Anti-neuronal antibodies in patients with HCV-related mixed cryoglobulinemia
Anti-neuronal antibodies in patients with HCV-related mixed cryoglobulinemia
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DOI：
10.1016/j.autrev.2008.07.027
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发表时间：
2008-10-01
影响因子：
13.6
通讯作者：
Roccatello, D.
中科院分区：
文献类型：
--
作者：
Alpa, M.;Ferrero, B.;Roccatello, D.
混合性冷球蛋白血症(MC)是一种以免疫复合体介导的累及小血管的系统性血管炎为特征的免疫学疾病，可表现为肾脏、皮肤、风湿和/或神经症状。直到最近，在丙型肝炎病毒相关的IgMk/IgGMC相关的周围神经病中可能出现的抗神经元自身抗体还没有得到广泛的研究。因此，对这些患者中的一个样本进行了免疫酶标法的抗神经元自身抗体检测。观察到抗GM1神经节苷脂和抗硫脂的血浆效价显著升高。根据电生理学研究的评估，异常滴度与活动性神经病变的证据有关。虽然传统上认为周围神经病变是由于可冷沉淀免疫复合体沉积在血管神经中引起的轴突缺血损伤，但在丙型肝炎相关的混合lgMk/lgG冷球蛋白白血病中，观察到抗GM I和抗硫脂抗体与周围神经系统受累显著相关。抗神经元反应可能是这种疾病中神经损伤的直接触发因素。(C)2008年，爱思唯尔出版。
Mixed cryoglobulinemia (MC) is an immunological disorder characterized by immune-complex-mediated systemic vasculitis involving small vessels, which may present with renal, cutaneous, rheumatologic, and/or neurological manifestations. Until recently, the possible appearance of anti-neuronal autoantibodies in peripheral neuropathy occurring in the context of hepatitis C virus (HCV)-associated IgMk/IgG MC has not been extensively addressed. Therefore, a sample of these patients were evaluated by means of immuno-enzyme methods of anti-neuronal autoantibody detection. A significant increase in plasma titers of both anti-GM1 ganglioside and anti-sulfatide was observed. Abnormal titers were associated with evidence of active neuropathy as assessed by electrophysiologic studies. While peripheral neuropathy was traditionally thought to result from axonal ischemic damage caused by deposits of cryoprecipitable immune complexes in the vasa nervorum, a significant association between anti-GM I and anti-sulfatide antibodies and involvement of the peripheral nervous system was observed in HCV-associated mixed lgMk/lgG cryoglobulinemia.Anti-neuronal reactivity could be a direct trigger of neurologic injury in this disorder. (C) 2008 Published by Elsevier B.V.