Cerebrospinal fluid metabolomics: detection of neuroinflammation in human central nervous system disease

Yan, Jingya; Kuzhiumparambil, Unnikrishnan; Bandodkar, Sushil; Dale, Russell C.; Fu, Shanlin

doi:10.1002/cti2.1318

Cited by 35 publications

(43 citation statements)

References 137 publications

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“…Up to now, there is still no clarity regarding the pathogenesis and how RANBP2 promotes the development of ANE. Early biomarkers for ANE are still under investigation, but CSF neopterin is one of those being looked at ( 34 , 35 ). Treatment evidence is limited to case reports and case series data.…”

Section: Para- and Post-infectious Neurological Disordersmentioning

confidence: 99%

Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

et al. 2022

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The direct impact and sequelae of infections in children and adults result in significant morbidity and mortality especially when they involve the central (CNS) or peripheral nervous system (PNS). The historical understanding of the pathophysiology has been mostly focused on the direct impact of the various pathogens through neural tissue invasion. However, with the better understanding of neuroimmunology, there is a rapidly growing realization of the contribution of the innate and adaptive host immune responses in the pathogenesis of many CNS and PNS diseases.The balance between the protective and pathologic sequelae of immunity is fragile and can easily be tipped towards harm for the host. The matter of immune privilege and surveillance of the CNS/PNS compartments and the role of the blood-brain barrier (BBB) and blood nerve barrier (BNB) makes this even more complex. Our understanding of the pathogenesis of many post-infectious manifestations of various microbial agents remains elusive, especially in the diverse African setting. Our exploration and better understanding of the neuroimmunology of some of the infectious diseases that we encounter in the continent will go a long way into helping us to improve their management and therefore lessen the burden.Africa is diverse and uniquely poised because of the mix of the classic, well described, autoimmune disease entities and the specifically “tropical” conditions. This review explores the current understanding of some of the para- and post-infectious autoimmune manifestations of CNS and PNS diseases in the African context. We highlight the clinical presentations, diagnosis and treatment of these neurological disorders and underscore the knowledge gaps and perspectives for future research using disease models of conditions that we see in the continent, some of which are not uniquely African and, where relevant, include discussion of the proposed mechanisms underlying pathogen-induced autoimmunity. This review covers the following conditions as models and highlight those in which a relationship with COVID-19 infection has been reported: a) Acute Necrotizing Encephalopathy; b) Measles-associated encephalopathies; c) Human Immunodeficiency Virus (HIV) neuroimmune disorders, and particularly the difficulties associated with classical post-infectious autoimmune disorders such as the Guillain-Barré syndrome in the context of HIV and other infections. Finally, we describe NMDA-R encephalitis, which can be post-HSV encephalitis, summarise other antibody-mediated CNS diseases and describe myasthenia gravis as the classic antibody-mediated disease but with special features in Africa.

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Section: Para- and Post-infectious Neurological Disordersmentioning

confidence: 99%

Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

et al. 2022

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“…Investigations based on metabolomics may have a role in distinguishing neuroinflammation from infection [57]. Of particular interest are lipid-based biomarkers, such as free phosphatidyl choline levels [58,59].…”

Section: Csf Features Of Infectionmentioning

confidence: 99%

Ventriculitis: Infection or Inflammation

2021

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Ventriculitis, or infection of the cerebrospinal fluid, in the presence of external ventricular drains (EVD), is an important complication and associated with substantial mortality, morbidity, and healthcare costs. Further, the conditions that require the insertion of an EVD, such as neurotrauma and subarachnoid hemorrhage, are themselves associated with inflammation of the cerebrospinal fluid. Phenotypically, patients with inflammation of the cerebrospinal fluid can present with very similar symptoms, signs, and laboratory findings to those with infection. This review examines various controversies relating to the definitions, diagnosis, challenges of differentiating infection from inflammation, prevention, and treatment of ventriculitis in patients with EVDs.

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“…Metabolite analysis and interpretation of CSF is fundamental to understanding the mechanisms of neuroinflammation, enabling biomarker discovery and disease diagnosis, and suggesting therapeutic directions. There are many challenges, however, to obtaining CSF normal controls from healthy individuals, owing to ethical issues and the invasive nature of the matrix [64]. Unlike CSF, biological samples such as blood and urine can be obtained non-invasively and safely, and various metabolic changes can be observed.…”

Section: Biomarkers Of Multiple Sclerosis (Mus)mentioning

confidence: 99%

“…Still, most of these are related to general inflammatory responses and cannot be used as clinical diagnostic indicators [65]. Therefore, the study of CSF metabolomics is essential to discover biomarkers for multiple sclerosis [64].…”

Section: Biomarkers Of Multiple Sclerosis (Mus)mentioning

confidence: 99%

Metabolomics in Autoimmune Diseases: Focus on Rheumatoid Arthritis, Systemic Lupus Erythematous, and Multiple Sclerosis

Seo

Jung

2021

Metabolites

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The metabolomics approach represents the last downstream phenotype and is widely used in clinical studies and drug discovery. In this paper, we outline recent advances in the metabolomics research of autoimmune diseases (ADs) such as rheumatoid arthritis (RA), multiple sclerosis (MuS), and systemic lupus erythematosus (SLE). The newly discovered biomarkers and the metabolic mechanism studies for these ADs are described here. In addition, studies elucidating the metabolic mechanisms underlying these ADs are presented. Metabolomics has the potential to contribute to pharmacotherapy personalization; thus, we summarize the biomarker studies performed to predict the personalization of medicine and drug response.

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Cerebrospinal fluid metabolomics: detection of neuroinflammation in human central nervous system disease

Cited by 35 publications

References 137 publications

Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

Post-Infectious Autoimmunity in the Central (CNS) and Peripheral (PNS) Nervous Systems: An African Perspective

Ventriculitis: Infection or Inflammation

Metabolomics in Autoimmune Diseases: Focus on Rheumatoid Arthritis, Systemic Lupus Erythematous, and Multiple Sclerosis

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