1. S. pneumoniae adheres to endothelial cells by using PspC, which binds laminin and pIgR, enabling transcytosis across the endothelium.
S. pneumoniae adheres to endothelial cells by using PspC, which binds laminin and pIgR, enabling transcytosis across the endothelium. Once in the CSF, pneumococci multiply freely and release bacterial products such as LTA and Ply, which are recognized by TLR2 and TLR4 on circulating APCs. The subsequent release of proinflammatory cytokines and chemokines from macrophages and microglial cells results in upregulation of endothelial cell P- and E-selectin and ICAM (which binds MAC-1 on leukocytes), leading to increased neutrophil recruitment into the CSF.
Barry B. Mook-Kanamori et al. Clin. Microbiol. Rev. 2011; doi: /CMR