Mitchell G W, Williams G S, Bosch E P, Hart M N
Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City 52242.
J Neurol Sci. 1991 Apr;102(2):170-6. doi: 10.1016/0022-510x(91)90065-f.
The expression of class II antigen was studied in sural nerve biopsies from patients with peripheral neuropathies. These included patients with chronic demyelinating polyradiculoneuropathy (CIDP), non-immune mediated neuropathies of diverse etiologies and controls without evidence of neuropathy. The major finding in CIDP was a marked increase in class II expression on Schwann cells. Endoneurial Schwann cell staining to the same degree as in CIDP was seen in diabetic symmetric proximal motor neuropathy, neuropathies associated with monoclonal gammopathies and hereditary sensory and autonomic neuropathy type 1. In the control nerves and the other non-immune mediated neuropathies class II expression was mainly restricted to endothelial and perineurial cells. Increased endoneurial expression of class II antigen was found to correlate with elevated cerebrospinal fluid (CSF) protein levels but not with other clinical variables or demyelination as defined by electrophysiologic criteria or teased fiber analysis. The increased expression of class II antigen on Schwann cells may be indicative of a breakdown in immunological tolerance but should not be used as a diagnostic marker for dysimmune neuropathies due to overlap with non-immune mediated neuropathies.
对周围神经病患者的腓肠神经活检组织中II类抗原的表达进行了研究。这些患者包括慢性脱髓鞘性多发性神经根神经病（CIDP）患者、病因多样的非免疫介导性神经病患者以及无神经病证据的对照者。CIDP的主要发现是施万细胞上II类抗原表达显著增加。在糖尿病性对称性近端运动神经病、与单克隆丙种球蛋白病相关的神经病以及遗传性感觉和自主神经病1型中，可见神经内膜施万细胞染色程度与CIDP相同。在对照神经和其他非免疫介导性神经病中，II类抗原表达主要局限于内皮细胞和神经束膜细胞。发现神经内膜II类抗原表达增加与脑脊液（CSF）蛋白水平升高相关，但与其他临床变量或根据电生理标准或 teased纤维分析定义的脱髓鞘无关。施万细胞上II类抗原表达增加可能表明免疫耐受破坏，但由于与非免疫介导性神经病存在重叠，不应将其用作免疫性神经病的诊断标志物。
