A rare but serious disease caused by flesh-eating bacteria has been studied, and researchers have identified the mechanism by which it progresses. This has lead them towards potentially effective treatments for it. You can read the full story here, at Newswise.

The disease, known as necrotising fasciitis, is caused by the bacterium Streptococcus pyogenes. This germ is usually associated with strep throat; a very common condition that causes a sore throat and fever. However, in rare cases, it can also lead to necrotising fasciitis. This disease is most commonly, but not always, caused by this bacterium, and affects about 1,200 people per year in the U.S. and 200,000 people annually worldwide. The infection breaks down muscle and connective tissue. However, the disease is very difficult to diagnose and treat, and the longer patients remain untreated the more deadly the disease can become. Necrotising fasciitis is thought to be fatal in approximately one-third of people, while other patients may need surgery or amputations.

However, the recent study, published in Cell, outlines new information about how the disease progresses and possible methods of halting its development. Researchers found that in mice models the bacterium uses the body’s immune neuronal signalling pathways to prevent an immune response.

Often when someone is injured, their nervous system will send two messages via neurones: one to the brain to elicit a pain response, and a second one to the immune system to stop it from sending out immune response cells. This is, counter-intuitively, often helpful because immune cells can actually worsen a tissue injury through inflammation. The bacterium S. pyogenes was found to exploit this process. In mice that were infected it caused these messages to be sent, which produced the intense pain reaction associated with necrotising fasciitis, and, significantly, prevented immune cells from acting at the site of damage. This lack of immune cells explains why patients with the disease rarely show inflammation with their pain. These messages mean that the body is unable to fight off the infection because an immune response is not activated.

The researchers also investigated possible ways to use this mechanism to limit the spread of infection. They found that by injecting mice with botulinum neurotoxin A (more commonly known as Botox), which blocks nerves, the infection could be contained in mice. It worked to stop disease development and prevent further tissue damage in mice that were injected before, immediately after, and two days after developing the disease. In another experiment, researchers blocked another molecule involved in the messaging process called CGRP. This was also found to successfully stop the infection.

Botox is currently used in several different medical treatments, including for migraines. CGRP blockers are also hoped to receive FDA approval as a migraine treatment shortly. Based on the research outlined here, it is thought that these two medicines will provide a new avenue of study for researchers looking for treatments of necrotising fasciitis.

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