The trigeminovascular system in bacterial meningitis.
Headache as a cardinal symptom of acute meningitis reflects activation of trigeminal afferents from the meninges. With their perivascular endings, these fibers form the so-called trigeminovascular system (TVS), which releases proinflammatory neuropeptides upon nociceptive stimulation. In the present article, we review a role of the TVS in enhancing the early inflammatory response of bacterial meningitis. Furthermore, we discuss inhibition of neuropeptide release from the TVS using 5HT(1B/D) agonists as a potential new anti-inflammatory treatment strategy for early bacterial meningitis.
Hoffmann
O
O
Department of Neurology, Universitaetsklinikum Charité, Humboldt University Berlin, 10098 Berlin, Germany.
Dirnagl
U
U
Weber
J R
JR
D000344:Afferent Pathways / Q000503:physiopathology; D000818:Animals; D006261:Headache / Q000503:physiopathology; D006801:Humans; D008578:Meninges / Q000098:blood supply* / Q000503:physiopathology; D016920:Meningitis, Bacterial / Q000503:physiopathology*; D020078:Neurogenic Inflammation / Q000503:physiopathology*; D009479:Neuropeptides / Q000037:antagonists & inhibitors / Q000378:metabolism; D014276:Trigeminal Nerve / Q000503:physiopathology*
D009479:Neuropeptides