Guillain-Barré syndrome: expanding the concept of molecular mimicry.

Guillain-Barré syndrome: expanding the concept of molecular mimicry.
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DOI:
10.1016/j.it.2022.02.003
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发表时间:
2022-04
影响因子:
16.8
通讯作者:
Jacobs, Bart C.
Jacobs, Bart C.
中科院分区:
医学1区
文献类型:
--
作者:
Laman, Jon D.;Huizinga, Ruth;Boons, Geert-Jan;Jacobs, Bart C.

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吉兰-巴利综合征 (GBS) 是一种快速进展的、单相的、具有潜在破坏性的人类免疫介导神经病。先前的感染会触发针对集中在人类周围神经中的神经节苷脂的交叉反应抗体的产生。 GBS 是由至少五种不同的常见细菌和病毒病原体引起的,这体现了多种微生物疾病因果关系的概念。该意见强调 GBS 是 B 细胞水平上真正的分子模拟的最有支持的例子。此外,我们认为,从机制上讲,单一和多重微生物碳水化合物表位诱导 IgM、IgA 和 IgG 亚类的方式挑战了 GBS 中胸腺依赖性 (TD) 与胸腺非依赖性 (TI) 抗体反应的经典概念。最后,我们讨论 GBS 如何成为推动其他抗体驱动的神经系统疾病的诊断和免疫治疗创新的典范。
Guillain-Barré syndrome (GBS) is a rapidly progressive, monophasic, and potentially devastating immune-mediated neuropathy in humans. Preceding infections trigger the production of cross-reactive antibodies against gangliosides concentrated in human peripheral nerves. GBS is elicited by at least five distinct common bacterial and viral pathogens, speaking to the notion of polymicrobial disease causation. This Opinion emphasizes that GBS is the best-supported example of true molecular mimicry at the B-cell level. Moreover, we argue that mechanistically, single and multiplexed microbial carbohydrate epitopes induce IgM, IgA, and IgG subclasses in ways that challenge the classic concept of thymus-dependent (TD) versus thymus-independent (TI) antibody responses in GBS. Finally, we discuss how GBS can be exemplary for driving innovation in diagnostics and immunotherapy for other antibody-driven neurological diseases.
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