Abstract
Autoimmune 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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aboagye-Kumi M, Yango A Jr, Fischer S et al (2008) Acute disseminated encephalomyelitis in a renal transplant recipient: a case report. Transplant Proc 40(5):1751–1753. https://doi.org/10.1016/j.transproceed.2007.11.073
Agrawal A, Goyal S (2012) Acute demyelinating encephalomyelitis in a child following malaria. Indian Pediatr 49(11):922–923. https://doi.org/10.1007/s13312-012-0198-y
Alexander M, Murthy J (2011) Acute disseminated encephalomyelitis: treatment guidelines. Ann Indian Acad Neurol 14(Suppl 1):S60–S64
Anilkumar AC, Foris LA, Tadi P (2021) Acute disseminated encephalomyelitis. [Updated 2021 May 4]. In: StatPearls [Internet]. StatPearls Publishing, Treasure Island, FL. https://www.ncbi.nlm.nih.gov/books/NBK430934
Bennetto L, Scolding N (2004) Inflammatory/post-infectious encephalomyelitis. J Neurol Neurosurg Psych 75:i22–i28. https://doi.org/10.1136/jnnp.2003.034256
Calvo-Barreiro L, Eixarch H, Montalban X, Espejo C (2018) Combined therapies to treat complex diseases: the role of the gut microbiota in multiple sclerosis. Autoimmun Rev 17(2):165–174. https://doi.org/10.1016/j.autrev.2017.11.019
Cantarel BL, Waubant E, Chehoud C, Kuczynski J, DeSantis TZ, Warrington J et al (2015) Gut microbiota in multiple sclerosis: possible influence of immunomodulators. J Investig Med 63(5):729–734
Caucheteux N, Maarouf A, Daelman L et al (2013) Acute disseminated encephalomyelitis in two renal transplant patients: is there a role for Epstein-Barr virus reactivation? Mult Scler 19(9):1222–1225. https://doi.org/10.1177/1352458513478674
Chervonsky AV (2013) Microbiota and autoimmunity. Cold Spring Harb Perspect Biol 5(3):a007294
Cleveland Clinic (n.d.) Acute disseminated encephalomyelitis (ADEM). https://my.clevelandclinic.org/health/diseases/14266-acute-disseminated-encephalomyelitis-adem. Accessed 12 Aug 2021
Correia AO, Feitosa PWG, de Sousa Moreira JL, Nogueira SAR, Fonseca RB, Nobre MEP (2020) Neurological manifestations of COVID-19 and other coronaviruses: a systematic review. Neurol Psychiatry Brain Res 37:27–32. https://doi.org/10.1016/j.npbr.2020.05.008
Drescher KM, Kono K, Bopegamage S et al (2004) Coxsackievirus B3 infection and type 1 diabetes development in NOD mice: insulitis determines the susceptibility of pancreatic islets to virus infection. Virology 329:381–394
Esmaeil Amini M, Shomali N, Bakhshi A, Rezaei S, Hemmatzadeh M, Hosseinzadeh R et al (2020) Gut microbiome and multiple sclerosis: new insights and perspective. Int Immunopharmacol 88:107024. https://doi.org/10.1016/j.intimp.2020.107024
Esposito S, Di Pietro GM, Madini B, Mastrolia MV, Rigante D (2015) A spectrum of inflammation and demyelination in acute disseminated encephalomyelitis (ADEM) of children. Autoimmun Rev 14(10):923–929. https://doi.org/10.1016/j.autrev.2015.06.002
Garg RK (2003) Acute disseminated encephalomyelitis. Postgraduate Med J 79:11–17
Garg RK, Singh H, Kumar N (2016) Chapter 10 - Pathophysiology of Acute Disseminated Encephalomyelitis. In: Multiple sclerosis-a mechanistic view. Elsevier, pp 201–248
Gibbons JL, Miller HG, Stanton JB (1956) Para-infectious encephalomyelitis and related syndromes: a critical review of the neurological complications of certain specific fevers. Q J Med 25(100):427–505. PMID: 13379602
Glenn JD, Mowry EM (2016) Emerging concepts on the gut microbiome and multiple sclerosis. J Interf Cytokine Res 36(6):347–357. https://doi.org/10.1089/jir.2015.0177
Hornig M (2013) The role of microbes and autoimmunity in the pathogenesis of neuropsychiatric illness. Curr Opin Rheumatol 25(4):488–795
Human Microbiome Project Consortium (2012) Structure, function, and diversity of the healthy human microbiome. Nature 486(7402):207–214
Iype M, Kunju PAM, Saradakutty G et al (2017) Short-term outcome of ADEM: results from a retrospective cohort study from South India. Mult Scler Relat Disord 18:128–134. https://doi.org/10.1016/j.msard.2017.09.018
Javed A, Khan O (2014) Acute disseminated encephalomyelitis. Handb Clin Neurol 123:705–717. https://doi.org/10.1016/B978-0-444-53488-0.00035-3
Jhangi S, Ganghi R, Glanz B, Cook S, Nejad P, Ward D et al (2014) Increased archaea species and changes with therapy in the gut microbiome of multiple sclerosis subjects. Neurology S24.001:82
Kobayashi S, Negishi Y, Ando N et al (2010) Two patients with acute rotavirus encephalitis associated with cerebellar signs and symptoms. Eur J Pediatr 169(10):1287–1291
Kouchaki E, Tamtaji OR, Salami M, Bahmani F, Daneshvar KR, Akbari E et al (2017) Clinical and metabolic response to probiotic supplementation in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled trial. Clin Nutr 36:1245–1249. https://doi.org/10.1016/j.clnu.2016.08.015
Krupp LB, Banwell B, Tenembaum S (2007) Consensus definitions proposed for pediatric multiple sclerosis and related disorders. Neurology 68(suppl 2):S7–S12
Krupp LB, Tardieu M, Amato MP et al (2013) International pediatric multiple sclerosis study group criteria for pediatric multiple sclerosis and immune-mediated central nervous system demyelinating disorders: revisions to the 2007 definitions. Mult Scler 19:1261–1267
Langley L, Zeicu C, Whitton L, Pauls M (2020) Acute disseminated encephalomyelitis (ADEM) associated with COVID-19. BMJ Case Rep 13(12):1–3
Lucas J (1790) An account of uncommon symptoms succeeding measles: with some additional remarks on the infection of measles and smallpox. Lond Med J 11:325
Lunn M, Hughes R (2011) The relationship between cytomegalovirus infection and Guillain–Barré syndrome. Clin Infect Dis 52(7):845–847. https://doi.org/10.1093/cid/cir082
Madan S, Aneja S, Tripathi RP et al (2005) Acute disseminated encephalomyelitis: a case series. Indian Pediatr 42:367–371
Malkiel S, Liao L, Cunningham MW et al (2000) T cell-dependent antibody response to the dominant epitope of streptococcal polysaccharide, N-acetyl-glucosamine, is cross-reactive with cardiac myosin. Infect Immun 68:5803–5808
Maramottom BV, Sarada C (2006) Clinical features and outcome of acute disseminated encephalomyelitis (ADEM): an outlook from South India. Ann Indian Acad Neurol 9(1):20–24
Marziali S, Picchi E, Di Giuliano F et al (2017) Acute disseminated encephalomyelitis following campylobacter jejuni gastroenteritis: case report and review of the literature. Neuroradiol J 30(1):65–70
McAlpine D (1931) Acute disseminated encephalomyelitis: its sequelea and its relationship to disseminated sclerosis. Lancet 217:846–852
Melinosky C (2020) Acute disseminated encephalomyelitis (ADEM). https://www.webmd.com/brain/acute-disseminated-encephalomyelitis-adem#:~:text=Acute%20disseminated%20encephalomyelitis%20(ADEM)%20is,don't%20have%20another%20attack. Accessed 24 July 2021
Menge T, Hemmer B, Nessler S, Wiendl H, Neuhaus O, Hartung HP et al (2005) Acute disseminated encephalomyelitis: an update. Arch Neurol 62(11):1673–1680. https://doi.org/10.1001/archneur.62.11.1673
Miranda G, Ramos E (2010) Chronic sequelae of acute disseminated encephalomyelitis in a child. PM R 2:868–871
Miyake S, Kim S, Suda W, Oshima K, Nakamura M, Matsuoka T et al (2015) Dysbiosis in the gut microbiota of patients with multiple sclerosis, with a striking depletion of species belonging to clostridia XIVa and IV clusters. PLoS One 10(9):e0137429
Moawad H (2019) What is acute disseminated encephalomyelitis (ADEM)? Brain and nervous system. https://www.verywellhealth.com/acute-disseminated-encephalomyelitis-adem-4691870. Accessed 23 July 2021
Montalvan V, Lee J, Bueso T, De Toledo J, Rivas K (2020) Neurological manifestations of COVID-19 and other coronavirus infections: a systematic review. Clin Neurol Neurosurg 194:105921. https://doi.org/10.1016/j.clineuro.2020.105921
Murthy JM (2002) Acute disseminated encephalomyelitis. Neurol India 50:238
Naidoo A, Paruk H, Bhagwan B et al (2017) Atypical presentations of acute disseminated encephalomyelitis (ADEM) in HIV infection. J Neurovirol 23(1):160–170. https://doi.org/10.1007/s13365-016-0481-0
National Organization for Rare Disorders (n.d.) Acute disseminated encephalomyelitis. https://rarediseases.org/rare-diseases/acute-disseminated-encephalomyelitis/. Accessed 13 Aug 2021
Novoa LJ, Nagra RM, Nakawatase T et al (1997) Fulminant demyelinating encephalomyelitis associated with productive HHV-6 infection in an immunocompetent adult. J Med Virol 52:301–308
Ochoa-Reparaz J, Mielcarz DW, Ditrio LE, Burroughs AR, Foureau DM, Haque-Begum S et al (2009) Role of gut commensal microflora in the development of experimental autoimmune encephalomyelitis. J Immunol 183:6041–6050
Ozden HT, Togan T (2016) An acute disseminated encephalomyelitis case due to mycobacterium tuberculosis. J Microbiol Infect Dis 6(1):28–31. https://doi.org/10.5799/ahinjs.02.2016.01.0210
Paterson RW, Brown RL, Benjamin L, Nortley R, Wiethoff S, Bharucha T (2020) The emerging spectrum of COVID-19 neurology: clinical, radiological, and laboratory findings. Brain 143(10):3104–3120. https://doi.org/10.1093/brain/awaa240
Pellegrino P, Carnovale C, Perrone V, Pozzi M, Antoniazzi S, Clementi E et al (2013) Acute disseminated encephalomyelitis onset: evaluation based on vaccine adverse events reporting systems. PLoS One 8:e77766
Pohl D, Alper G, Haren KV, Kornberg AJ, Lucchinetti CF, Tenembaum S et al (2016) Acute disseminated encephalomyelitis: updates on an inflammatory CNS syndrome. Neurology 87(9 Suppl 2):S38–S45. https://doi.org/10.1212/WNL.0000000000002825
Schwartz KL, Richardson SE, MacGregor D, Mahant S, Raghuram K, Bitnun A (2019) Adenovirus-associated central nervous system disease in children. J Pediatr 205:130–137. https://doi.org/10.1016/j.jpeds.2018.09.036
Sharon G, Sampson TR, Geschwind DH, Mazmanian SK (2016) The central nervous system and the gut microbiome. Cell 167(4):915–932. https://doi.org/10.1016/j.cell.2016.10.027
Sheikh AAE, Sheikh AB, Sagheer S et al (2018) Acute intermittent porphyria: a rare cause of acute disseminated encephalomyelitis. Cureus 10(7):e2989. https://doi.org/10.7759/cureus.2989
Sidhu J, Maheshwari A, Gupta R, Devgan V (2015) Acute disseminated encephalomyelitis after plasmodium vivax infection: case report and review of literature. Pediatr Rep 7(2):5859
Soares CN, Souza APC, Santos R, Spitz M (2018) An acute disseminated encephalomyelitis (ADEM) case after yellow fever immunization. Ann Clin Radiol 1(2):1010
Sonneville R, Klein I, de Broucker T et al (2009) Post-infectious encephalitis in adults: diagnosis and management. J Infect 58(5):321–328. https://doi.org/10.1016/j.jinf.2009.02.011
Turnbaugh PJ, Ley RE, Hamady M, Fraser-Liggett CM, Knight R, Gordon JI (2007) The human microbiome project. Nature 449(7164):804–810
Visser LH, van der Meché FG et al (1996) Cytomegalovirus infection and Guillain-Barré syndrome: the clinical, electrophysiologic, and prognostic features. Dutch Guillain-Barré Study Group. Neurology 47(3):668–673. https://doi.org/10.1212/wnl.47.3.668
Wang Y, Kasper LH (2014) The role of microbiome in central nervous system disorders. Brain Behav Immun 38:1–12. https://doi.org/10.1016/j.bbi.2013.12.015
Wucherpfennig KW (2001) Mechanisms for the induction of autoimmunity by infectious agents. J Clin Invest 108(8):1097–1104
Yang JH, Vuong KT, Moodley A, Chuang NA, Chen DY (2021) A case of tuberculosis-associated acute disseminated encephalomyelitis in a seven-month-old infant. Cureus 13(7):e16299
Zelada-Ríos L, Pacheco-Barrios K, Galecio-Castillo M, Yamunaqué-Chunga C, Álvarez-Toledo K, Otiniano-Sifuentes R (2021) Acute disseminated encephalomyelitis and COVID-19: a systematic synthesis of worldwide cases. J Neuroimmunol 359:577674. https://doi.org/10.1016/j.jneuroim.2021.577674; Epub ahead of print
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Agrawal, A., Bhattacharyya, S. (2022). Microorganisms in Pathogenesis and Management of Acute Disseminated Encephalomyelitis (ADEM). In: Dwivedi, M.K., Sankaranarayanan, A., Kemp, E.H., Shoenfeld, Y. (eds) Role of Microorganisms in Pathogenesis and Management of Autoimmune Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-19-4800-8_11
Download citation
DOI: https://doi.org/10.1007/978-981-19-4800-8_11
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-19-4799-5
Online ISBN: 978-981-19-4800-8
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)