CSF and serum immune parameters in Sydenham's chorea: evidence of an autoimmune syndrome?

被引:57
作者
Church, AJ
Dale, RC
Cardoso, F
Candler, PM
Chapman, MD
Allen, ML
Klein, NJ
Lees, AJ
Giovannoni, G
机构
[1] Inst Neurol, Neuroinflammat Dept, Neuroimmunol Unit, London WC1N 3BG, England
[2] Inst Child Hlth, Neurosci Unit, London, England
[3] Univ Fed Minas Gerais, Dept Psychiat & Neurol, Belo Horizonte, MG, Brazil
[4] Inst Child Hlth, Immunobiol Unit, London, England
[5] UCL Royal Free & Univ Coll Hosp Med Sch, Rita Lila Weston Inst Neurol Studies, London, England
关键词
Sydenham's chorea; cytokines; IL-4; anti-basal ganglia antibodies; oligoclonal bands;
D O I
10.1016/S0165-5728(03)00012-2
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Previous investigations have suggested that Sydenham's chorea (SC) may be an autoantibody mediated disorder. We examined this autoimmune hypothesis by measuring Th1 (IFN-gamma, IL-12) and Th2 (IL-4, IL-10) cytokines, oligoclonal bands (OCB) and anti-basal ganglia antibodies (ABGA). CSF IL-4 was elevated in 31% of acute SC and 50% of persistent SC. CSF IL-10 was also elevated in 31% of acute SC but 0% of persistent SC. CSF IFN-gamma was undetectable in all patients. Serums IL-4, IL-10 and IL-12 were elevated in acute compared to persistent SC. OCB were found in 46% of acute SC, ABGA were in 93% of acute SC and 50% of persistent SC was of IgG(1) and IgG(3) subclass. These findings support an autoantibody pathogenesis. (C) 2003 Elsevier Science B.V. All rights reserved.
引用
收藏
页码:149 / 153
页数:5
相关论文
共 13 条
[1]   Anti-basal ganglia antibodies in acute and persistent Sydenham's chorea [J].
Church, AJ ;
Cardoso, F ;
Dale, RC ;
Lees, AJ ;
Thompson, EJ ;
Giovannoni, G .
NEUROLOGY, 2002, 59 (02) :227-231
[2]   GUIDELINES FOR THE DIAGNOSIS OF RHEUMATIC-FEVER - JONES CRITERIA, 1992 UPDATE [J].
DAJANI, AS ;
AYOUB, E ;
BIERMAN, FZ ;
BISNO, AL ;
DENNY, FW ;
DURACK, DT ;
FERRIERI, P ;
FREED, M ;
GERBER, M ;
KAPLAN, EL ;
KARCHMER, AW ;
MARKOWITZ, M ;
RAHIMTOOLA, SH ;
SHULMAN, ST ;
STOLLERMAN, G ;
TAKAHASHI, M ;
TARANTA, A ;
TAUBERT, KA ;
WILSON, W .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1992, 268 (15) :2069-2073
[3]   Poststreptococcal acute disseminated encephalomyelitis with basal ganglia involvement and auto-reactive antibasal ganglia antibodies [J].
Dale, RC ;
Church, AJ ;
Cardoso, F ;
Goddard, E ;
Cox, TC ;
Chong, WK ;
Williams, A ;
Klein, NJ ;
Neville, BG ;
Thompson, EJ ;
Giovannoni, G .
ANNALS OF NEUROLOGY, 2001, 50 (05) :588-595
[4]   CORTICOSTEROIDS IN TREATMENT OF SYDENHAMS CHOREA [J].
GREEN, LN .
ARCHIVES OF NEUROLOGY, 1978, 35 (01) :53-54
[5]   Anti-striatal antibodies in Tourette syndrome cause neuronal dysfunction [J].
Hallett, JJ ;
Harling-Berg, CJ ;
Knopf, PM ;
Stopa, EG ;
Kiessling, LS .
JOURNAL OF NEUROIMMUNOLOGY, 2000, 111 (1-2) :195-202
[6]   ANTIBODIES REACTING WITH CYTOPLASM OF SUBTHALAMIC AND CAUDATE NUCLEI NEURONS IN CHOREA AND ACUTE RHEUMATIC-FEVER [J].
HUSBY, G ;
VANDERIJN, I ;
ZABRISKIE, JB ;
ABDIN, ZH ;
WILLIAMS, RC .
JOURNAL OF EXPERIMENTAL MEDICINE, 1976, 144 (04) :1094-1110
[7]  
KIESSLING LS, 1993, PEDIATRICS, V92, P39
[8]   Antineuronal antibodies in rheumatic chorea [J].
Kotby, AA ;
El Badawy, N ;
El Sokkary, S ;
Moawad, H ;
El Shawarby, M .
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY, 1998, 5 (06) :836-839
[9]  
Mittleman BB, 1997, ADV EXP MED BIOL, V418, P933
[10]   Therapeutic plasma exchange and intravenous immunoglobulin for obsessive-compulsive disorder and tic disorders in childhood [J].
Perlmutter, SJ ;
Leitman, SF ;
Garvey, MA ;
Hamburger, S ;
Feldman, E ;
Leonard, HL ;
Swedo, SE .
LANCET, 1999, 354 (9185) :1153-1158