Jacobs B C, Endtz H, van der Meché F G, Hazenberg M P, Achtereekte H A, van Doorn P A
Department of Neurology, University Hospital Dijkzigt, The Netherlands.
Ann Neurol. 1995 Feb;37(2):260-4. doi: 10.1002/ana.410370218.
Three patients who had diarrhea prior to the development of Miller Fisher syndrome are presented. Campylobacter jejuni was isolated from stool specimens from all patients. High titers of anti-GQ1b IgG antibodies were demonstrated in the serum of these patients by enzyme-linked immunosorbent assay and thin-layer chromatography overlay. In enzyme-linked immunosorbent assay inhibition studies the anti-GQ1b IgG antibodies bound specifically to whole bacteria of the Miller Fisher syndrome-associated C. jejuni strains. The presence of anti-GQ1b IgG binding epitopes on the surface of the C. jejuni from the patients was not exclusively associated with a specific Penner serotype. It is suggested that anti-GQ1b antibodies are formed during the initial infection that elicits Miller Fisher syndrome. The cross-reactivity of anti-GQ1b IgG antibodies with surface epitopes on Miller Fisher syndrome-associated C. jejuni strains supports the hypothesis of molecular mimicry between bacteria and neural tissue.
本文报告了3例在发生米勒-费希尔综合征之前出现腹泻的患者。所有患者的粪便标本中均分离出空肠弯曲菌。通过酶联免疫吸附测定和薄层色谱覆盖法在这些患者的血清中检测到高滴度的抗GQ1b IgG抗体。在酶联免疫吸附测定抑制研究中,抗GQ1b IgG抗体与米勒-费希尔综合征相关空肠弯曲菌菌株的全菌特异性结合。患者空肠弯曲菌表面抗GQ1b IgG结合表位的存在并不完全与特定的彭纳血清型相关。提示抗GQ1b抗体是在引发米勒-费希尔综合征的初始感染过程中形成的。抗GQ1b IgG抗体与米勒-费希尔综合征相关空肠弯曲菌菌株表面表位的交叉反应支持了细菌与神经组织之间分子模拟的假说。