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

Authors

  • Alejandro Rivas-Castro Centro Médico Nacional “20 de Noviembre”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico https://orcid.org/0000-0002-4621-558X
  • Citlaltepetl Salinas-Lara Departamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, Mexico
  • Carlos Sánchez Garibay Departamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, Mexico
  • Edgar Abarca-Rojano Sección de Estudios de Pogrado e Investigacion, Escuela Superior de Medicina Instituto Politécnico Nacional, Mexico City, Mexico https://orcid.org/0000-0002-0807-7104
  • Rogelio Hernández-Pando Experimental Pathology Section. Department of Pathology. National Institute of Medical Sciences and Nutrition, Mexico City, Mexico https://orcid.org/0000-0003-1292-3833
  • Brenda Marquina-Castillo Researcher in Medical Sciences
  • Manuel Alejandro Flores Barrada Profesor investigador de la universidad Juárez Autónoma de Tabasco de la división académica multidisciplinaria Comalcalco, Tabasco, Mexico https://orcid.org/0000-0002-1005-098X
  • Yazmín Peralta-Díaz Departamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, Mexico
  • Elsa Yazmín León-Marroquín Departamento de Física Médica, Hospital de Oncología Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México
  • Martha Lilia Tena Suck Departamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Mexico City, Mexico
  • Jessica Medina Mendoza Resident Doctor at Hospital Juárez de Mexico, Mexico City, Mexico
  • Yaser Sánchez Gama Harvard Medical School, Boston, MA, United States
  • Luis O Soto Rojas Laboratorio de Patogénesis Molecular, Laboratorio 4, Edificio A4, Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Edomex, Mexico
  • José Alberto Choreño Parra Departamento de Enseñanza, Instituto Nacional de Enfermedades Respiratorias Isanel Cosío Villegas, Mexico City, Mexico
  • José Pablo Romero-López Red MEDICI, Carrera médico cirujano, Facultad de Estudios Superiores Iztacala UNAM, Mexico, Mexico https://orcid.org/0000-0002-0140-7676

DOI:

https://doi.org/10.3855/jidc.17544

Keywords:

vasculitis, CNS tuberculosis, TNF- α, TNF-R1, TNF-R2

Abstract

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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Published

2023-10-31

How to Cite

1.
Rivas-Castro A, Salinas-Lara C, Sánchez Garibay C, Abarca-Rojano E, Hernández-Pando R, Marquina-Castillo B, Flores Barrada MA, Peralta-Díaz Y, León-Marroquín EY, Tena Suck ML, Medina Mendoza J, Sánchez Gama Y, Soto Rojas LO, Choreño Parra JA, Romero-López JP (2023) The role of TNF receptors as mediators of chronic vasculitis in possible milder forms of the CNS tuberculosis. J Infect Dev Ctries 17:1458–1465. doi: 10.3855/jidc.17544

Issue

Vol. 17 No. 10: October 2023

Section

Original Articles

License

Copyright (c) 2023 M.D. Rivas-Castro, Dr., DR. SANCHEZ GARIBAY, Abarca-Rojano Edgar PhD, Dr Hernández-Pando , DRA. MARQUINA CASTILLO, DR. FLORES BARRADA, DRA. PERALTA DIAZ, DRA. LEÓN-MARROQUÍN, DRA. TENA-SUCK, DRA. MEDINA-MENDOZA, Yaser Sánchez Gama, Dr. Luis O. Soto Rojas, Ph.D., DR. CHOREÑO PARRA, DR. ROMERO LÓPEZ

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