In Defense of the Brain: Current Concepts in the Immunopathogenesis and Clinical Aspects of Cns Infections - Hardcover

Hardcover

ISBN 10: 0865425558 ISBN 13: 9780865425552

Publisher: Wiley-Blackwell, 1997

Synopsis

In Defense of the Brain covers the most up-to-date topics in CNS infections, including bacterial meningitis, leukocyte migration, microglia, and other afflictions that affect the nervous system.

Co-authored by Jack Remington, author of the successful series Current Clinical Topics in Infectious Diseases, this book is written by leaders in the field of infectious disease.

About this title

From the Back Cover:

In Defense of the Brain covers the most up-to-date topics in CNS infections including bacterial meningitis, leukocyte migration, microglia and various other afflictions that affect the nervous system.

From The New England Journal of Medicine:

The purpose of In Defense of the Brain is clearly defined by the editors in their preface: "We asked the contributors to provide the reader a current understanding, at the molecular level, of the strategies used by the host to defend the brain." There is clearly a need for a book that summarizes the many recent advances in knowledge of the pathogenesis of infections of the central nervous system. The editors, however, were only partially successful in achieving their objective.

Unfortunately, for the infections in which understanding of immunopathogenesis is limited, the editors gave the chapter authors the option of stressing new concepts of treatment and prevention. This option allowed the editors to include discussions of toxoplasmosis, cystocercosis, cryptococcal meningitis, rabies, and prion diseases, but these provide little or no information about host defenses at the molecular level. By including such topics, the editors created a more complete "mini-textbook" on infections of the central nervous system at the expense of obscuring their primary objective. These chapters could have been omitted, because the information included in them is available in any recent infectious-disease textbook.

As in many multiauthored books, repetition is a problem: the anatomy of the blood-brain barrier is discussed in chapters 1, 2, and 6; the cytokines released during infections of the central nervous system are described in chapters 4, 5, and 7. The first eight chapters also do not seem to be in the most appropriate sequence. Chapters 1, 2, 6, 7, and 8 discuss the pathogenesis of bacterial meningitis. Interpolated between chapters 2 and 6 are chapters on microglia, defenses against viral and parasitic infections, and glia-mediated neurotoxicity. The reader interested in bacterial meningitis would do well to read the chapters in the sequence 1, 6, 7, 8, 2, 3, and 5.

The initial eight chapters on bacterial meningitis and on the role of microglia in defending the brain clearly succeed in providing the reader with an up-to-date review of the strategies used by the host to defend the brain against infection. Each of the remaining 12 chapters is devoted to a specific pathogen. Unfortunately, because so little is known about pathogenesis at the molecular level for some of the pathogens discussed in the book, almost half the chapters cannot meet the primary objective of the editors. In the remainder, there is considerable repetition of the earlier descriptions of cytokines and cellular elements involved in host defenses.

Given the high quality of the writing overall, it is unfortunate that the index is so unhelpful. Important topics missing from the index include outer membrane protein, pili, fimbria, adhesins, and bacterial polysaccharide capsules. Some authors cited in the text are indexed, but others are not, without any obvious reason. Thus, the index fails to function either as a topical index or as an authors' index.

This book will be of interest to specialists, whether in infectious diseases, microbiology, or neurology. A major attraction for such readers will be the excellent bibliographies. All the articles are up to date through early 1996. The book is much too detailed and too expensive for the general medical reader.

Reviewed by Ronald Gold, M.D., M.P.H.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About this edition

• Publisher: Wiley-Blackwell
• Publication date: 1997
• ISBN 10: 0865425558
• ISBN 13: 9780865425552
• Binding: Hardcover
• Edition number: 1
• Number of pages: 355
• Editor: Peterson Phillip K, Remington MD Jack S.