Current concepts in the pathogenesis of meningitis caused by Streptococcus pneumoniae

Meli, Damian N.; Christen, Stephan; Leib, Stephen L.; Täuber, Martin G. (2002). Current concepts in the pathogenesis of meningitis caused by Streptococcus pneumoniae. Current opinion in infectious diseases, 15(3), pp. 253-357. Hagerstown, Md.: Wolters Kluwer Lippincott Williams & Wilkins 10.1097/00001432-200206000-00007

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In spite of improved antimicrobial therapy, bacterial meningitis still results in brain damage leading to significant long-term neurological sequelae in a substantial number of survivors, as confirmed by several recent studies. Meningitis caused by Streptococcus pneumoniae is associated with a particularly severe outcome. Experimental studies over the past few years have increased our understanding of the molecular mechanisms underlying the events that ultimately lead to brain damage during meningitis. Necrotic damage to the cerebral cortex is at least partly mediated by ischemia and oxygen radicals and therefore offers a promising target for adjunctive therapeutic intervention. Neuronal apoptosis in the hippocampus may represent the major pathological process responsible for cognitive impairment and learning disabilities in survivors. However, the mechanisms involved in causing this damage remain largely unknown. Anti-inflammatory treatment with corticosteroids aggravates hippocampal damage, thus underlining the potential shortcomings of current adjuvant strategies. In contrast, the combined inhibition of matrix metalloproteinase and tumour necrosis factor-alpha converting enzyme protected both the cortex and hippocampus in experimental meningitis, and may represent a promising new approach to adjunctive therapy. It is the hope that a more refined molecular understanding of the pathogenesis of brain damage during bacterial meningitis will lead to new adjunctive therapies.

Item Type:	Journal Article (Further Contribution)
Division/Institute:	04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
UniBE Contributor:	Christen, Stephan, Leib, Stephen, Täuber, Martin G.
Subjects:	500 Science > 570 Life sciences; biology 600 Technology > 610 Medicine & health
ISSN:	0951-7375
ISBN:	12015459
Publisher:	Wolters Kluwer Lippincott Williams & Wilkins
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:56
Last Modified:	05 Dec 2022 14:17
Publisher DOI:	10.1097/00001432-200206000-00007
PubMed ID:	12015459
Web of Science ID:	000175773900007
URI:	https://boris.unibe.ch/id/eprint/23690 (FactScience: 43484)