Gorodezky C, Carranza J M, Bustamante A, Yescas P, Martinez A, Alonso Vilatela M E
Department of Immunogenetics, Instituto Nacional de Diagnostico y Referencia Epidemiologicos, Mexico City, Mexico.
Acta Otolaryngol. 1991;111(6):1070-4. doi: 10.3109/00016489109100758.
The etiology of Bell's palsy (BP) is still unknown, but infectious, immunological and genetic factors have been suggested to play a role in the pathogenesis of the disease. We analyzed blood samples of 92 Mexican Mestizo patients diagnosed as having BP according to established international criteria, and the results were compared to a group of apparently healthy controls of the same ethnic origin. HLA class I (A, B, C) and Class II (DR, DQ) products of the major histocompatibility complex (MHC), and the percentages of CD3, CD4 and CD8 T-cell subsets were investigated. The number of family antecedents was surprisingly high (46%), supporting a genetic basis. There was a slight increase of DRw13, suggesting a possible susceptibility class II-linked gene. A significant decrease of DR4 (pc = 0.001) was detected, which may indicate the existence of a resistance DR-linked gene. Thus, a non DR4 carrier may be in high risk of expressing BP. In the acute phase of the disease, the T-cell subsets showed a decrease in CD3 and CD4 cells when compared to controls. CD8 cells were increased in the same stage. A transient T-cell imbalance was thus observed which recovered in the convalescent phase. None of the patients with CD4 lower than 40% were DR4, suggesting that the DR-linked resistance gene may predispose to the T-cell defect.
贝尔麻痹（BP）的病因尚不清楚，但已有研究表明感染、免疫和遗传因素在该疾病的发病机制中起作用。我们分析了92例根据既定国际标准诊断为BP的墨西哥混血患者的血样，并将结果与一组相同种族来源的明显健康对照进行比较。研究了主要组织相容性复合体（MHC）的I类（A、B、C）和II类（DR、DQ）产物，以及CD3、CD4和CD8 T细胞亚群的百分比。家族病史的比例出奇地高（46%），支持遗传基础。DRw13略有增加，提示可能存在与II类相关的易感基因。检测到DR4显著降低（pc = 0.001），这可能表明存在与DR相关的抗性基因。因此，非DR4携带者可能有较高的BP发病风险。在疾病急性期，与对照组相比，T细胞亚群显示CD3和CD4细胞减少。同一阶段CD8细胞增加。因此观察到短暂的T细胞失衡，在恢复期恢复。CD4低于40%的患者均无DR4，提示与DR相关的抗性基因可能易导致T细胞缺陷。
