■已经注意到急性COVID-19综合征和COVID-19疫苗接种后综合征之间的症状可能重叠。我们报告了在SARS-CoV-2感染或疫苗接种后表现类似中枢(CNS)或外周神经系统(PNS)的患者的配对描述,这表明在存在针对ACE2蛋白的抗独特型抗体的情况下,两者可能引发了类似的免疫介导的神经系统疾病。
■四名患者在SARS-CoV-2感染或接种疫苗后表现出重叠的神经系统表现:神经根炎,格林-巴利综合征,和MRI阴性脊髓炎,分别,分享抗ACE2抗体的阳性。针对AQP-4,MOG,GlyR,GAD,和两栖动物,中枢神经系统综合征的神经抗体,所有患者的PNS综合征的抗神经节苷脂抗体检测均为阴性。
■在从COVID-19感染中恢复的患者中检测到针对ACE2的抗独特型抗体,据推测,这种抗体可能介导SARS-CoV-2感染或接种疫苗后的不良事件,导致免疫系统针对表达ACE2的细胞(如神经元)的激活。我们的数据揭示了由SARS-CoV-2感染或疫苗接种引发的临床重叠综合征,分享抗ACE2抗体的阳性。他们的存在,在没有中枢神经系统或PNS受累的其他经典自身免疫标志物的情况下,表明它们可能在异常免疫反应的背景下发挥积极作用。
■针对ACE2的抗独特型抗体可能由SARS-CoV-2感染和疫苗接种引起,可能导致神经系统自身免疫表现。它们的致病作用,然而,还有待大规模论证,更结构化的研究。
UNASSIGNED: A potential overlap in symptoms between post-acute COVID-19 syndrome and post-COVID-19 vaccination syndrome has been noted. We report a paired description of patients presenting with similar manifestations involving the central (CNS) or peripheral nervous system (PNS) following SARS-CoV-2 infection or vaccination, suggesting that both may have triggered similar immune-mediated neurological disorders in the presence of anti-idiotype antibodies directed against the ACE2 protein.
UNASSIGNED: Four patients exhibited overlapping neurological manifestations following SARS-CoV-2 infection or vaccination: radiculitis, Guillain-Barré syndrome, and MRI-negative myelitis, respectively, sharing positivity for anti-ACE2 antibodies. Autoantibodies against AQP-4, MOG, GlyR, GAD, and amphiphysin, onconeural antibodies for CNS syndromes, and anti-ganglioside antibodies for PNS syndromes tested negative in all patients.
UNASSIGNED: Anti-idiotype antibodies against ACE2 have been detected in patients who recovered from COVID-19 infection, and it has been hypothesized that such antibodies may mediate adverse events following SARS-CoV-2 infection or vaccination, resulting in the activation of the immune system against cells expressing ACE2, such as neurons. Our data reveal clinically overlapping syndromes triggered by SARS-CoV-2 infection or vaccination, sharing positivity for anti-ACE2 antibodies. Their presence, in the absence of other classic autoimmune markers of CNS or PNS involvement, suggests that they might play an active role in the context of an aberrant immune response.
UNASSIGNED: Anti-idiotype antibodies directed against ACE2 may be triggered by both SARS-CoV-2 infection and vaccination, possibly contributing to neurological autoimmune manifestations. Their pathogenic role, however, remains to be demonstrated in large-scale, more structured studies.