Correlation between Monocyte Gene Expression and Inflammation on Brain Imaging in Patients with Solitary Cerebral Cysticercus Granuloma

Betcy Evangeline Pamela Department of Neurological Sciences, Christian Medical College, Vellore, India;

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Subashini Thamizhmaran Department of Neurological Sciences, Christian Medical College, Vellore, India;

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Josephin Manoj Department of Neurological Sciences, Christian Medical College, Vellore, India;

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Anupriya Thanigachalam Department of Neurological Sciences, Christian Medical College, Vellore, India;

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Hélène Carabin Department of Pathology and Microbiology, University of Montreal, Canada;
Department of Social and Preventive Medicine, University of Montreal, Canada;
Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma;
Centre de Recherche en Santé Publique (CReSP), Montreal, Canada;
Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), Saint-Hyacinthe, Canada;

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Vasudevan Prabhakaran Department of Neurological Sciences, Christian Medical College, Vellore, India;

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Ranjith K. Moorthy Department of Neurological Sciences, Christian Medical College, Vellore, India;

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Anna Oommen Gudalur Adivasi Hospital, Gudalur, India;

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Douglas A. Drevets Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

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Vedantam Rajshekhar Department of Neurological Sciences, Christian Medical College, Vellore, India;

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ABSTRACT.

Prior work has shown that 14 monocyte genes are upregulated in patients with different forms of parenchymal neurocysticercosis, including solitary cysticercus granuloma (SCG). The aim of this study was to investigate whether changes in inflammation associated with SCG seen on follow-up brain imaging are also reflected in changes in expression of these 14 genes. Peripheral blood CD14+ monocytes were isolated from 20 patients with SCG at initial diagnosis and at clinical and imaging follow-up of 6 months or more. Expressions of 14 target monocyte genes were determined by quantitative polymerase chain reaction at each visit. At a median follow-up of 14 months, the SCG had resolved in 11 patients, was persistent in four patients, and had calcified in five patients. Edema seen in the initial imaging in 17 patients had resolved in 15 patients and was markedly reduced in two patients. The expression levels of the monocyte genes LRRFIP2, TAXIBP1, and MZB1 were significantly lower at follow-up, regardless of the status of SCG on follow-up imaging. Our findings show that expression levels of monocyte genes involved with inflammatory processes decrease in patients with SCG concomitant with follow-up imaging that reveals a reduction in inflammation as revealed by complete or near-complete resolution of edema, as well as resolution or reduction in the enhancement of the granuloma.

Author Notes

Financial support: This study was supported by a grant from the National Institute of Neurological Diseases and Stroke (Grant number R01N, S098891) (Multiple Principal Investigators: H. C., D. A. D., and V. R). H. C. is funded by the Canada Research Chair in Epidemiology and One Health (CRC 950-231857).

Authors’ addresses: Betcy Evangeline Pamela, Subashini Thamizhmaran, Josephin Manoj, Anupriya Thanigachalam, Vasudevan Prabhakaran, Ranjith K. Moorthy, and Vedantam Rajshekhar, Department of Neurological Sciences, Christian Medical College, Vellore, India, E-mails: betcyevangeline07@gmail.com, subatamil96@gmail.com, josephinjustinbabu86@gmail.com, anutc91@gmail.com, prabhakaran@cmcvellore.ac.in, ranjith@cmcvellore.ac.in, and rajshekhar@cmcvellore.ac.in. Hélène Carabin, Department of Pathology and Microbiology and Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada, Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, Centre de Recherche en Santé Publique (CReSP), Montreal, Canada, and Groupe de Recherche en Épidémiologie des Zoonoses et Santé Publique (GREZOSP), Saint-Hyacinthe, Canada, E-mail: helene.carabin@umontreal.ca. Anna Oommen, Gudalur Adivasi Hospital, Gudalur, India, E-mail: annasoommen@gmail.com. Douglas A. Drevets, Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, E-mail: Douglas-Drevets@ouhsc.edu.

Address correspondence to Douglas A. Drevets, Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, E-mail: douglas-drevets@ouhsc.edu or Vedantam Rajshekhar, Department of Neurological Sciences, Christian Medical College, Vellore 632004, Tamilnadu, India, E-mail: rajshekhar@cmcvellore.ac.in
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