Petratos S, Gonzales M E
Walter and Eliza Hall Institute of Medical Research, Department of Anatomical Pathology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Neuropathology. 2000 Dec;20(4):257-72. doi: 10.1046/j.1440-1789.2000.00356.x.
Of the eight clinically defined neuropathies associated with HIV infection, there is compelling evidence that acute and chronic inflammatory demyelinating polyneuropathy (IDPN) have an autoimmune pathogenesis. Many non-HIV infected individuals who suffer from sensory-motor nerve dysfunction have autoimmune indicators. The immunopathogenesis of demyelination must involve neuritogenic components in myelin. The various antigens suspected to play a role in HIV-seronegative IDPN include (i) P2 protein; (ii) sulfatide (GalS); (iii) various gangliosides (especially GM1); (iv) galactocerebroside (GalC); and (v) glycoproteins or glycolipids with the carbohydrate epitope glucuronyl-3-sulfate. These glycoproteins or glycolipids may be individually targeted, or an immune attack may be raised against a combination of any of these epitopes. The glycolipids, however, especially GalS, have recently evoked much interest as mediators of immune events underlying both non-HIV and HIV-associated demyelinating neuropathies. The present review outlines the recent research findings of antiglycolipid antibodies present in HIV-infected patients with and without peripheral nerve dysfunction, in an attempt to arrive at some consensus as to whether these antibodies may play a role in the immunopathogenesis of HIV-associated inflammatory demyelinating polyneuropathy.
在与HIV感染相关的8种临床定义的神经病变中，有确凿证据表明急性和慢性炎症性脱髓鞘性多发性神经病（IDPN）具有自身免疫发病机制。许多患有感觉运动神经功能障碍的非HIV感染个体都有自身免疫指标。脱髓鞘的免疫发病机制必定涉及髓鞘中的神经源性成分。怀疑在HIV血清阴性的IDPN中起作用的各种抗原包括：（i）P2蛋白；（ii）硫脂（半乳糖硫酸酯）；（iii）各种神经节苷脂（尤其是GM1）；（iv）半乳糖脑苷脂（GalC）；以及（v）带有碳水化合物表位葡糖醛酸基-3-硫酸酯的糖蛋白或糖脂。这些糖蛋白或糖脂可能被单独靶向，或者可能针对这些表位中的任何组合引发免疫攻击。然而，糖脂，尤其是半乳糖硫酸酯，最近作为非HIV和HIV相关脱髓鞘性神经病潜在免疫事件的介质引起了广泛关注。本综述概述了有或无周围神经功能障碍的HIV感染患者中抗糖脂抗体的最新研究发现，试图就是否这些抗体可能在HIV相关炎症性脱髓鞘性多发性神经病的免疫发病机制中起作用达成一些共识。
