Forooghian Farzin, Cheung Roy K, Smith W Clay, O'Connor Paul, Dosch Hans-Michael
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.
J Clin Immunol. 2007 Jul;27(4):388-96. doi: 10.1007/s10875-007-9091-1. Epub 2007 Apr 10.
Although myelin autoimmunity is known to be a major factor in the pathogenesis of multiple sclerosis (MS), the role of nonmyelin antigens is less clear. Given the complexity of this disease, it is possible that autoimmunity against nonmyelin antigens also has a pathogenic role. Autoantibodies against enolase and arrestin have previously been reported in MS patients. The T-cell response to these antigens, however, has not been established.
Thirty-five patients with MS were recruited, along with thirty-five healthy controls. T-cell proliferative responses against non-neuronal enolase, neuron-specific enolase (NSE), retinal arrestin, beta-arrestin, and myelin basic protein were determined.
MS patients had a greater prevalence of positive T-cell proliferative responses to NSE, retinal arrestin, and beta-arrestin than healthy controls (p<0.0001). The proliferative response against NSE, retinal arrestin, and beta-arrestin correlated with the response against myelin basic protein (p < or = 0.004). Furthermore, the proliferative response against retinal arrestin was correlated to beta-arrestin (p<0.0001), whereas there was no such correlation between non-neuronal enolase and NSE (p = 0.23).
There is accumulating evidence to suggest that the pathogenesis of MS involves more than just myelin autoimmunity/destruction. Autoimmunity against nonmyelin antigens may be a component of this myriad of immunopathological events. NSE, retinal arrestin, and beta-arrestin are novel nonmyelin autoantigens that deserve further investigation in this respect. Autoimmunity against these antigens may be linked to neurodegeneration, defective remyelination, and predisposition to uveitis in multiple sclerosis. Further investigation of the role of these antigens in MS is warranted.
虽然已知髓鞘自身免疫是多发性硬化症(MS)发病机制中的一个主要因素,但非髓鞘抗原的作用尚不清楚。鉴于这种疾病的复杂性,针对非髓鞘抗原的自身免疫也可能具有致病作用。此前已有报道称MS患者体内存在针对烯醇化酶和抑制蛋白的自身抗体。然而,针对这些抗原的T细胞反应尚未得到证实。
招募了35例MS患者以及35名健康对照者。测定了针对非神经元烯醇化酶、神经元特异性烯醇化酶(NSE)、视网膜抑制蛋白、β-抑制蛋白和髓鞘碱性蛋白的T细胞增殖反应。
与健康对照者相比,MS患者对NSE、视网膜抑制蛋白和β-抑制蛋白的T细胞增殖反应阳性率更高(p<0.0001)。针对NSE、视网膜抑制蛋白和β-抑制蛋白的增殖反应与针对髓鞘碱性蛋白的反应相关(p≤0.004)。此外,针对视网膜抑制蛋白的增殖反应与β-抑制蛋白相关(p<0.0001),而非神经元烯醇化酶和NSE之间不存在这种相关性(p = 0.23)。
越来越多的证据表明,MS的发病机制不仅仅涉及髓鞘自身免疫/破坏。针对非髓鞘抗原的自身免疫可能是这一系列免疫病理事件的一个组成部分。NSE、视网膜抑制蛋白和β-抑制蛋白是新的非髓鞘自身抗原,在这方面值得进一步研究。针对这些抗原的自身免疫可能与MS中的神经退行性变、髓鞘再生缺陷和葡萄膜炎易感性有关。有必要进一步研究这些抗原在MS中的作用。