title: Vaccination and infection as causative factors in Japanese patients with Rasmussen syndrome: molecular mimicry and HLA class I.
abstract: 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.
authors.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama Aoi-ku, Shizuoka 420-8688, Japan. takahashi-ped@umin.ac.jp
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Kazumi
authors.initials: K
authors.lastname: Matsuda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kubota
authors.forename: Jiro
authors.initials: J
authors.lastname: Shimomura
authors.forename: Etsuko
authors.initials: E
authors.lastname: Yamasaki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kudo
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Fukushima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Osaka
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Akasaka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Imamura
authors.forename: Shinji
authors.initials: S
authors.lastname: Yamada
authors.forename: Naomi
authors.initials: N
authors.lastname: Kondo
authors.forename: Tateki
authors.initials: T
authors.lastname: Fujiwara
mesh_terms: 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*
chemical_list: D015395:Histocompatibility Antigens Class I