Vaccination and infection as causative factors in Japanese patients with Rasmussen syndrome: molecular mimicry and HLA class I.
Vaccination and infection as causative factors in Japanese patients with Rasmussen syndrome: molecular mimicry and HLA class I.
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DOI：
10.1080/17402520600589522
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发表时间：
2006-06
影响因子：
--
通讯作者：
Fujiwara, Tateki
中科院分区：
文献类型：
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作者：
Takahashi, Yukitoshi;Matsuda, Kazumi;Kubota, Yuko;Shimomura, Jiro;Yamasaki, Etsuko;Kudo, Tatsuya;Fukushima, Katsuyuki;Osaka, Hitoshi;Akasaka, Noriyuki;Imamura, Atsushi;Yamada, Shinji;Kondo, Naomi;Fujiwara, Tateki
拉斯穆森综合征是一种顽固性癫痫，其病因可能与细胞和体液自身免疫有关。几乎一半的患者有一些先前的致病因素，38.2%的日本患者感染，5.9%的日本患者接种疫苗，8.9%的日本患者头部受伤。在1例甲型流感感染后癫痫发作的患者中，通过淋巴细胞刺激试验，患者的淋巴细胞与Glurε2和流感疫苗组分发生交叉反应。数据库分析显示，甲型流感病毒血凝素和GluRε2分子含有与患者的HLAI类结合基序(HLAHLAHLA0201)的多肽。A*2402、6.4(A*0201)、6.3(A*2601)和11.4(B*4601)是Rasmussen综合征的相对危险度。HLAI-A和B类单倍型的相对危险度分别为无穷大(A*2601+B*5401)、21.1(A*2402+B*1501)、13.3(A*2402+B*4801)和5.1(A*2402+B*5201)。部分HLAI类等位基因和单倍型可能是日本患者的危险因素。细胞毒性T淋巴细胞的交叉反应可能参与了从感染到中枢神经系统受累的过程。
Rasmussen syndrome is an intractable epilepsy with a putative causal relation with cellular and humoral autoimmunity. Almost half of the patients have some preceding causative factors, with infections found in 38.2%, vaccinations in 5.9% and head trauma in 8.9% of Japanese patients. In a patient with seizure onset after influenza A infections, cross-reaction of the patient's lymphocytes with GluRε2 and influenza vaccine components was demonstrated by lymphocyte stimulation test. Database analyses revealed that influenza A virus hemagglutinin and GluRε2 molecules contain peptides with the patient's HLA class I binding motif (HLA − A*0201). The relative risks of HLA class I genotypes for Rasmussen syndrome are 6.1 (A*2402), 6.4 (A*0201), 6.3 (A*2601) and 11.4 (B*4601). The relative risks of HLA class I-A and B haplotypes are infinity (A*2601+B*5401), 21.1 (A*2402+B*1501), 13.3 (A*2402+B*4801) and 5.1 (A*2402+B*5201). Some alleles and haplotypes of HLA class I may be the risk factors in Japanese patients. Cross-reactivity of cytotoxic T lymphocytes may contribute to the processes leading from infection to the involvement of CNS.