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抗神经节苷脂抗体与神经病变:我们的研究综述

Anti-ganglioside antibody and neuropathy: review of our research.

作者信息

Yuki N

机构信息

Department of Neurology, Dokkyo University School of Medicine, Tochigi, Japan.

出版信息

J Peripher Nerv Syst. 1998;3(1):3-18.

Abstract

Some patients developed Guillain-Barré syndrome (GBS) after the administration of bovine gangliosides. Patients with GBS subsequent to Campylobacter jejuni enteritis frequently have IgG antibody to GM1 ganglioside. Fisher's syndrome (FS), a variant of GBS, is associated with IgG antibody to GQ1b ganglioside. We showed the existence of molecular mimicry between GM1 and lipopolysaccharide (LPS) of C. jejuni isolated from a GBS patient, and that between GQ1b and C. jejuni LPSs from FS patients. Several lines of evidence suggest a pathogenic role for anti-ganglioside antibodies. Some patients developed sensorimotor polyneuropathy after anti-GD2 antibody administration. Anti-GM1 antibody can block motor nerve conduction. The molecular mimicry between infectious agents and gangliosides may function in the production of anti-ganglioside antibodies and the development of GBS and FS. Anti-GQ1b IgG antibody is detected also in Bickerstaff's brainstem encephalitis and acute ophthalmoparesis, which suggests that these conditions are categorized as autoimmune diseases related to FS. Since a tryptophan-immobilized column effectively adsorb anti-GQ1b IgG antibody, immunoadsorption with the column should be considered as an alternative form of plasmapheresis for the anti-GQ1b IgG antibody syndrome.

摘要

一些患者在使用牛神经节苷脂后出现了吉兰-巴雷综合征(GBS)。空肠弯曲菌肠炎后发生GBS的患者通常有针对GM1神经节苷脂的IgG抗体。费舍尔综合征(FS)是GBS的一种变体,与针对GQ1b神经节苷脂的IgG抗体有关。我们发现从一名GBS患者分离出的空肠弯曲菌的GM1与脂多糖(LPS)之间存在分子模拟,以及FS患者的GQ1b与空肠弯曲菌LPS之间存在分子模拟。多条证据表明抗神经节苷脂抗体具有致病作用。一些患者在使用抗GD2抗体后出现感觉运动性多发性神经病。抗GM1抗体可阻断运动神经传导。感染因子与神经节苷脂之间的分子模拟可能在抗神经节苷脂抗体的产生以及GBS和FS的发生中起作用。在比克斯特法夫脑干脑炎和急性眼肌麻痹中也检测到抗GQ1b IgG抗体,这表明这些病症可归类为与FS相关联的自身免疫性疾病。由于色氨酸固定柱能有效吸附抗GQ1b IgG抗体,对于抗GQ1b IgG抗体综合征,用该柱进行免疫吸附应被视为血浆置换的一种替代形式。

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