空肠弯曲菌诱发实验性周围神经病的免疫学机理的研究

目的　研究空肠弯曲菌（Ｃｊ）诱发实验性周围神经病的可能性和免疫学机理。方法　取经两株空肠弯曲菌反复亚临床感染的、经多种丝裂原刺激的大鼠外周血单个核细胞（ＰＢＭＣ） 上清液和新鲜血清，以未感染鼠ＰＢＭＣ上清液及血清作对照，分别对１８５ 只其他大鼠进行神经外膜下或静脉注射。７ 或１４ 天后取坐骨神经行组织学检查。结果　病变的神经原纤维呈典型的轴索变性和（ 或） 髓鞘脱失改变， 伴巨噬细胞和淋巴细胞浸润；经神经外膜下注射者，４２．５ ％ 神经原纤维病变，其中８０．８ ％ 为轴索变性，对照组仅３．１ ％ 原纤维损害（Ｐ＜ ０．０１） ；经静脉注射者，１９．９％ 神经原纤维病变，轴索变性和髓鞘脱失分别占２５．４％ 和７４．６％ ， 对照组无任何病变（０／４８０） ；两种菌型均显示相似的致病力。静脉注射ＰＢＭＣ上清液并不同时引起肝、肾和脑病变。经Ｃｊ 感染的大鼠的ＰＢＭＣ上清液ＩｇＧ 含量明显增加。结论　以Ｃｊ 反复亚临床感染大鼠的上清液和血清进行神经外膜下或静脉注射，均诱发周围神经病，并对周围神经组织有免疫学特异性。细胞和体液免疫皆参与其致病过程。

Experimental peripheral neuropathy induced by Campylobacter jejuni infection

Objective To induce experimental peripheral neuropathy by immunoreaction after Campylobacter jejuni (Cj) infection and explore their immune pathogenesis Methods PBMCs were taken from 21 Wistar rats that had been repeatedly injected with suspension of two Cj strains intraperitoneally The supernatants or fresh sera of the infected rats or control group were respectively injected perineurally and intravenously to totally 185 other rats (experimental group), and sacrificed on the 7th day after perineural injection and the 14th day after intravenous injection Histological examination of the sciatic nerves was performed microscopically and electron microscopically Results Typical axonal degeneration and demyelination were seen in most fibers with remarkable macrophage and lymphocyte infiltration in some severe damaged fascicles Pathological changes were identified in 42 5% teasing fibers after perineural injection Among them, 80 8% fibers had axonal degeneration, but in control group, only 3 1% of fibers were found damaged ( P <0 01) Pathological changes were found in 19 9% fibers after intravenous injection of PBMC supernatant, including 25 4% axonal degenerating and 74 6% demyelinating fibers No abnormality was found in control group Their livers, kidneys and brains of 10 rats were still normal although there were typical experimental neuropathies after intravenous injection of PBMC supernatant Conclusion Experimental neuropathy was successfully induced by immunoreaction after Cj infection Both cellular and humoral immunological pathogenesis were involved Immune specificity to peripheral nerves was well shown in the pathogenic process Axonal degeneration was much more often seen in the group injected with the PBMC supernatant perineurally than intravenously, indicating that local increase of pressure inside fascicles after perineurial injection probably plays a role in the pathogenesis of axonal degeneration