Cuban Epidemic Neuropathy: Insights into the Toxic–Nutritional Hypothesis through International Collaboration
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| Natura: | Artículo científico |
| Lingua: | en |
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Medical Education Cooperation with Cuba
2018
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| _version_ | 1876460528664051712 |
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| author | Alina González-Quevedo Monteagudo |
| author_facet | Alina González-Quevedo Monteagudo |
| contents | Cuban Epidemic Neuropathy: Insights into the Toxic–Nutritional Hypothesis through International Collaboration Alina González-Quevedo Monteagudo Rosaralis Santiesteban-Freixas Janis T. Eells Lucimey Lima Alfredo A. Sadun Medicina Cuba Optic neuritis optic neuropathy disease outbreaks peripheral neuropathy From 1991 to 1993, an epidemic of optic and peripheral neuropathy— the largest of the century—broke out in Cuba, affecting more than 50,000 people. Initially the main clinical features were decreased visual acuity, central and cecocentral scotomas, impaired color vision and absence of the papillomacular bundle. Later, peripheral and mixed optic–peripheral forms began to appear. Due to the magnitude of the epidemic, the Cuban government requested help from the international community at the 46th World Health Assembly in 1993. PAHO and WHO immediately responded by sending a mission of international experts. Several hypotheses regarding the pathogenesis of Cuban epidemic neuropathy were put forward including: toxic, nutritional, genetic and infectious. The authors refer to extensive studies by researchers sponsored by the Cuban government and PAHO/WHO, joined by scientists from several other countries, including the USA. This paper describes their multidisciplinary work, particularly devoted to investigating the hypothesis of a primary toxic–nutritional cause of the epidemic. Clinical aspects, such as case de nition and clinical description, were vital issues from the start. Cuban physicians who rst examined patients received a clear impression of its toxic–nutritional origin, later con rmed by international experts. Research then focused on the mechanisms contributing to damage under the toxic–nutritional hypothesis. These included injuries to the mitochondrial oxidative phosphorylation pathway, nutritional de ciencies, excitotoxicity, formate toxicity and dysfunction of the blood–brain barrier. It was expected that the results of such international collaboration into this major health problem would also shed more light on mechanisms underlying other nutritional or tropical myeloneuropathies. 2018 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437577134014 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.2 Vol.20 |
| format | Artículo científico |
| id | redalyc_437577134014 |
| institution | Redalyc |
| language | en |
| publishDate | 2018 |
| publisher | Medical Education Cooperation with Cuba |
| spellingShingle | Cuban Epidemic Neuropathy: Insights into the Toxic–Nutritional Hypothesis through International Collaboration Alina González-Quevedo Monteagudo Medicina Cuba Optic neuritis optic neuropathy disease outbreaks peripheral neuropathy Cuban Epidemic Neuropathy: Insights into the Toxic–Nutritional Hypothesis through International Collaboration Alina González-Quevedo Monteagudo Rosaralis Santiesteban-Freixas Janis T. Eells Lucimey Lima Alfredo A. Sadun Medicina Cuba Optic neuritis optic neuropathy disease outbreaks peripheral neuropathy From 1991 to 1993, an epidemic of optic and peripheral neuropathy— the largest of the century—broke out in Cuba, affecting more than 50,000 people. Initially the main clinical features were decreased visual acuity, central and cecocentral scotomas, impaired color vision and absence of the papillomacular bundle. Later, peripheral and mixed optic–peripheral forms began to appear. Due to the magnitude of the epidemic, the Cuban government requested help from the international community at the 46th World Health Assembly in 1993. PAHO and WHO immediately responded by sending a mission of international experts. Several hypotheses regarding the pathogenesis of Cuban epidemic neuropathy were put forward including: toxic, nutritional, genetic and infectious. The authors refer to extensive studies by researchers sponsored by the Cuban government and PAHO/WHO, joined by scientists from several other countries, including the USA. This paper describes their multidisciplinary work, particularly devoted to investigating the hypothesis of a primary toxic–nutritional cause of the epidemic. Clinical aspects, such as case de nition and clinical description, were vital issues from the start. Cuban physicians who rst examined patients received a clear impression of its toxic–nutritional origin, later con rmed by international experts. Research then focused on the mechanisms contributing to damage under the toxic–nutritional hypothesis. These included injuries to the mitochondrial oxidative phosphorylation pathway, nutritional de ciencies, excitotoxicity, formate toxicity and dysfunction of the blood–brain barrier. It was expected that the results of such international collaboration into this major health problem would also shed more light on mechanisms underlying other nutritional or tropical myeloneuropathies. 2018 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437577134014 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.2 Vol.20 |
| title | Cuban Epidemic Neuropathy: Insights into the Toxic–Nutritional Hypothesis through International Collaboration |
| topic | Medicina Cuba Optic neuritis optic neuropathy disease outbreaks peripheral neuropathy |
| url | https://www.redalyc.org/articulo.oa?id=437577134014 |