醫(yī)學免疫學課件：急性運動軸索型神經(jīng)病和空腸彎曲桿菌感染

1、Acute motor axonal neuropathy and Campylobacter jejuniGuillainBarre syndrome Classifications of GBS Symptoms of GBS Campylobactor jejuni Pathogenesis TreatmentClassificationAcute inflammatory demyelinating polyneuropathy (AIDP)Acute motor axonal neuropathy (AMAN)Acute sensorimotor axonal neuropathy

2、(AMSAN)The Miller Fisher syndrome (MFS)/contents/guillain-barre-syndrome-in-adults-clinical-features-and-diagnosis?source=see_linkAxonal neuropathySymptoms MFS/watch?v=gMTIKcWmRgI ophthalmoplegia ataxia areflexia 1/4 extremity weaknessSymptomsWillison, H. J., Jacobs, B. C., & van Doorn, P. A. (2016)

3、. Guillain-Barr syndrome. The Lancet, 388(10045), 717-727. doi:10.1016/s0140-6736(16)00339-1Symptoms AIDP, AMAN, AMSAN progressive, symmetric weakness decreased or absent reflexes paresthesia pain dysautonomia/contents/guillain-barre-syndrome-in-adults-clinical-features-and-diagnosis?source=see_link

4、Symptoms AIDP, AMAN, AMSANWillison, H. J., Jacobs, B. C., & van Doorn, P. A. (2016). Guillain-Barr syndrome. The Lancet, 388(10045), 717-727. doi:10.1016/s0140-6736(16)00339-1PathogenesisCriteria for “molecular mimicry”1. epidemiological association between the infectious agent and immune-mediated d

5、isease2. identification of T cells or antibodies directed against the patients target antigens3. identification of microbial mimicry of the target antigen4. reproduction of the disease in an animal modelReview. Axonal Guillain-Barre syndrome: concepts and controversies. 2013, lancetCampylobacter jej

6、uniJawetz, Melnick & Adelbergs Medical Microbiology 26th (2013)Pathogenesis AMAN & C. jejuni 1. epidemiology associationKokubun, N., Shahrizaila, N., Koga, M., Hirata, K., & Yuki, N. (2013). The demyelination neurophysiological criteria can be misleading in Campylobacter jejuni-related Guillain-Barr

7、e syndrome. Clin Neurophysiol, 124(8), 1671-1679. doi:10.1016/j.clinph.2013.02.010/wiki/Nerve_conduction_study71-year-old womanPure motor symptoms Serum anti-ganglioside antibodyPathogenesis AMAN & C. jejuni 1. epidemiology associationKokubun, N., Shahrizaila, N., Koga, M., Hirata, K., & Yuki, N. (2

8、013). The demyelination neurophysiological criteria can be misleading in Campylobacter jejuni-related Guillain-Barre syndrome. Clin Neurophysiol, 124(8), 1671-1679. doi:10.1016/j.clinph.2013.02.010DML: distal motor latencyCMAP: compound muscle action potentialsPathogenesis AMAN & C. jejuni 1. epidem

9、iology associationKokubun, N., Shahrizaila, N., Koga, M., Hirata, K., & Yuki, N. (2013). The demyelination neurophysiological criteria can be misleading in Campylobacter jejuni-related Guillain-Barre syndrome. Clin Neurophysiol, 124(8), 1671-1679. doi:10.1016/j.clinph.2013.02.010Pathogenesis AMAN2.

10、anti-ganglioside antibodiesanti-GM1 antibodiesanti-GD1a antibodiesanti-GalNac-GD1a antibodiesanti-GD1b antibodies/contents/guillain-barre-syndrome-in-adults-clinical-features-and-diagnosis?source=see_linkPathogenesis AMANe.g., GBS autoantibodies vs. C. jejuni components (GM1 & C-Dps) Kawamura, N., P

11、iao, H., Minohara, M., Matsushita, T., Kusunoki, S., Matsumoto, H., . . . Kira, J. (2011). Campylobacter jejuni DNA-binding protein from starved cells in Guillain-Barre syndrome patients. J Neuroimmunol, 240-241, 74-78. doi:10.1016/j.jneuroim.2011.09.004Pathogenesis AMANe.g., GBS autoantibodies vs.

12、C. jejuni components (C-Dps) Kawamura, N., Piao, H., Minohara, M., Matsushita, T., Kusunoki, S., Matsumoto, H., . . . Kira, J. (2011). Campylobacter jejuni DNA-binding protein from starved cells in Guillain-Barre syndrome patients. J Neuroimmunol, 240-241, 74-78. doi:10.1016/j.jneuroim.2011.09.004Pa

13、thogenesis AMANe.g., GBS autoantibodies vs. C. jejuni components (GM1) Kawamura, N., Piao, H., Minohara, M., Matsushita, T., Kusunoki, S., Matsumoto, H., . . . Kira, J. (2011). Campylobacter jejuni DNA-binding protein from starved cells in Guillain-Barre syndrome patients. J Neuroimmunol, 240-241, 7

14、4-78. doi:10.1016/j.jneuroim.2011.09.004Pathogenesis AMANe.g., GBS autoantibodies vs. C. jejuni components (GM1) Cis (i.e. side-to-side) interactions Combinatorial glycoarrayKey:(1)Sphingomyelin,(2)Phosphatidylserine, (3)Globoside, (4)Cereamide trihexosides (CTH), (5) Sulfated glucuronyl paraglobosi

15、de (SGPG), (6)GM2, (7)GM3, (8)GD2, (9)GA1, (10)Galactocerebroside (GalC), (11)LM1, (12)GM1,(13)GD1a, (14)GD1b, (15)GD3, (16)GQ1b, (17)GT1b, (18)Sulfatide.Rinaldi, S., Brennan, K. M., Kalna, G., Walgaard, C., van Doorn, P., Jacobs, B. C., . . . Willison, H. J. (2013). Antibodies to heteromeric glycol

16、ipid complexes in Guillain-Barre syndrome. PLoS One, 8(12), e82337. doi:10.1371/journal.pone.0082337Pathogenesis AMAN3. LOSLOS & various ganglioside4. animal modelRabbit LOSGoodfellow, J. A., & Willison, H. J. (2016). Guillain-Barre syndrome: a century of progress. Nat Rev Neurol, 12(12), 723-731. d

17、oi:10.1038/nrneurol.2016.172Pathogenesis AMANGoodfellow, J. A., & Willison, H. J. (2016). Guillain-Barre syndrome: a century of progress. Nat Rev Neurol, 12(12), 723-731. doi:10.1038/nrneurol.2016.172Pathogenesis TLRRinaldi, S., Brennan, K. M., Kalna, G., Walgaard, C., van Doorn, P., Jacobs, B. C., . . . Willison, H. J. (2013). Antibodies to heteromeric glycolipid complexes in Guillain-Barre syndrome. PLoS One, 8(12), e82337. doi:10.1371/journal.pone.0082337Pathogenesis C. jejuniPhongsisay, V. (2016). The immunobiology of Campylobacter jejuni: Innate immunity