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Cited by 99Bacterial Infections and VaccinesComplement system in diseasesSepsis Diagnosis and Treatment

Classification and Pathogenesis of Meningococcal Infections

Brandtzaeg, Petter, van Deuren, Marcel·2012·Methods in Molecular Biology
DOI 10.1007/978-1-61779-346-2_2
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Abstract

The clinical symptoms induced by Neisseria meningitidis reflect compartmentalized intravascular and intracranial bacterial growth and inflammation. In this chapter, we describe a classification system for meningococcal disease based on the nature of the clinical symptoms. Meningococci invade the subarachnoid space and cause meningitis in as many as 50-70% of patients. The bacteremic phase is moderate in patients with meningitis and mild systemic meningococcemia but graded high in patients with septic shock. Three landmark studies using this classification system and comprising 862 patients showed that 37-49% developed meningitis without shock, 10-18% shock without meningitis, 7-12% shock and meningitis, and 18-33% had mild meningococcemia without shock or meningitis. N. meningitidis lipopolysaccharide (LPS) is the principal trigger of the innate immune system via activation of the Toll-like receptor 4-MD2 cell surface receptor complex on myeloid and nonmyeloid human cells. The intracellular signals are conveyed via MyD88-dependent and -independent pathways altering the expression of >4,600 genes in target cells such as monocytes. However, non-LPS molecules contribute to inflammation, but 10-100-fold higher concentrations are required to reach the same responses as induced by LPS. Activation of the complement and coagulation systems is related to the bacterial load in the circulation and contributes to the development of shock, organ dysfunction, thrombus formation, bleeding, and long-term complications in patients. Despite rapid intervention and advances in patient intensive care, why as many as 30% of patients with systemic meningococcal disease develop massive meningococcemia leading to shock and death is still not understood.

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  • Bacterial meningitis can be caused by gram-negative bacteria, such as Neisseria meningitidis, often resulting in long-term cognitive problems, and much of the pathology has been attributed to endotoxin.

    “Bacterial meningitis can be caused by gram-negative bacteria, such as Neisseria meningitidis, infecting the brain meninges, often resulting in long-term cognitive problems, and much of the pathology has been attributed to endotoxin [107].”

    From The endotoxin hypothesis of neurodegeneration (2019) · cites this paper as [107]

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Authors
Brandtzaeg, P., & van Deuren, M.
Affiliations
University of Oslo (NO)
Corresponding author
Brandtzaeg, Petter
ORCID
Brandtzaeg, Petter
Venue
Methods in Molecular Biology
Publisher
Humana Press
Published
2011-09-09
Volume
799
Pages
21-35
ISSN
  • 1064-3745 (ISSN-L)
  • 1940-6029
DOI
10.1007/978-1-61779-346-2_2
OpenAlex
W2395880431
Cited by
99
References
60
Citations by year
2026: 5 · 2025: 1 · 2024: 2 · 2023: 7 · 2022: 8 · 2021: 6 · 2020: 8 · 2019: 13 · 2018: 11 · 2017: 7 · 2016: 5 · 2015: 8 · 2014: 9 · 2013: 7 · 2012: 2
FWCI
14.56
Type
book chapter
Language
en
Open access
closed
Licence
Locations
  • Methods in molecular biology (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Life Sciences › Immunology and Microbiology › Immunology › Complement system in diseases
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Keywords
Neisseria meningitidis, meningococcal disease, meningitis, septic shock, meningococcal sepsis, disease classification, lipopolysaccharide, TLR4, MyD88 signaling, innate immunity, complement activation, coagulation, organ dysfunction, thrombosis
MeSH terms
Animals, Complement Activation, DNA, Bacterial, Humans, Immunity, Innate, Lipopolysaccharides, Meningococcal Infections, Neisseria meningitidis, Research, Shock, Septic, Swine, Waterhouse-Friderichsen Syndrome, Models, Animal

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