The role of TNF receptors as mediators of chronic vasculitis in possible milder forms of the CNS tuberculosis

Introduction: Central nervous system (CNS) tuberculosis (TB) is the most severe form of TB due to its high mortality and functional sequelae. There are several differential diagnoses for TB; and, it can also cause secondary conditions, such as vasculitis. Methodology: 155 biopsies, corresponding...

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Main Authors: Alejandro Rivas-Castro, Citlaltepetl Salinas-Lara, Carlos Sánchez Garibay, Edgar Abarca-Rojano, Rogelio Hernández-Pando, Brenda Marquina-Castillo, Manuel Alejandro Flores Barrada, Yazmín Peralta-Díaz, Elsa Yazmín León-Marroquín, Martha Lilia Tena Suck, Jessica Medina Mendoza, Yaser Sánchez Gama, Luis O Soto Rojas, José Alberto Choreño Parra, José Pablo Romero-López
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2023-10-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/17544
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author Alejandro Rivas-Castro
Citlaltepetl Salinas-Lara
Carlos Sánchez Garibay
Edgar Abarca-Rojano
Rogelio Hernández-Pando
Brenda Marquina-Castillo
Manuel Alejandro Flores Barrada
Yazmín Peralta-Díaz
Elsa Yazmín León-Marroquín
Martha Lilia Tena Suck
Jessica Medina Mendoza
Yaser Sánchez Gama
Luis O Soto Rojas
José Alberto Choreño Parra
José Pablo Romero-López
author_facet Alejandro Rivas-Castro
Citlaltepetl Salinas-Lara
Carlos Sánchez Garibay
Edgar Abarca-Rojano
Rogelio Hernández-Pando
Brenda Marquina-Castillo
Manuel Alejandro Flores Barrada
Yazmín Peralta-Díaz
Elsa Yazmín León-Marroquín
Martha Lilia Tena Suck
Jessica Medina Mendoza
Yaser Sánchez Gama
Luis O Soto Rojas
José Alberto Choreño Parra
José Pablo Romero-López
author_sort Alejandro Rivas-Castro
collection DOAJ
description Introduction: Central nervous system (CNS) tuberculosis (TB) is the most severe form of TB due to its high mortality and functional sequelae. There are several differential diagnoses for TB; and, it can also cause secondary conditions, such as vasculitis. Methodology: 155 biopsies, corresponding to 155 different patients out of 5,386 registered biopsies from 2008-2013, met the criteria of unknown etiology vasculitis and evidence of cerebral vascular disease. These were analyzed to assess the presence of central nervous system TB. The selected cases were assessed with Suzaan Marais (SM) criteria for clinical tuberculosis. After that, Ziehl-Neelsen (ZN) staining and polymerase chain reaction (PCR) were performed to amplify a fragment of the insertion sequence IS6110 of M. tuberculosis. 21 patients met the criteria for definitive tuberculosis by ZN staining and PCR, and 2 met the criteria for possible tuberculosis. Tumor necrosis factor (TNF)-α, TNF-R1, and TNF-R2 were determined by immunohistochemistry in histological sections from formalin-fixed paraffin-embedded (FF-PE) tissues in the 23 selected patients. Results: Granulomatous TB was present in almost half of the cases. TNF-R1 and TNF-R2 were expressed mainly in blood vessels, histiocytes, and macrophages. TNF-R2 expression was higher than the other markers, which suggests an anti-inflammatory response against M. tuberculosis Conclusions: The histopathological presentation of TB is not always limited to granulomas, abscesses, or meningitis; there are also clinical presentations characterized only with chronic inflammation of nervous and vascular tissue.
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spelling doaj-art-c1b0f96be7374db99c97ad72a00161dc2025-08-20T02:14:16ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802023-10-01171010.3855/jidc.17544The role of TNF receptors as mediators of chronic vasculitis in possible milder forms of the CNS tuberculosisAlejandro Rivas-Castro0Citlaltepetl Salinas-Lara1Carlos Sánchez Garibay2Edgar Abarca-Rojano3Rogelio Hernández-Pando4Brenda Marquina-Castillo5Manuel Alejandro Flores Barrada6Yazmín Peralta-Díaz7Elsa Yazmín León-Marroquín8Martha Lilia Tena Suck9Jessica Medina Mendoza10Yaser Sánchez Gama11Luis O Soto Rojas12José Alberto Choreño Parra13José Pablo Romero-López14Centro Médico Nacional “20 de Noviembre”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, MexicoDepartamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, MexicoDepartamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, MexicoSección de Estudios de Pogrado e Investigacion, Escuela Superior de Medicina Instituto Politécnico Nacional, Mexico City, MexicoExperimental Pathology Section. Department of Pathology. National Institute of Medical Sciences and Nutrition, Mexico City, MexicoResearcher in Medical SciencesProfesor investigador de la universidad Juárez Autónoma de Tabasco de la división académica multidisciplinaria Comalcalco, Tabasco, MexicoDepartamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, MexicoDepartamento de Física Médica, Hospital de Oncología Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México Departamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, MexicoResident Doctor at Hospital Juárez de Mexico, Mexico City, MexicoHarvard Medical School, Boston, MA, United StatesLaboratorio de Patogénesis Molecular, Laboratorio 4, Edificio A4, Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Edomex, MexicoDepartamento de Enseñanza, Instituto Nacional de Enfermedades Respiratorias Isanel Cosío Villegas, Mexico City, Mexico Red MEDICI, Carrera médico cirujano, Facultad de Estudios Superiores Iztacala UNAM, Mexico, Mexico Introduction: Central nervous system (CNS) tuberculosis (TB) is the most severe form of TB due to its high mortality and functional sequelae. There are several differential diagnoses for TB; and, it can also cause secondary conditions, such as vasculitis. Methodology: 155 biopsies, corresponding to 155 different patients out of 5,386 registered biopsies from 2008-2013, met the criteria of unknown etiology vasculitis and evidence of cerebral vascular disease. These were analyzed to assess the presence of central nervous system TB. The selected cases were assessed with Suzaan Marais (SM) criteria for clinical tuberculosis. After that, Ziehl-Neelsen (ZN) staining and polymerase chain reaction (PCR) were performed to amplify a fragment of the insertion sequence IS6110 of M. tuberculosis. 21 patients met the criteria for definitive tuberculosis by ZN staining and PCR, and 2 met the criteria for possible tuberculosis. Tumor necrosis factor (TNF)-α, TNF-R1, and TNF-R2 were determined by immunohistochemistry in histological sections from formalin-fixed paraffin-embedded (FF-PE) tissues in the 23 selected patients. Results: Granulomatous TB was present in almost half of the cases. TNF-R1 and TNF-R2 were expressed mainly in blood vessels, histiocytes, and macrophages. TNF-R2 expression was higher than the other markers, which suggests an anti-inflammatory response against M. tuberculosis Conclusions: The histopathological presentation of TB is not always limited to granulomas, abscesses, or meningitis; there are also clinical presentations characterized only with chronic inflammation of nervous and vascular tissue. https://jidc.org/index.php/journal/article/view/17544vasculitisCNS tuberculosisTNF- αTNF-R1TNF-R2
spellingShingle Alejandro Rivas-Castro
Citlaltepetl Salinas-Lara
Carlos Sánchez Garibay
Edgar Abarca-Rojano
Rogelio Hernández-Pando
Brenda Marquina-Castillo
Manuel Alejandro Flores Barrada
Yazmín Peralta-Díaz
Elsa Yazmín León-Marroquín
Martha Lilia Tena Suck
Jessica Medina Mendoza
Yaser Sánchez Gama
Luis O Soto Rojas
José Alberto Choreño Parra
José Pablo Romero-López
The role of TNF receptors as mediators of chronic vasculitis in possible milder forms of the CNS tuberculosis
Journal of Infection in Developing Countries
vasculitis
CNS tuberculosis
TNF- α
TNF-R1
TNF-R2
title The role of TNF receptors as mediators of chronic vasculitis in possible milder forms of the CNS tuberculosis
title_full The role of TNF receptors as mediators of chronic vasculitis in possible milder forms of the CNS tuberculosis
title_fullStr The role of TNF receptors as mediators of chronic vasculitis in possible milder forms of the CNS tuberculosis
title_full_unstemmed The role of TNF receptors as mediators of chronic vasculitis in possible milder forms of the CNS tuberculosis
title_short The role of TNF receptors as mediators of chronic vasculitis in possible milder forms of the CNS tuberculosis
title_sort role of tnf receptors as mediators of chronic vasculitis in possible milder forms of the cns tuberculosis
topic vasculitis
CNS tuberculosis
TNF- α
TNF-R1
TNF-R2
url https://jidc.org/index.php/journal/article/view/17544
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