摘要
视神经脊髓炎谱系疾病(NMOSD)是主要累及视神经、脊髓的抗原抗体介导多种细胞因子参与的中枢神经系统(CNS)炎性脱髓鞘疾病。致病性水通道蛋白4(AQP4)抗体广泛存在于星形胶质细胞足突,其与抗原结合后可引起补体激活和B细胞、T细胞中趋化因子、炎性细胞因子上调,进一步促进炎症反应。白细胞介素-6可促进B细胞激活,诱导辅助性T细胞(Th)极化和AQP4抗体产生,增强血脑屏障(BBB)通透性,促进CNS炎性细胞浸润。产气荚膜梭菌(CPs)过度生长可促使细胞向Th17分化,CPs通过影响Th17与调节性T细胞(Treg)之间的平衡参与NMOSD的发病机制。本文对NMOSD发病机制的研究进展进行综述,以期为NMOSD的诊治提供一定参考。
Neuromyelitis optica spectrum disorders(NMOSD) are a range of central nervous system(CNS)inflammatory demyelinating diseases which mainly involve the optic nerve and spinal cord. Antibody against aquaporin 4(AQP 4), a channel protein widely distributed in the astrocyte foot process, is found to be the cause of NMOSD. The combination of AQP4 antibody with antigen can cause complement activation, up-regulation of chemokines and inflammatory cytokines in B cells and T cells, and further promote inflammatory reaction. Interleukin-6 can promote B cell activation, induce Th cell polarization and AQP4 antibody production, which increase blood-brain barrier permeability and promote inflammatory cell infiltration in the central nervous system. Overgrowth of Clostridium perfringens(CPs) promotes cell differentiation into T helper cells 17, and CPS is involved in the pathogenesis of NMOSD by affecting the balance between Th17 and regulatory T cells(Treg). This paper reviewed the recent advances of pathogenesis of NMOSD, aiming to provide reference for the diagnosis and treatment of NMOSD.
作者
贾琳琳
蒋玙姝
张梦歌
马伟锋
张涛
李玮
JIA Linlin;JIANG Yushu;ZHANG Mengge;MA Weifeng;ZHANG Tao;LI Wei(Department of Neurology,Henan Provincial People′s Hospital of Xinxiang Medical University,Zhengzhou,Henan,450003;Department of Neurology,Zhengzhou University People′s Hospital,Henan Provincial People′s Hospital,Zhengzhou,Henan,450003)
出处
《实用临床医药杂志》
CAS
2022年第7期132-138,共7页
Journal of Clinical Medicine in Practice
基金
河南省医学科技攻关计划项目(SBGJ2018077)。
