Reis Patricia Alves, Castro-Faria-Neto Hugo Caire
Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
Biochemistry Department, Roberto Alcântara Gomes Biology Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Front Neurosci. 2022 Feb 18;15:742158. doi: 10.3389/fnins.2021.742158. eCollection 2021.
In response to pathogens or damage signs, the immune system is activated in order to eliminate the noxious stimuli. The inflammatory response to infectious diseases induces systemic events, including cytokine storm phenomenon, vascular dysfunction, and coagulopathy, that can lead to multiple-organ dysfunction. The central nervous system (CNS) is one of the major organs affected, and symptoms such as sickness behavior (depression and fever, among others), or even delirium, can be observed due to activation of endothelial and glial cells, leading to neuroinflammation. Several reports have been shown that, due to CNS alterations caused by neuroinflammation, some sequels can be developed in special cognitive decline. There is still no any treatment to avoid cognitive impairment, especially those developed due to systemic infectious diseases, but preclinical and clinical trials have pointed out controlling neuroinflammatory events to avoid the development of this sequel. In this minireview, we point to the possible mechanisms that triggers long-term cognitive decline, proposing the acute neuroinflammatory events as a potential therapeutical target to treat this sequel that has been associated to several infectious diseases, such as malaria, sepsis, and, more recently, the new SARS-Cov2 infection.
针对病原体或损伤信号，免疫系统被激活以消除有害刺激。对传染病的炎症反应会引发全身性事件，包括细胞因子风暴现象、血管功能障碍和凝血病，这些可能导致多器官功能障碍。中枢神经系统（CNS）是受影响的主要器官之一，由于内皮细胞和神经胶质细胞的激活，可观察到诸如疾病行为（如抑郁和发热等）甚至谵妄等症状，从而导致神经炎症。多项报告表明，由于神经炎症引起的中枢神经系统改变，可能会出现一些特殊的认知衰退后遗症。目前仍没有任何治疗方法可以避免认知障碍，尤其是由全身性传染病引起的认知障碍，但临床前和临床试验已指出，控制神经炎症事件可避免这种后遗症的发生。在本综述中，我们指出了引发长期认知衰退的可能机制，提出急性神经炎症事件作为治疗这种与多种传染病（如疟疾、败血症以及最近的新型SARS-CoV2感染）相关后遗症的潜在治疗靶点。
