Evidence for neuroinflammation and neuroprotection in HCV infection-associated encephalopathy

Bokemeyer, Martin; Xq, Ding; Goldbecker, Annemarie; Raab, Peter; Heeren, Meike; Arvanitis, Demetrios A.; Hl, Tillmann; Lanfermann, Heinrich; Weißenborn, Karin

doi:10.1136/gut.2010.217976

Cited by 97 publications

(119 citation statements)

References 45 publications

(48 reference statements)

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“…Few of the HCV patients with severe fatigue also complain of sleep disturbances, restless leg syndrome, muscle and joint pain, and depression. A recent study of 53 HCVpositive patients with neuropsychiatric has shown an increase choline and myoinositol concentrations in the basal ganglia and white matter, and an increase in the concentration of creatinine, Nacetylaspartate (NAA), and Nacetyl aspartylglutamate in basal ganglia [58] , these findings are consistent with the HCVinduced chronic cellular inflammation. Another study revealed an increased ratio of choline/creatine (Cho/Cr) in the basal ganglia as well as the frontal white matter of HCV infected patients through magnetic resonance spectroscopy [59] .…”

Section: Mechanisms Contributing To Neurological Dysfunctionsupporting

confidence: 77%

Hepatitis C virus and neurological damage

Mathew

Faheem

Ibrahim

et al. 2016

WJH

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Author contributions: Mathew S and Faheem M contributed equally to this manuscript; Qadri I conceived and designed the topic; Mathew S, Faheem M, Ibrahim SM, Iqbal W and Rauff B contributed to materials and wrote the paper; Faheem M, Ibrahim SM, Iqbal W, Rauff B, Fatima K and Qadri I contributed to proof reading of the manuscript.Supported by KACST large R and D grant to Ishtiaq Qadri (#162-34).Conflict-of-interest statement: Authors declare no conflict of interests for this article. AbstractChronic hepatitis C virus (HCV) infection exhibits a wide range of extrahepatic complications, affecting various organs in the human body. Numerous HCV patients suffer neurological manifestations, ranging from cognitive impairment to peripheral neuropathy. Overexpression of the host immune response leads to the production of immune complexes, cryoglobulins, as well as autoantibodies, which is a major pathogenic mechanism responsible for nervous system dysfunction. Alternatively circulating inflammatory cytokines and chemokines and HCV replication in neurons is another factor that severely affects the nervous system. Furthermore, HCV infection causes both sensory and motor peripheral neuropathy in the mixed cryoglobulinemia as well as known as an important risk aspect for stroke. These extrahepatic manifestations are the reason behind underlying hepatic encephalopathy and chronic liver disease. The brain is an apt location for HCV replication, where the HCV virus may directly wield neurotoxicity. Other mechanisms that takes place by chronic HCV infection due the pathogenesis of neuropsychiatric disorders includes derangement of metabolic pathways of infected cells, autoimmune disorders, systemic or cerebral inflammation and alterations in neurotransmitter circuits. HCV and its pathogenic role is suggested by enhancement of psychiatric and neurological symptoms in patients attaining a sustained virologic response followed by treatment with interferon; however, further studies are required to fully assess the impact of HCV infection and its specific antiviral targets associated with neuropsychiatric disorders. REVIEWSubmit a

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Section: Mechanisms Contributing To Neurological Dysfunctionsupporting

confidence: 77%

Hepatitis C virus and neurological damage

Mathew

Faheem

Ibrahim

et al. 2016

WJH

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“…We recently found MRS markers of neuroinflammation to be increased in HCV patients with only mild neuropsychiatric symptoms in contrast to those with severe symptoms, suggesting a neuroprotective effect of the inflammatory response [2]. Thus, our findings are in contrast to the conclusion drawn by Byrnes et al, who hypothesize that their MRI results reflected reduced neuroinflammation as a consequence of HCV eradication and that reduced neuroinflammation caused the improvement of the psychometric test results observed in their patient group.…”

Section: To the Editorcontrasting

confidence: 86%

Neuroinflammation in HCV-infection – Peril or protection?

Pflugrad

Ding

Tillmann

et al. 2012

Journal of Hepatology

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“…Patients infected with HCV showed elevated Cho, Cr, and mIns compared to healthy controls and those with hepatitis B, which may be due to microglial activation. Those cerebral metabolite abnormalities were independent of HE (Bokemeyer et al 2011;Chang et al 2013), indicating neuronal damage was mainly due to the HCV infection (Bladowska et al 2013;Chang et al 2013).…”

Section: General Application By Mr Imaging Of Neuroinflammation In Hementioning

confidence: 97%

PET and MR imaging of neuroinflammation in hepatic encephalopathy

Yang

et al. 2014

Metab Brain Dis

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Neurological or psychiatric abnormalities associated with hepatic encephalopathy (HE) range from subclinical findings to coma. HE is commonly accompanied with the accumulation of toxic substances in bloodstream. The toxicity effect of hyperammonemia on astrocyte, such as the alteration in neurotransmission, oxidative stress, astrocyte swelling, is considered as an important factor in the pathogenesis of HE. Besides, neuroinflammation has captured more attention in the process of HE, but the mechanism of neuroinflammation leading to HE remains unclear. Molecular imaging techniques such as positron emission tomography (PET) and magnetic resonance imaging (MRI) targeting activated microglia and/ or other mediators appear to be promising noninvasive approaches to assess HE. This review focuses on novel imaging and therapy strategies of neuroinflammation in HE.

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Evidence for neuroinflammation and neuroprotection in HCV infection-associated encephalopathy

Cited by 97 publications

References 45 publications

Hepatitis C virus and neurological damage

Hepatitis C virus and neurological damage

Neuroinflammation in HCV-infection – Peril or protection?

PET and MR imaging of neuroinflammation in hepatic encephalopathy

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