cancer, and diabetes.Many of the explanations for the increased incidence of these conditions in people with lower socioeconomic status SES suggest they are the result of poor diet, low levels of exercise, dangerous jobs exposure to toxins etc.Hesdorffer et al.Seizure Activity Left Temporal Lobectomy' title='Seizure Activity Left Temporal Lobectomy' /> Karl Bhm The Early Years Warner Classics 9. 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