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The Journal of Experimental Medicine Oct 2022Recent studies have defined a novel population of PD-1+ TCF-1+ stem-like CD8 T cells in chronic infections and cancer. These quiescent cells reside in lymphoid tissues,...
Recent studies have defined a novel population of PD-1+ TCF-1+ stem-like CD8 T cells in chronic infections and cancer. These quiescent cells reside in lymphoid tissues, are critical for maintaining the CD8 T cell response under conditions of persistent antigen, and provide the proliferative burst after PD-1 blockade. Here we examined the role of TGF-β in regulating the differentiation of virus-specific CD8 T cells during chronic LCMV infection of mice. We found that TGF-β signaling was not essential for the generation of the stem-like CD8 T cells but was critical for maintaining the stem-like state and quiescence of these cells. TGF-β regulated the unique transcriptional program of the stem-like subset, including upregulation of inhibitory receptors specifically expressed on these cells. TGF-β also promoted the terminal differentiation of exhausted CD8 T cells by suppressing the effector-associated program. Together, the absence of TGF-β signaling resulted in significantly increased accumulation of effector-like CD8 T cells. These findings have implications for immunotherapies in general and especially for T cell therapy against chronic infections and cancer.
Topics: Animals; CD8-Positive T-Lymphocytes; Lymphocytic Choriomeningitis; Lymphocytic choriomeningitis virus; Mice; Neoplasms; Persistent Infection; Programmed Cell Death 1 Receptor; Transforming Growth Factor beta
PubMed: 35980386
DOI: 10.1084/jem.20211574 -
Journal of Clinical Medicine Jun 2018To review the current published literature on the use of procalcitonin as a diagnostic and prognostic marker in adult patients with meningitis. (Review)
Review
OBJECTIVE
To review the current published literature on the use of procalcitonin as a diagnostic and prognostic marker in adult patients with meningitis.
METHODS
We conducted a PubMed search to identify all relevant publications regarding the diagnostic and prognostic value of serum procalcitonin in patients with a known or suspected central nervous system infection. We also reviewed the bibliographies of all identified manuscripts in an attempt to identify additional relevant references.
RESULTS
A significant body of evidence suggests that serum procalcitonin has a promising role and can be a useful biomarker in the assessment of patients with meningitis.
CONCLUSIONS
Our literature review suggests that data on the role of Cerebrospinal Fluid (CSF) procalcitonin are limited, whereas serum procalcitonin (S⁻PCT) is probably a useful tool in the evaluation of patients with a known or suspected central nervous system infection and can help distinguish between bacterial and viral meningitis.
PubMed: 29891780
DOI: 10.3390/jcm7060148 -
Journal of Chemotherapy (Florence,... Apr 2017
The pharmacokinetic basis of oral valacyclovir treatment of herpes simplex virus (HSV) or varicella zoster virus (VZV) meningitis, meningoencephalitis or encephalitis in adults.
Topics: Acyclovir; Adult; Encephalitis; Herpes Simplex; Herpesvirus 3, Human; Humans; Male; Meningitis, Viral; Meningoencephalitis; Simplexvirus; Valacyclovir; Valine; Varicella Zoster Virus Infection
PubMed: 26239190
DOI: 10.1179/1973947815Y.0000000065 -
The Lancet. Infectious Diseases Nov 2016
Topics: Humans; Meningitis; Meningitis, Viral
PubMed: 27527750
DOI: 10.1016/S1473-3099(16)30221-3 -
Enfermedades Infecciosas Y... Jan 2024Enterovirus (EV) infections are the most frequent infections in the neonatal period and in many cases lead to hospital admission of the newborn (NB). The aim of this... (Observational Study)
Observational Study
INTRODUCTION
Enterovirus (EV) infections are the most frequent infections in the neonatal period and in many cases lead to hospital admission of the newborn (NB). The aim of this study was to determine the incidence of EV in the etiology of neonatal meningitis and to define the clinical characteristics of newborns with EV meningitis.
MATERIAL AND METHOD
Retrospective observational cohort study. Including 91 NBs with meningitis and gestational age greater than 34 weeks gestational age (GA) attended in our center over a period of 16 years.
RESULTS
The percentage of NBs with EV meningitis was higher than that of NBs with bacterial meningitis (BM) and accounted for 78% (n=71). Half of the NBs with EV infection had a history of epidemic environment among their caregivers. Fever was present in 96% of cases as a clinical sign and, in general, sensory disturbances represented the main neurological alterations. Antibiotics (ATB) were given to 71.4% of patients with EV infection. Detection of EV in CSF samples showed a high sensitivity for the diagnosis of EV meningitis. The most frequently implicated EV types were echovirus 11, coxsackievirus B5, echovirus 18, 25 and 7.
CONCLUSIONS
The results of this series show that enterovirus infection is a common cause of neonatal meningitis. These data underline the importance of rapid EV testing of infants with suspected meningitis. This allows early diagnosis and reduces antibiotic treatment, hospitalization time and related costs.
Topics: Infant; Infant, Newborn; Humans; Retrospective Studies; Enterovirus; Enterovirus Infections; Meningitis, Viral; Hospitalization; Infant, Newborn, Diseases; Anti-Bacterial Agents
PubMed: 36624031
DOI: 10.1016/j.eimce.2022.12.012 -
Infectious Diseases (London, England) Jun 2015Aseptic meningitis is considered a benign and self-limiting clinical condition. In contrast to viral encephalitis and bacterial meningitis, the prognosis is usually... (Review)
Review
Aseptic meningitis is considered a benign and self-limiting clinical condition. In contrast to viral encephalitis and bacterial meningitis, the prognosis is usually good. The existing literature is scarce on the potential long-term neuropsychiatric consequences of aseptic meningitis. Previous studies have primarily been retrospective and differences in methodologies make it difficult to draw conclusions regarding the prevalence and nature of neuropsychiatric manifestations. However, studies have reported decreased psychomotor speed and impaired executive and visuo-constructive functions following aseptic meningitis. Larger controlled prospective studies are urgently needed to elucidate the neuropsychiatric complications of aseptic meningitis.
Topics: Adolescent; Adult; Cognition Disorders; Dyssomnias; Female; Humans; Male; Meningitis, Aseptic; Mental Disorders; Middle Aged; Nervous System Diseases; Young Adult
PubMed: 25738613
DOI: 10.3109/23744235.2015.1018838 -
Practical Neurology Aug 2017Hepatitis E is the most common cause of hepatitis worldwide. While originally considered a disease of developing countries, it is increasingly recognised in developed... (Review)
Review
Hepatitis E is the most common cause of hepatitis worldwide. While originally considered a disease of developing countries, it is increasingly recognised in developed countries, probably related to contaminated pork meat, and where infection is often asymptomatic. However, several non-liver manifestations have become apparent, the most important of which are neurological, including Guillain-Barré syndrome (acute inflammatory demyelinating polyradiculoneuropathy (AIDP)), neuralgic amyotrophy and meningoencephalitis. We recommend testing all patients with AIDP and neuralgic amyotrophy for hepatitis E and consider testing any patient with an unexplained neurological illness and abnormal liver function tests for the virus.
Topics: Brachial Plexus Neuritis; Encephalitis, Viral; Guillain-Barre Syndrome; Hepatitis E; Hepatitis E virus; Humans; Meningitis, Viral; Nervous System Diseases
PubMed: 28647707
DOI: 10.1136/practneurol-2016-001588 -
Cureus May 2023Benign recurrent aseptic meningitis is a rare condition characterized by recurring, self-limited episodes of aseptic meningitis. Meningeal irritation typically occurs...
Benign recurrent aseptic meningitis is a rare condition characterized by recurring, self-limited episodes of aseptic meningitis. Meningeal irritation typically occurs first, accompanied by fever and mononuclear cell pleocytosis. The diagnosis is only made after other known causes of lymphocytic meningitis have been excluded. Resolution typically occurs within two to seven days without residual neurological deficit. Aseptic meningitis is most frequently caused by viruses; Mollaret's meningitis has been linked to the herpes simplex virus 2 (HSV 2). It is unclear if prophylactic medication is indicated for these patients. We describe a patient who was experiencing her seventh episode of aseptic meningitis.
PubMed: 37284381
DOI: 10.7759/cureus.38559 -
Medicine Jul 2022Viral infection is the most common cause of aseptic meningitis. The purpose of this study was to identify the viruses responsible for aseptic meningitis to better...
BACKGROUND
Viral infection is the most common cause of aseptic meningitis. The purpose of this study was to identify the viruses responsible for aseptic meningitis to better understand the clinical presentations of this disease.
METHOD
Between March 2009 and February 2010, we collected 297 cerebrospinal fluid specimens from children with aseptic meningitis admitted to a pediatric hospital in Yunnan (China). Viruses were detected by using "in house" real-time quantitative polymerase chain reaction or reverse-transcription real-time quantitative polymerase chain reaction from these samples. Phylogenetic analyses were conducted using the Molecular Evolutionary Genetic Analysis version 7.0 software, with the neighbor-joining method.
RESULTS
Viral infection was diagnosed in 35 of the 297 children (11.8%). The causative viruses were identified to be enteroviruses in 25 cases (71.4%), varicella-zoster virus in 5 cases (14.3%), herpes simplex virus 1 in 2 cases (5.7%), and herpes simplex virus 2, Epstein-Barr virus, and human herpesvirus 6 in 1 case each (2.9% each). Of the enteroviruses, coxsackievirus B5 was the most frequently detected serotype (10/25 cases; 40.0%) and all coxsackievirus B5 strains belonged to C group.
CONCLUSIONS
In the study, a causative virus was only found in the minority of cases, of them, enteroviruses were the most frequently detected viruses in patients with viral meningitis, followed by varicella-zoster virus and herpes simplex virus. Our findings underscore the need for enhanced surveillance and etiological study of aseptic meningitis.
Topics: Child; China; Enterovirus; Enterovirus Infections; Epstein-Barr Virus Infections; Herpesvirus 2, Human; Herpesvirus 3, Human; Herpesvirus 4, Human; Humans; Meningitis, Aseptic; Meningitis, Viral; Phylogeny; Viruses
PubMed: 35777023
DOI: 10.1097/MD.0000000000029772 -
Medecine Et Maladies Infectieuses Jun 2018Cerebrospinal fluid (CSF) leukocytes analysis is commonly used to diagnose meningitis and to differentiate bacterial from viral meningitis. Interpreting CSF monocytes... (Comparative Study)
Comparative Study
OBJECTIVE
Cerebrospinal fluid (CSF) leukocytes analysis is commonly used to diagnose meningitis and to differentiate bacterial from viral meningitis. Interpreting CSF monocytes can be difficult for physicians, especially in France where lymphocytes and monocytes results are sometimes pooled.
PATIENTS AND METHODS
We assessed SF monocytes in patients presenting with microbiologically confirmed meningitis (CSF leukocyte count>10/mm for adults or >30/mm for children<2 months), i.e. bacterial meningitis (BM), viral meningitis (VM), and neuroborreliosis (NB).
RESULTS
Two-hundred patients (82 BM, 86 VM, and 32 NB) were included. The proportions of monocytes were higher in VM (median 8%; range 0-57%) than in BM (median 5%; range 0-60%, P=0.03) or NB (median 5%; range 0-53%, P=0.46), with a high value overlap between conditions.
CONCLUSION
CSF monocytes should not be used to discriminate BM from VM and NB because of value overlaps.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cerebrospinal Fluid; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Infant; Lyme Neuroborreliosis; Male; Meningitis, Bacterial; Meningitis, Viral; Middle Aged; Monocytes; Retrospective Studies; Young Adult
PubMed: 29628177
DOI: 10.1016/j.medmal.2018.03.002