Staines Donald R
Gold Coast Public Health Unit, 10-12 Young Street, Southport 4215, Qld, Australia.
Med Hypotheses. 2004;62(5):653-7. doi: 10.1016/j.mehy.2004.01.004.
Sudden infant death syndrome (SIDS) remains a perplexing diagnosis with conflicting laboratory investigation and lack of a biologically plausible aetiology. Investigations into the endogenous vasoactive neuropeptides, including pituitary adenylate cyclase-activating polypeptide (PACAP) and vasoactive intestinal peptide (VIP) are revealing the critical role these substances have in homeostasis including thermo- and cardiovascular regulation. For example, studies in PACAP receptor-deficient mice have revealed sudden neonatal death attributed to respiratory control defects, possibly due to mutations in genes encoding components of PACAP signalling pathways. PACAP and VIP belong to the secretin/glucagon superfamily of hormones and function as vasoactive neuropeptides. They act as hormones, neurotransmitters, immune modulators and neurotrophes. They are readily catalysed to small peptide fragments. They and their binding sites are immunogenic and are known to be associated with a range of autoimmune conditions. Vasoactive neuropeptides have a known role in thermoregulation and deficiency states are associated with higher neonatal death rates in rats. PACAP plays a significant role in carbohydrate and lipid metabolism and impairment of functioning has potentially serious consequences. It is postulated PACAP and VIP receptors in brain may become compromised through autoimmune phenomena resulting in cardio-respiratory dysfunction and death. This paper discusses the potential role of certain vasoactive neuropeptides in causing autoimmune responses in susceptible infants predisposing them to SIDS.
婴儿猝死综合征（SIDS）仍然是一个令人困惑的诊断，实验室检查结果相互矛盾，且缺乏生物学上合理的病因。对内源性血管活性神经肽的研究，包括垂体腺苷酸环化酶激活多肽（PACAP）和血管活性肠肽（VIP），正在揭示这些物质在体内平衡中的关键作用，包括体温和心血管调节。例如，对PACAP受体缺陷小鼠的研究发现，新生儿猝死归因于呼吸控制缺陷，可能是由于编码PACAP信号通路成分的基因突变所致。PACAP和VIP属于促胰液素/胰高血糖素超家族激素，作为血管活性神经肽发挥作用。它们充当激素、神经递质、免疫调节剂和神经营养因子。它们很容易被催化成小肽片段。它们及其结合位点具有免疫原性，已知与一系列自身免疫性疾病有关。血管活性神经肽在体温调节中具有已知作用，缺乏状态与大鼠较高的新生儿死亡率有关。PACAP在碳水化合物和脂质代谢中起重要作用，功能受损可能会产生严重后果。据推测，大脑中的PACAP和VIP受体可能会因自身免疫现象而受损，导致心肺功能障碍和死亡。本文讨论了某些血管活性神经肽在易感婴儿中引发自身免疫反应，使其易患SIDS的潜在作用。
