In vivo Radiodetoxification of Salmonella minnesota Lipopolysaccharides with radio-labeled Leucine Enkephalin cures sensory polyneuropathy: A Case report
Keywords:
Radio-labeled Leucine Enkephalin, Lipopolysaccharides, Polyneuropathy, ParkinsonismAbstract
Background: Lipopolysaccharides (LPS) which are part of the outer cell wall of Gram negative bacteria can cause generalized inflammation, sepsis and septic shock with multiorgan failure. Other short and long term nuerological sequelae of LPS include polyneuropathy, encephalopathy and parkinsonism. The neurotransmitter and delta-opioid receptor agonist leucine enkephalin (Leu-enk) which has neuro- and cytoprotective action has been shown to stimulate dopaminergic neurons and reduce anti-LPS- antibody production of LPS-stimulated B-cells among other actions. This makes Leu-enk a potential agent for the treatment of LPS induced polyneuropathy and parkinsonism. This is the first case report of in vivo radiodetoxification of Salmonella minnesota lipopolysaccharides (LPS) in a patient with lipopolysaccharide-induced polyneuropathy, encephalopathy and parkinsonism 14 yrs after LPS- induced sepsis by a lab accident in 1995.
Methods: The case records and experience of the patient and a Review of relevant literature was utilised.
Results: The long-term neurological sequelae of sepsis was treated with 1 micromol doses once to two times a week of radio-labeled leucine enkephalin in a 37 years old female patient, with a 14 year history of lipopolysaccharide- induced polyneuropathy, encephalopathy and parkinsonism after LPS-induced sepsis by a lab accident in 1995.
Electroneurography studies were performed before and after the treatment as well as positron emission tomographies of the cerebral cortex and of the striatum. Lipopolysaccharides were also measured via Limulus Lysate Assay of the cerebrospinal fluid and Fourier transform infrared spectroscopy analysis of the blood. The patient experienced remarkable improvement in both sensory and parkinsonian symptoms with the restoration of sustained sensory action potentials in the sensory nerves as shown by electroneurography studies indicative of cure of sensory polyneuropathy.
Conclusion: Radio labelled leucine enkephalin (leu-enk), is effective in treating the acute and chronic polynueropathy and parkinsonsian features of gram negative sepsis as shown in this fisrt case report of its use. Lue-enk effects results from various mechanisms which lead to reduced nueroinflammtion and improved cerebral blood and lymphatic flow in addition to other moloeular actions.
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