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寨卡病毒自身免疫与吉兰-巴雷综合征。

Zika autoimmunity and Guillain-Barré syndrome.

机构信息

Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Curr Opin Rheumatol. 2019 Sep;31(5):484-487. doi: 10.1097/BOR.0000000000000629.

Abstract

PURPOSE OF REVIEW

To summarize the recent data regarding Guillain-Barré syndrome (GBS) as an autoimmune disorder following infection with Zika virus (ZIKV) infection, including the proposed pathogenic mechanisms and the role of autoantibodies.

RECENT FINDINGS

The loss of self-tolerance that leads to autoimmune diseases is a multifactorial process that may be illustrated as 'the mosaic of autoimmunity'. Infectious agents may contribute to the development of autoimmunity by several proposed mechanisms. One of the central mechanisms is molecular mimicry, which is also the most plausible mechanism in the case of ZIKV-induced autoimmune disorders.A recent meta-analysis found a low prevalence of GBS associated with ZIKV infection. Nevertheless, the estimated cost of illness for patients with GBS associated with ZIKV are tremendous and exceed 4.7 million dollars per year in Brazil alone.

SUMMARY

Currently, there is sufficient data to indicate that ZIKV infection is one of many triggers and factors that may contribute to the development GBS. Thus, it is advised to evaluate and determine ZIKV exposure and infection in the management of potential GBS patients.

摘要

目的综述

总结寨卡病毒(ZIKV)感染后吉兰-巴雷综合征(GBS)作为一种自身免疫性疾病的最新数据,包括提出的发病机制和自身抗体的作用。

最近的发现

导致自身免疫性疾病的自身耐受丧失是一个多因素过程,可以用“自身免疫的镶嵌体”来表示。感染因子可能通过几种提出的机制导致自身免疫。其中一个中心机制是分子模拟,这也是 ZIKV 诱导的自身免疫性疾病最合理的机制。最近的一项荟萃分析发现,与 ZIKV 感染相关的 GBS 患病率较低。然而,与 ZIKV 相关的 GBS 患者的疾病总花费巨大,仅巴西每年就超过 470 万美元。

总结

目前,有足够的数据表明 ZIKV 感染是导致 GBS 发展的众多触发因素和因素之一。因此,建议在管理潜在 GBS 患者时评估和确定 ZIKV 暴露和感染。

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