Pertussis Encephalopathy With High Cerebrospinal Fluid Antibody Titers to Pertussis Toxin and Filamentous Hemagglutinin

Abstract

A 7-year-old unimmunized girl with pertussis presented with respiratory failure and electroencephalographic evidence of an encephalopathy. The cerebrospinal fluid (CSF)/serum ratio of antibodies to pertussis toxin and filamentous hemagglutinin were 11- and ninefold higher than the CSF/serum ratio of total immunoglobulin G. The CSF/serum ratio of albumin was normal. These findings indicate production of antibodies in the central nervous system to Bordetella pertussis antigens and imply, therefore, that the pertussis encephalopathy in this girl was associated with the entry of pertussis antigens into the central nervous system.

Whole-Cell but Not Acellular Pertussis Vaccines Induce Convulsive Activity in Mice: Evidence of a Role for Toxin-Induced Interleukin-1β in a New Murine Model for Analysis of Neuronal Side Effects of Vaccination

“…Significantly, it has been suggested that PT may enhance histamine-induced vascular permeability (39). The demonstration of antibodies to PT and filamentous hemagglutinin in the cerebrospinal fluid of a child with pertussis has been used as evidence to support the suggestion that pertussis antigens may gain entry to the CNS during infection (7). It has also been reported that another AB toxin, cholera toxin, can be transported to the brain and can enhance trafficking of third party antigens to neural tissue following nasal delivery in mice (35).…”

Pertussis toxin permeabilization enhances the traversal of Escherichia coli K1, macrophages, and monocytes in a cerebral endothelial barrier model in vitro

“…Neurological disorders have been occasionally associated with the human respiratory tract infection 'whooping cough' and have been attributed to the causative agent Bordetella pertussis (Geier and Geier, 2004;Grant et al, 1998;Heininger et al, 2004). These complications occur especially in young infants and in some reports have been associated with whole-cell vaccination (Grant et al, 1998;Menkes and Kinsbourne, 1990).…”

“…These complications occur especially in young infants and in some reports have been associated with whole-cell vaccination (Grant et al, 1998;Menkes and Kinsbourne, 1990). The CDC reported in 2001 that neurological complications such as encephalopathies occur in 0.1% of all reported pertussis cases probably as a result of hypoxia from coughing or possibly from toxin activities (CDC, 2002).…”

Pertussis Toxin Exploits Specific Host Cell Signaling Pathways for Promoting Invasion and Translocation of Escherichia coli K1 RS218 in Human Brain-derived Microvascular Endothelial Cells

“…Bordetella pertussis is the causative agent of the respiratory disease whooping cough, which in young infants may occasionally be associated with neurological disorders (1)(2)(3). It has been shown in several studies that pertussis toxin (PTx), 2 a decisive and secreted virulence factor of B. pertussis, affects cerebral vascular barriers and transiently increases the permeability of the blood-brain barrier (1,(3)(4)(5)(6)(7)(8).…”

“…It has been shown in several studies that pertussis toxin (PTx), 2 a decisive and secreted virulence factor of B. pertussis, affects cerebral vascular barriers and transiently increases the permeability of the blood-brain barrier (1,(3)(4)(5)(6)(7)(8). PTx belongs to the class of AB toxins with a catalytically active monomeric A-subunit, which transfers ADP-ribose from NAD to a cysteine residue of G i proteins (9,10).…”