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[寨卡病毒与吉兰-巴雷综合征]

[Zika Virus and Guillain-Barré Syndrome].

作者信息

Koike Haruki

机构信息

Nagoya University Graduate School of Medicine.

出版信息

Brain Nerve. 2018 Feb;70(2):113-120. doi: 10.11477/mf.1416200963.

Abstract

Recent studies revealed an association between Zika virus infection and a variety of neurological disorders, including microcephaly, meningoencephalitis, myelitis, and Guillain-Barré syndrome (GBS). Following the first report of a patient diagnosed with GBS after Zika virus infection in December 2013, the number of GBS patients significantly increased in endemic countries, such as French-Polynesia and Latin American countries. Electrophysiological studies suggested that patients suffering from GBS associated with Zika virus infection manifest acute inflammatory demyelinating polyneuropathy (AIDP), rather than acute motor axonal neuropathy (AMAN). Causative autoantibodies, such as the anti-ganglioside antibodies in AMAN associated with Campylobacter jejuni infection, have not been identified in GBS associated with Zika virus infection. However, a recent study revealed a high level of peptide sharing between Zika virus polyprotein and human proteins related to myelin, demyelination, and axonal neuropathies. Additionally, another study reported significant peptide overlap between Zika virus and Cytomegalovirus, which is also related to microcephaly and AIDP. Further reserch is needed to elucidate the pathogenesis of GBS associated with Zika virus infection.

摘要

最近的研究揭示了寨卡病毒感染与多种神经系统疾病之间的关联,包括小头畸形、脑膜脑炎、脊髓炎和吉兰-巴雷综合征(GBS)。2013年12月首次报告了一名寨卡病毒感染后被诊断为GBS的患者,在法属波利尼西亚和拉丁美洲国家等流行国家,GBS患者数量显著增加。电生理研究表明,患有与寨卡病毒感染相关的GBS的患者表现为急性炎症性脱髓鞘性多发性神经病(AIDP),而非急性运动轴索性神经病(AMAN)。在与寨卡病毒感染相关的GBS中,尚未发现诸如与空肠弯曲菌感染相关的AMAN中的抗神经节苷脂抗体等致病性自身抗体。然而,最近的一项研究揭示了寨卡病毒多聚蛋白与人类髓鞘、脱髓鞘和轴索性神经病相关蛋白之间存在高水平的肽共享。此外,另一项研究报告称,寨卡病毒与巨细胞病毒之间存在显著的肽重叠,而巨细胞病毒也与小头畸形和AIDP有关。需要进一步研究以阐明与寨卡病毒感染相关的GBS的发病机制。

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