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狂犬病疫苗接种所致格林-巴利综合征的免疫学研究。

Immunologic studies of rabies vaccination-induced Guillain-Barré syndrome.

作者信息

Hemachudha T, Griffin D E, Chen W W, Johnson R T

机构信息

Department of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand.

出版信息

Neurology. 1988 Mar;38(3):375-8. doi: 10.1212/wnl.38.3.375.

Abstract

Patients with Guillain-Barré syndrome (GBS) induced by rabies vaccines prepared from either suckling mouse brain (SMB) or mature sheep brain (Semple vaccine) and patients with sporadic, idiopathic GBS were studied for antibody to myelin basic protein (MBP), P2 protein, and Schwann cells. Sera from all four Semple vaccine- and one of five SMB vaccine-induced GBS patients, but none of the sporadic GBS patients, had antibody to MBP. Sera from Semple vaccinees also had antibody to fixed, transformed Schwann cells, but similar amounts of antibody were found in sera from Semple vaccinees with CNS complications and with minor non-neurologic complications, suggesting that this antibody was not specifically linked to the development of polyneuritis. None of the sera had detectable antibody to P2 protein. We conclude that patients with GBS constitute a heterogeneous population and that different target antigens may serve as a focus for this presumed autoimmune disease.

摘要

对由乳鼠脑制备的狂犬病疫苗(SMB)或成熟羊脑制备的狂犬病疫苗(Semple疫苗)诱导的格林-巴利综合征(GBS)患者以及散发性特发性GBS患者,进行了针对髓鞘碱性蛋白(MBP)、P2蛋白和施万细胞抗体的研究。在所有4例Semple疫苗诱导的GBS患者和5例SMB疫苗诱导的GBS患者中的1例患者血清中发现了MBP抗体,但散发性GBS患者中均未发现。Semple疫苗接种者的血清中也存在针对固定化、转化型施万细胞的抗体,但在伴有中枢神经系统并发症和轻度非神经系统并发症的Semple疫苗接种者血清中发现了相似量的抗体,这表明该抗体与多发性神经炎的发生并无特异性关联。所有血清中均未检测到针对P2蛋白的抗体。我们得出结论,GBS患者构成一个异质性群体,不同的靶抗原可能是这种推测的自身免疫性疾病的发病焦点。

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