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Bacterial toxins and Multiple Sclerosis.

Abstract

The primary pathogenetic mechanism responsible for the distinctive demyelinating lesions in the Central Nervous System (CNS) in Multiple Sclerosis (MS), first described in remarkable detail by Charcot more than 170 years ago, remains one of the most baffling conundrums in medicine. A possible role for bacterial cell molecules and transportable proteins in the pathogenesis of MS is reviewed. The ability of bacterial toxins to distort immunity and to cause distinctive toxic damage in the nervous system is discussed in the light of largely forgotten data linking bacterial nasopharyngeal infections with optic neuritis, optochiasmatic arachnoiditis and MS. While the blood-brain barrier substantially protects the CNS from hematogenous toxins, there is a route by which the barrier may be by-passed. Data is reviewed which shows that the CSF and extra-cellular fluid circulation is bi-directionally linked to the lymphatic drainage channels of the nasopharyngeal mucosa. While this provides a facility by which the CNS may mount immunological responses to antigenic challenges from within, it is also a route by which products of nasopharyngeal infection may drain into the CNS and be processed by the immune cells of the meninges and Virchow-Robin perivascular spaces. If potentially toxic bacterial products are identified in early MS tissues at these sites, this would provide an entirely new insight into the pathogenetic mechanisms of this frustratingly enigmatic disease.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Cambridge Biostability, NIAB, Cambridge, UK. fwg@greenstorthe.freeserve.co.uk

    Source

    Journal of the neurological sciences 262:1-2 2007 Nov 15 pg 105-12

    MeSH

    Bacterial Infections
    Bacterial Toxins
    Cerebrospinal Fluid
    Humans
    Lymphatic System
    Multiple Sclerosis
    Nasal Cavity
    Nasopharyngeal Diseases
    Paranasal Sinus Diseases
    Subarachnoid Space

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    17707408

    Citation

    Gay, Frederick. "Bacterial Toxins and Multiple Sclerosis." Journal of the Neurological Sciences, vol. 262, no. 1-2, 2007, pp. 105-12.
    Gay F. Bacterial toxins and Multiple Sclerosis. J Neurol Sci. 2007;262(1-2):105-12.
    Gay, F. (2007). Bacterial toxins and Multiple Sclerosis. Journal of the Neurological Sciences, 262(1-2), pp. 105-12.
    Gay F. Bacterial Toxins and Multiple Sclerosis. J Neurol Sci. 2007 Nov 15;262(1-2):105-12. PubMed PMID: 17707408.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Bacterial toxins and Multiple Sclerosis. A1 - Gay,Frederick, Y1 - 2007/08/20/ PY - 2007/8/21/pubmed PY - 2007/12/19/medline PY - 2007/8/21/entrez SP - 105 EP - 12 JF - Journal of the neurological sciences JO - J. Neurol. Sci. VL - 262 IS - 1-2 N2 - The primary pathogenetic mechanism responsible for the distinctive demyelinating lesions in the Central Nervous System (CNS) in Multiple Sclerosis (MS), first described in remarkable detail by Charcot more than 170 years ago, remains one of the most baffling conundrums in medicine. A possible role for bacterial cell molecules and transportable proteins in the pathogenesis of MS is reviewed. The ability of bacterial toxins to distort immunity and to cause distinctive toxic damage in the nervous system is discussed in the light of largely forgotten data linking bacterial nasopharyngeal infections with optic neuritis, optochiasmatic arachnoiditis and MS. While the blood-brain barrier substantially protects the CNS from hematogenous toxins, there is a route by which the barrier may be by-passed. Data is reviewed which shows that the CSF and extra-cellular fluid circulation is bi-directionally linked to the lymphatic drainage channels of the nasopharyngeal mucosa. While this provides a facility by which the CNS may mount immunological responses to antigenic challenges from within, it is also a route by which products of nasopharyngeal infection may drain into the CNS and be processed by the immune cells of the meninges and Virchow-Robin perivascular spaces. If potentially toxic bacterial products are identified in early MS tissues at these sites, this would provide an entirely new insight into the pathogenetic mechanisms of this frustratingly enigmatic disease. SN - 0022-510X UR - https://www.unboundmedicine.com/medline/citation/17707408/Bacterial_toxins_and_Multiple_Sclerosis L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(07)00464-9 DB - PRIME DP - Unbound Medicine ER -