Microorganisms in Pathogenesis and Management of Acute Disseminated Encephalomyelitis (ADEM)

Abstract

AbstractAutoimmune diseases are said to occur when the immune system of the host reacts against its own antigens, also called self-antigens. Many microorganisms trigger and initiate autoimmunity by a number of mechanisms like bystander lysis and antigenic mimicry. Autoimmunity can also be flared up by a wide variety of microbes. Acute disseminated encephalomyelitis (or ADEM) is one such autoimmune disease in which either microbes or immunizations have an important role to play. ADEM is an acute, rapidly progressive autoimmune disorder. It is characterized by demyelination in the white matter and deep gray matter of the brain and spinal cord that takes place due to inflammation occurring in response to a preceding infection or even cases of immunization. Many underlying mechanisms can ultimately lead to the occurrence of ADEM following any infection or vaccination, such as molecular mimicry, nonspecific sensitization by the body’s own reactive T-cells, axonal injury, and edema. As no specific etiologic agent has been constantly identified behind ADEM, and the role of any specific underlying mechanism is still debated, more research is needed to further establish the relationship with these mechanisms. If microbial etiologies and the link behind these autoimmune diseases are more and more deliberated upon, new strategies can be formulated to target these microbes flaring up autoimmunity. A complex interplay of factors like the host genotype, host microbiome, the environment, diet, and microbial etiology can help in developing so many autoimmune diseases. These things are indeed very interesting to note and study. Here, we thus try to present relevant information about the epidemiology and pathogenesis behind the microbes causing autoimmunity in general and ADEM in particular.KeywordsAutoimmuneInfectionVaccinationMicroorganismsAcute disseminated encephalomyelitis (ADEM)Immune responseDemyelinationMicrobesEncephalomyelitisBacteriaViruses