Phần 1: Nghiên cứu về tổn thương não màng não do loài amip ăn não người Naeglaria fowleri vẫn còn bỏ ngõ và tỷ lệ tử vong còn cao
Việc nghiên cứu và tìm hiểu về một tác nhân gây bệnh, đặc biệt là các tác nhân ký sinh trùng nhiệt đới bị lãng quên là rất quan trọng bởi nếu bỏ qua, chúng dễ dàng dẫn đến các biến chứng nguy hiểm và đe dọa tính mạng của bệnh nhân và cả cộng đồng nếu nguy cơ lây nhiễm cao.
Một trong những tác nhân ký sinh trùng đơn bào gây bệnh nghiêm trọng cơ quan thần kinh trung ương ở người với tỷ lệ tử vong lên đến gần 100% mặc dù bệnh nhân đang ở trong các cơ sở y tế hiện đại và ở quốc gia có nền y học bậc nhất thế giới. Đó chính là loại amip ăn não Naegleria fowleri đã gây tử vong 2 bệnh nhân ở Việt Nam năm 2014. Bản đồ phân bố ở trên toàn cầu cho thấy nhiều cá bệnh xuất hiện ở các châu lục (màu xanh). Lòai amip Naegleria fowleri đã được phát hiện trên tất cả châu lục, ngoại trừ vùng Nam Cực. Bệnh được mô tả như một nguyên nhân của viêm màng não do amip tiên phát (primary amebic meningoencephalitis-PAM) trên hơn 16 quốc gia. Mãi đến năm2012, có khoảng 310 ca được báo cáo trên phạm vi toàn cầu. Nhiễm trùng N. fowleri không phải là một bệnh đáng lưu ý ở Mỹ. Dựa trên các danh mục amip sống tự do của Trung tâm Phòng chống bệnh tật (USCDC), có 138 ca viêm màng não tiên phát do amip xảy ra ở Mỹ từ năm 1962-2015. Trong số 138 ca, có 135 ca tử vong và chỉ có 3 ca sống sót, điều này cho thấy nhiễm trùng có tỷ lệ tử vong lên đến 98%. Tại Mỹ, PAM là một bệnh hiếm và xảy ra không cân xứng trên nhóm trẻ em dưới 13 tuổi.
Hình 1 Dưới đây là một số công trình nghiên cứu trên thế giới và Việt Nam về các ca bệnh cũng như các nghiên cứu chuyên sâu về cơ chế bệnh sinh, tác nhân gây bệnh, miễn dịch, chẩn đoán cổ điển và phân tử, điều trị và phòng bệnh, các khuyến cáo của các cơ quan chức năng y tế liên quan.
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Hình 3Diagnosis of the primary amoebic meningoencephalitis due to Naegleria fowleri.
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Hình 5Development of a high- versus low-pathogenicity model of the free-living amoeba Naegleria fowleri.
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Hình 5Identification of Naegleria fowleri proteins linked to primary amoebic meningoencephalitis.
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Hình 6Naegleria fowleri: Diagnosis, Pathophysiology of Brain Inflammation, and Antimicrobial Treatments.
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Hình 7Diagnosis, Clinical Course, and Treatment of Primary Amoebic Meningoencephalitis in the United States, 1937-2013.
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Hình 8Characterization of Naegleria fowleri strains isolated from human cases of primary amoebic meningoencephalitis in Mexico.
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Hình 9Effective PCR-based detection of Naegleria fowleri from cultured sample and PAM-developed mouse.
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Hình 10Pathogenesis of amoebic encephalitis: Are the amoebae being credited to an 'inside job' done by the host immune response?
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Hình 11Torn from the Headlines: Surviving the "Brain Eating Amoeba".
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Hình 12Prevalence of Naegleria fowleri in Environmental Samples from Northern Part of India.
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Hình 13Identification of cysteine protease inhibitors as new drug leads against Naegleria fowleri.
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Identification and significance of Naegleria fowleri isolated from the hot spring which related to the first primary amebic meningoencephalitis (PAM) patient in Taiwan.
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CYP51 is an essential drug target for the treatment of primary amoebic meningoencephalitis (PAM).
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Primary Amebic Meningoencephalitis as Cause of Headache and Fever.
Sherin K, Linam WM, Jett S.
Am Fam Physician . 2016 Apr 15;93(8):644. No abstract available.
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Primary amoebic meningoencephalitis with subsequent organ procurement: a case study.
Tuppeny M.
J Neurosci Nurs . 2011 Oct;43(5):274-9. doi: 10.1097/JNN.0b013e318227ef6e.
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Identification of peptidases in highly pathogenic vs. weakly pathogenic Naegleria fowleri amebae.
Vyas IK, Jamerson M, Cabral GA, Marciano-Cabral F.
J Eukaryot Microbiol . 2015 Jan-Feb;62(1):51-9. doi: 10.1111/jeu.12152. Epub 2014 Aug 21.
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A case report: primary amoebic meningoencephalitis in a young Zambian adult.
Chomba M, Mucheleng'anga LA, Fwoloshi S, Ngulube J, Mutengo MM.
BMC Infect Dis . 2017 Aug 1;17(1):532. doi: 10.1186/s12879-017-2638-8.
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Primary amoebic meningoencephalitis caused by Naegleria fowleri: an old enemy presenting new challenges.
Siddiqui R, Khan NA.
PLoS Negl Trop Dis . 2014 Aug 14;8(8):e3017. doi: 10.1371/journal.pntd.0003017. eCollection 2014 Aug. Review.
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Synergistic activities of azithromycin and amphotericin B against Naegleria fowleri in vitro and in a mouse model of primary amebic meningoencephalitis.
Soltow SM, Brenner GM.
Antimicrob Agents Chemother . 2007 Jan;51(1):23-7. Epub 2006 Oct 23.
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Vaccination with lentiviral vector expressing the nfa1 gene confers a protective immune response to mice infected with Naegleria fowleri.
Kim JH, Sohn HJ, Lee J, Yang HJ, Chwae YJ, Kim K, Park S, Shin HJ.
Clin Vaccine Immunol . 2013 Jul;20(7):1055-60. doi: 10.1128/CVI.00210-13. Epub 2013 May 15.
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A real-time PCR diagnostic method for detection of Naegleria fowleri.
Madarová L, Trnková K, Feiková S, Klement C, Obernauerová M.
Exp Parasitol . 2010 Sep;126(1):37-41. doi: 10.1016/j.exppara.2009.11.001. Epub 2009 Nov 15.
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Protective immunity against Naegleria fowleri infection on mice immunized with the rNfa1 protein using mucosal adjuvants.
Lee J, Yoo JK, Sohn HJ, Kang HK, Kim D, Shin HJ, Kim JH.
Parasitol Res . 2015 Apr;114(4):1377-85. doi: 10.1007/s00436-015-4316-3. Epub 2015 Jan 22.
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Naegleria fowleri: contact-dependent secretion of electrondense granules (EDG).
Chávez-Munguía B, Villatoro LS, Omaña-Molina M, Rodríguez-Monroy MA, Segovia-Gamboa N, Martínez-Palomo A.
Exp Parasitol . 2014 Jul;142:1-6. doi: 10.1016/j.exppara.2014.03.027. Epub 2014 Apr 8.
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Primary amebic meningoencephalitis associated with ritual nasal rinsing—St Thomas, US Virgin Islands, 2012.
[No authors listed]
Clin Infect Dis . 2014 Feb;58(3):ii. No abstract available.
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[Primary amoebic meningoencephalitis: a case report].
Cubero-Menéndez O, Cubero-Rego D.
Rev Neurol . 2004 Feb 16-29;38(4):336-8. Spanish.
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Detection of biomarkers of pathogenic Naegleria fowleri through mass spectrometry and proteomics.
Moura H, Izquierdo F, Woolfitt AR, Wagner G, Pinto T, del Aguila C, Barr JR.
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Fatal Naegleria fowleri infection acquired in Minnesota: possible expanded range of a deadly thermophilic organism.
Kemble SK, Lynfield R, DeVries AS, Drehner DM, Pomputius WF 3rd, Beach MJ, Visvesvara GS, da Silva AJ, Hill VR, Yoder JS, Xiao L, Smith KE, Danila R.
Clin Infect Dis . 2012 Mar;54(6):805-9. doi: 10.1093/cid/cir961. Epub 2012 Jan 11.
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Infections with free-living amebae.
Visvesvara GS.
Handb Clin Neurol . 2013;114:153-68. doi: 10.1016/B978-0-444-53490-3.00010-8. Review.
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Fatal consequences of freshwater pearl diving.
Phu NH, Hoang Mai NT, Nghia HD, Chau TT, Loc PP, Thai le H, Phuong TM, Thai CQ, Man DN, Van Vinh Chau N, Nga TV, Campbell J, Baker S, Whitehorn J.
Lancet . 2013 Jan 12;381(9861):176. doi: 10.1016/S0140-6736(12)61730-9. No abstract available.
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Assessing the risk of primary amoebic meningoencephalitis from swimming in the presence of environmental Naegleria fowleri.
Cabanes PA, Wallet F, Pringuez E, Pernin P.
Appl Environ Microbiol . 2001 Jul;67(7):2927-31.
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Isolation and molecular typing of Naegleria fowleri from the brain of a cow that died of primary amebic meningoencephalitis.
Visvesvara GS, De Jonckheere JF, Sriram R, Daft B.
J Clin Microbiol . 2005 Aug;43(8):4203-4.
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Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan.
Shakoor S, Beg MA, Mahmood SF, Bandea R, Sriram R, Noman F, Ali F, Visvesvara GS, Zafar A.
Emerg Infect Dis . 2011 Feb;17(2):258-61. doi: 10.3201/eid1702.100442.
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Seasonal meningoencephalitis in Holstein cattle caused by Naegleria fowleri.
Daft BM, Visvesvara GS, Read DH, Kinde H, Uzal FA, Manzer MD.
J Vet Diagn Invest . 2005 Nov;17(6):605-9.
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Primary Amebic Meningoencephalitis Associated with Hot Spring Exposure During International Travel - Seminole County, Florida, July 2014.
Booth PJ, Bodager D, Slade TA, Jett S.
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Use of organs for transplantation from a donor with primary meningoencephalitis due to Naegleria fowleri.
Bennett WM, Nespral JF, Rosson MW, McEvoy KM.
Am J Transplant . 2008 Jun;8(6):1334-5. doi: 10.1111/j.1600-6143.2008.02217.x. Epub 2008 Apr 29.
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Primary amebic meningoencephalitis deaths associated with sinus irrigation using contaminated tap water.
Yoder JS, Straif-Bourgeois S, Roy SL, Moore TA, Visvesvara GS, Ratard RC, Hill VR, Wilson JD, Linscott AJ, Crager R, Kozak NA, Sriram R, Narayanan J, Mull B, Kahler AM, Schneeberger C, da Silva AJ, Poudel M, Baumgarten KL, Xiao L, Beach MJ.
Clin Infect Dis . 2012 Nov;55(9):e79-85. doi: 10.1093/cid/cis626. Epub 2012 Aug 22.
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Excretory and Secretory Proteins of Naegleria fowleri Induce Inflammatory Responses in BV-2 Microglial Cells.
Lee J, Kang JM, Kim TI, Kim JH, Sohn HJ, Na BK, Shin HJ.
J Eukaryot Microbiol . 2017 Mar;64(2):183-192. doi: 10.1111/jeu.12350. Epub 2016 Aug 23.
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Naegleria meningitis: a rare survival.
Jain R, Prabhakar S, Modi M, Bhatia R, Sehgal R.
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