ジカウイルスとギラン・バレー症候群

Zika Virus and Guillain-Barré Syndrome

近年，ジカ熱の世界的な流行に伴いジカウイルスとギラン・バレー症候群（GBS）との関連が注目されるようになった。日本においてはジカ熱の流行は確認されていないものの，海外渡航からの帰国後に発症した患者が報告されている。ジカ熱に関連したGBSは脱髄型の病型を呈する場合が多く，治療は一般的なGBSに準じて行われている。発症の誘因となる自己抗体が明らかになっておらず，病態に関しては今後の研究課題である。

Abstract

Recent studies revealed an association between Zika virus infection and a variety of neurological disorders, including microcephaly, meningoencephalitis, myelitis, and Guillain-Barré syndrome (GBS). Following the first report of a patient diagnosed with GBS after Zika virus infection in December 2013, the number of GBS patients significantly increased in endemic countries, such as French-Polynesia and Latin American countries. Electrophysiological studies suggested that patients suffering from GBS associated with Zika virus infection manifest acute inflammatory demyelinating polyneuropathy (AIDP), rather than acute motor axonal neuropathy (AMAN). Causative autoantibodies, such as the anti-ganglioside antibodies in AMAN associated with Campylobacter jejuni infection, have not been identified in GBS associated with Zika virus infection. However, a recent study revealed a high level of peptide sharing between Zika virus polyprotein and human proteins related to myelin, demyelination, and axonal neuropathies. Additionally, another study reported significant peptide overlap between Zika virus and Cytomegalovirus, which is also related to microcephaly and AIDP. Further reserch is needed to elucidate the pathogenesis of GBS associated with Zika virus infection.