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Title: | Konzo risk factors, determinants and etiopathogenesis: what is new? A systematic review | Authors: | BAGUMA, Marius Nzabara, Fabrice Balemba, Ghislain Maheshe Malembaka, Espoir Bwenge Migabo, Christiane Mudumbi, Germain BITO, Virginie Cliff, Julie RIGO, Jean-Michel Chabwine, Joëlle Nsimire |
Issue Date: | 2021 | Publisher: | ELSEVIER | Source: | NEUROTOXICOLOGY, 85 , p. 54 -67 | Abstract: | Konzo is a toxico-nutritional upper motor neuron disease causing a spastic paraparesis in schoolchildren and childbearing women in some African countries. Almost a century since the first description of konzo, its underlying etiopathogenic mechanisms and causative agent remain unknown. This paper aims at refreshing the current knowledge of konzo determinants and pathogenesis in order to enlighten potential new research and management perspectives. Literature research was performed in PubMed and Web of Science databases according to the PRISMA methodology. Available data show that cassava-derived cyanide poisoning and protein malnutrition constitute two well-documented risk factors of konzo. However, observational studies have failed to demonstrate the causal relationship between konzo and cyanide poisoning. Thiocyanate, the current marker of choice of cyanide exposure, may underestimate the actual level of cyanide poisoning in konzo patients as a larger amount of cyanide is detoxified via other unusual pathways in the context of protein malnutrition characterizing these patients. Furthermore, the appearance of konzo may be the consequence of the interplay of several factors including cyanide metabolites, nutritional deficiencies, psycho-emotional and geo-environmental factors, resulting in pathophysiologic phenomena such as excitotoxicity or oxidative stress, responsible for neuronal damage that takes place at sparse cellular and/or subcellular levels. | Keywords: | Konzo;cassava;cyanide intoxication;malnutrition;motor neuron disease | Document URI: | http://hdl.handle.net/1942/34089 | ISSN: | 0161-813X | e-ISSN: | 1872-9711 | DOI: | 10.1016/j.neuro.2021.05.001 | ISI #: | 000672854600006 | Rights: | 2021 Elsevier B.V. All rights reserved. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2022 |
Appears in Collections: | Research publications |
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File | Description | Size | Format | |
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Accepted manuscript - NEUTOX-D-21-00038_R1.pdf | Peer-reviewed author version | 1.88 MB | Adobe PDF | View/Open |
Konzo risk factors, determinants and etiopathogenesis_ What is new_ A systematic review _ Elsevier Enhanced Reader.pdf Restricted Access | Published version | 8.15 MB | Adobe PDF | View/Open Request a copy |
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