Pathogens penetrating the central nervous system: Infection pathways and the cellular and molecular mechanisms of invasion

Samantha J. Dando, Alan Mackay-Sim, Robert Norton, Bart J. Currie, James A. St John, Jenny A K Ekberg, Michael Batzloff, Glen C. Ulett, Ifor R. Beacham*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

126 Citations (Scopus)

Abstract

The brain is well protected against microbial invasion by cellular barriers, such as the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (BCSFB). In addition, cells within the central nervous system (CNS) are capable of producing an immune response against invading pathogens. Nonetheless, a range of pathogenic microbes make their way to the CNS, and the resulting infections can cause significant morbidity and mortality. Bacteria, amoebae, fungi, and viruses are capableof CNS invasion, with the latter using axonal transport as a common route of infection. In this review, we compare the mechanisms by which bacterial pathogens reach the CNS and infect the brain. In particular, we focus on recent data regarding mechanisms of bacterial translocation from the nasal mucosa to the brain, which represents a little explored pathway of bacterial invasion but has been proposed as being particularly important in explaining how infection with Burkholderia pseu-domallei can result in melioidosis encephalomyelitis.

Original languageEnglish
Pages (from-to)691-726
Number of pages36
JournalClinical Microbiology Reviews
Volume27
Issue number4
DOIs
Publication statusPublished - 1 Oct 2014
Externally publishedYes

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    Dando, S. J., Mackay-Sim, A., Norton, R., Currie, B. J., St John, J. A., Ekberg, J. A. K., Batzloff, M., Ulett, G. C., & Beacham, I. R. (2014). Pathogens penetrating the central nervous system: Infection pathways and the cellular and molecular mechanisms of invasion. Clinical Microbiology Reviews, 27(4), 691-726. https://doi.org/10.1128/CMR.00118-13