Comment: Human papillomavirus vaccination, induced autoimmunity, and neuromyelitis optica

ArticleinNeurology 79(3):287 · June 2012with13 Reads
Impact Factor: 8.29 · DOI: 10.1212/WNL.0b013e31825fe10e · Source: PubMed


    Neuromyelitis optica (NMO) was initially thought be an aggressive subtype of multiple sclerosis (MS), but evidence suggests the majority of NMO phenotypes are rather due to autoimmunity against aquaporin 4 (AQP4).(e1,e2) Infection preceding a first attack of NMO may occur in up to 30% of seropositive cases, although no specific agent has been identified(1, e3); similarly, NMO may follow immunization but causality has not been established.(2, e4,e5) Association of infection or vaccination and autoimmunity is well described in other neuroinflammatory conditions such as Guillain-Barré syndrome (GBS) and acute disseminated encephalomyelitis.(e6,e7) Endogenous human proteins share sequence homology with microbial antigens, implicating molecular mimicry as the putative mechanism for immunologic crossreactivity and thus autoimmunity.