Pneumonia's link with the head and heart

Two immune mechanisms are theoretically involved in the CNS manifestations of M pneumoniae: a direct type, in which inflammatory cytokines locally induced by lipoproteins contained in the bacterial cell membrane have a role; and an indirect type, in which autoimmunity, through cross-reaction between...

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Bibliographic Details
Published in:The Lancet (British edition) 2010-07, Vol.376 (9738), p.388-388
Main Authors: Mariotti, Paolo, MD, Nociti, Viviana, MD, Stefanini, Maria Chiara, MD, Frisullo, Giovanni, MD, De Rosa, Gabriella, MD, Colosimo, Cesare, Prof, Batocchi, Anna Paola, Dr
Format: Article
Language:English
Subjects:
Aortic Valve - diagnostic imaging
Aortic Valve - pathology
Aortic Valve Insufficiency - diagnostic imaging
Aortic Valve Insufficiency - microbiology
Arm
Autoimmunity
Bacteria
Biological and medical sciences
Brain - microbiology
Brain - pathology
Cardiovascular diseases
Child
Data collection
Dystonia - etiology
Echocardiography, Doppler
Encephalitis - complications
Encephalitis - diagnostic imaging
Encephalitis - immunology
Encephalitis - microbiology
Endocarditis - complications
Endocarditis - diagnostic imaging
Endocarditis - immunology
Endocarditis - microbiology
Female
General aspects
Humans
Immunoglobulin G - blood
Immunoglobulin M - blood
Internal Medicine
Magnetic Resonance Imaging
Medical research
Medical sciences
Mycoplasma pneumoniae - immunology
Pneumonia, Mycoplasma - complications
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Summary:Two immune mechanisms are theoretically involved in the CNS manifestations of M pneumoniae: a direct type, in which inflammatory cytokines locally induced by lipoproteins contained in the bacterial cell membrane have a role; and an indirect type, in which autoimmunity, through cross-reaction between bacterial cell components and human cells has a role.4 Polyclonal B-cell activation as well as the production of various autoantibodies, including to brain tissue, can occur in the course of M pneumoniae infection.4 This activation may be non-specific (independent of antigen) such as in superantigen-mediated diseases, or by a mechanism of molecular mimicry.4 The latter mechanism is known to underlie rheumatic heart disease, caused by group A β-haemolytic streptococci.5 The similarity between post-infectious striatal encephalitis caused by M pneumoniae and that by group A β-haemolytic streptococci led us to do echocardiography on our patient and discover her endocarditis.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(10)60711-8