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兰德里氏综合征(1859年)以及格林-巴利-施特罗尔综合征(1916年)的病因。

The causes of the syndromes of Landry (1859) and of Guillain, Barré and Strohl (1916).

作者信息

Alvord E C, Jahnke U, Fischer E H

机构信息

Department of Pathology, University of Washington School of Medicine, Seattle 98195.

出版信息

Rev Neurol (Paris). 1987;143(8-9):571-9.

PMID:2445014
Abstract

Post-infectious and post-vaccinal peripheral neuritis or encephalomyelitis have frequently been considered the human equivalents of experimental allergic neuritis (EAN) or encephalomyelitis (EAE). The major basis for these comparisons between diseases in humans and experimental animals rests on the classical observations of "paralytic accidents" of Pasteur-type vaccination against rabies. These old observations in humans injected with brain tissue indicate a remarkable heterogeneity of periphéral as well as central nervous system syndromes, quite in contrast with the remarkable specificity for either peripheral or central involvement in most experimental animals. The syndromes of Landry (1859) and of Guillain, Barré and Strohl (1916) differ clinically and pathologically, the latter a purely peripheral neuritis and the former a mixture of transverse myelitis and facial neuritis. Each can be caused by many different factors, including 1) direct infection by wild or attenuated rabies virus, 2) direct auto-sensitization by myelin antigens in the vaccine and 3) indirect or cross-reactive sensitization by viral or bacterial antigenic determinants (epitopes) with sufficient chemical homology with aminoacid sequences in central or peripheral myelin antigens to be recognized as immunological homologies.

摘要

感染后和疫苗接种后周围神经炎或脑脊髓炎常被视为人类版的实验性变应性神经炎(EAN)或实验性变应性脑脊髓炎(EAE)。人类疾病与实验动物疾病之间进行这些比较的主要依据在于对狂犬病巴斯德型疫苗“麻痹性意外”的经典观察。这些对注射脑组织的人类的早期观察表明,外周以及中枢神经系统综合征存在显著的异质性,这与大多数实验动物中外周或中枢受累的显著特异性形成鲜明对比。朗德里(1859年)综合征和吉兰 - 巴雷 - 施特罗尔(1916年)综合征在临床和病理上有所不同,后者是单纯的周围神经炎,前者是横贯性脊髓炎和面部神经炎的混合。每一种都可能由许多不同因素引起,包括1)野生或减毒狂犬病病毒的直接感染,2)疫苗中髓磷脂抗原的直接自身致敏,以及3)病毒或细菌抗原决定簇(表位)与中枢或外周髓磷脂抗原中的氨基酸序列具有足够化学同源性而被识别为免疫同源物的间接或交叉反应致敏。

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