Vaccination and infection as causative factors in Japanese patients with Rasmussen syndrome: molecular mimicry and HLA class I.
Rasmussen syndrome is an intractable epilepsy with a putative causal relation with cellular and humoral autoimmunity. Almost half of the patients have some preceding causative factors, with infections found in 38.2%, vaccinations in 5.9% and head trauma in 8.9% of Japanese patients. In a patient with seizure onset after influenza A infections, cross-reaction of the patient's lymphocytes with GluR epsilon 2 and influenza vaccine components was demonstrated by lymphocyte stimulation test. Database analyses revealed that influenza A virus hemagglutinin and GluR epsilon 2 molecules contain peptides with the patient's HLA class I binding motif (HLA - A*0201). The relative risks of HLA class I genotypes for Rasmussen syndrome are 6.1 (A*2402), 6.4 (A*0201), 6.3 (A*2601) and 11.4 (B*4601). The relative risks of HLA class I-A and B haplotypes are infinity (A*2601 + B*5401), 21.1 (A*2402 + B*1501), 13.3 (A*2402 + B*4801) and 5.1 (A*2402 + B*5201). Some alleles and haplotypes of HLA class I may be the risk factors in Japanese patients. Cross-reactivity of cytotoxic T lymphocytes may contribute to the processes leading from infection to the involvement of CNS.
Takahashi
Yukitoshi
Y
National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama Aoi-ku, Shizuoka 420-8688, Japan. takahashi-ped@umin.ac.jp
Matsuda
Kazumi
K
Kubota
Yuko
Y
Shimomura
Jiro
J
Yamasaki
Etsuko
E
Kudo
Tatsuya
T
Fukushima
Katsuyuki
K
Osaka
Hitoshi
H
Akasaka
Noriyuki
N
Imamura
Atsushi
A
Yamada
Shinji
S
Kondo
Naomi
N
Fujiwara
Tateki
T
D004660:Encephalitis / Q000209:etiology* / Q000235:genetics*; D015395:Histocompatibility Antigens Class I / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007564:Japan; D018716:Molecular Mimicry; D014611:Vaccination / Q000009:adverse effects*
D015395:Histocompatibility Antigens Class I