Japanese

Pathomechanisms of Autoantibody Production against the Nervous System Kimiyoshi Arimura 1 1Okatsu Neurology and Rehabilitation Hospital Keyword: autoantibodies , immune-mediated neurological disorders , central tolerance , peripheral tolerance , innate immunity pp.323-332
Published Date 2013/4/1
DOI https://doi.org/10.11477/mf.1416101457
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Abstract

 In immune-mediated neurological disorders, the production of autoantibodies against the nervous system occurs mainly because of impaired immune tolerance. In myasthenia gravis (MG), the thymus shows pathologic alterations, particularly in anti-AChR antibody-positive patients. Further, resection of the thymus induces a clinical recovery. The MG thymus contains all the elements, including AChR antigens, AChR-specific T cells, and antigen-secreting B cells, that are required to initiate and sustain autoantibody production. Central tolerance, established by the repertoire selection of immature T lymphocytes in the thymus, is impaired in MG patients who are positive for anti-AChR antibodies. Recent evidence suggests that chronic inflammation elicited by viral infection is important for the production of AChR antibodies. Antibodies against ganglioside are crucial for the diagnosis of Guillain-Barré syndrome (GBS). Molecular mimicry between the lipooligosaccharides of Camplylobacter jejuni and gangliosides of the peripheral nerve causes the production of antibodies. However, less than 1 in 1000 patients infected with C. jejuni develop GBS. This fact suggests that some host factors might influence the production of antibodies. A recent hypothesis suggests that transient impairment of peripheral tolerance due to infection may play a crucial role in GBS pathogenesis. In summary, autoantibody production might correlate with the impairment of immune tolerance as well as with innate immunity.


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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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