Читать книгу Neurology - Charles H. Clarke - Страница 79

T‐cell‐mediated disease is difficult to define, and targets of T‐cell receptors hard to isolate. These conditions are less reversible than B‐cell‐mediated disease:

 In paraneoplastic diseases there are T‐cytotoxic mechanisms of cell injury, such as with anti‐Hu, anti‐Yo and anti‐Ri.

 Cerebral and peripheral nerve vasculitis: the final path to tissue damage involves T‐cell infiltration.

 MS is the best‐described T‐cell disorder, but among the most mysterious. Whether the process of myelin and axonal destruction is a neurodegeneration, primarily autoimmune, and/or driven by some viral pathogen remains unknown.

 CIDP (Chronic Inflammatory Demyelinating Polyneuropathy) is an example of T‐cell‐mediated PNS disease. There are deficiencies in the autoimmune regulator protein AIRE, reduced T‐regulatory mechanisms, failure of Fas‐Fas ligand lymphocyte down‐regulation and mixed Th1 and Th2 cytokine profile up‐regulation, both in serum and endoneurium. B‐cell‐mediated pathways are also involved.