Guillain–Barré syndrome (GBS) is the most frequent cause of acute flaccid paralysis. Having seen my first GBS patient in 1989, I have since then dedicated my time in research towards understanding the pathogenesis of GBS. Along with several colleagues, we identified IgG autoantibodies against ganglioside GM1 in two patients with GBS subsequent to Campylobacter jejuni enteritis. We proceeded to demonstrate molecular mimicry between GM1 and bacterial lipo-oligosaccharide of C. jejuni isolated from a patient with GBS. Our group then established a disease model for GBS by sensitization with GM1 or GM1-like lipo-oligosaccharide. With this, a new paradigm that carbohydrate mimicry can cause autoimmune disorders was demonstrated, making GBS the first proof of molecular mimicry in autoimmune disease. Patients with Fisher syndrome, characterized by ophthalmoplegia and ataxia, can develop the disease after an infection by C. jejuni. We showed that the genetic polymorphism of C. jejuni sialyltransferase, an enzyme essential to the biosynthesis of ganglioside-like lipo-oligosaccharides determines whether patients develop GBS or Fisher syndrome. This introduces another paradigm that microbial genetic polymorphism can determine the clinical phenotype of human autoimmune diseases. Similarities between the clinical presentation of Fisher syndrome and Bickerstaff brainstem encephalitis have caused debate as to whether they are in fact the same disease. We demonstrated that IgG anti-GQ1b antibodies were common to both, suggesting that they are part of the same disease spectrum. We followed this work by clarifying the nosological relationship between the various clinical presentations within the anti-GQ1b antibody syndrome. In this review, I wanted to share my journey from being a clinician to a clinician-scientist in the hopes of inspiring younger clinicians to follow a similar path.
A method for the synthesis of carbohydrate chains (glycosaminoglycans) and their coupling to peptides was investigated using proteoglycans. Glycosidases generally catalyze a hydrolytic reaction, but can also mediate the reverse reaction, which in this case is a transglycosylation. In the transglycosylation reaction of bovine testicular hyaluronidase, which is an endoglycosidase, glycosaminoglycans (hyaluronan and chondroitin sulfates) release disaccharide (uronic acid-N-acetylhexosamine) moieties from non-reducing terminal sites, and then the liberated disaccharides are transferred immediately to the non-reducing termini of other glycosaminoglycan chains. Using such continuous reactions, it is possible to synthesize glycosaminoglycan chains according to a specific design. It then becomes possible to transfer glycosaminoglycan chains synthesized on a peptide to other peptides using the transglycosylation reaction of endo-β-xylosidase acting on the linkage region between a peptide and glycosaminoglycan chains of proteoglycans. We believe this approach will open a new field for the synthesis of homogeneous proteoglycans or their corresponding analogues.
Toward the expansion of the genetic alphabet of DNA, several artificial third base pairs (unnatural base pairs) have been created. Synthetic DNAs containing the unnatural base pairs can be amplified faithfully by PCR, along with the natural A–T and G–C pairs, and transcribed into RNA. The unnatural base pair systems now have high potential to open the door to next generation biotechnology. The creation of unnatural base pairs is a consequence of repeating “proof of concept” experiments. In the process, initially designed base pairs were modified to address their weak points. Some of them were artificially evolved to ones with higher efficiency and selectivity in polymerase reactions, while others were eliminated from the analysis. Here, we describe the process of unnatural base pair development, as well as the tests of their applications.
The concept of “stabilization” of atmospheric CO2 concentration is re-examined in connection with climate-change mitigation strategies. A new “zero-emissions stabilization (Z-stabilization)” is proposed, where CO2 emissions are reduced to zero at some time and thereafter the concentration is decreased by natural removal processes, eventually reaching an equilibrated stable state. Simplified climate experiments show that, under Z-stabilization, considerably larger emissions are permissible in the near future compared with traditional stabilization, with the same constraint on temperature rise. Over longer time scales, the concentration and temperature decrease close to their equilibrium values, much lower than those under traditional stabilization. The smaller temperature rise at final state is essential to avoid longer-term risk of sea level rise, a significant concern under traditional stabilization. Because of these advantages a Z-stabilization pathway can be a candidate of practical mitigation strategies as treated in Part 2.
Following Part 1, a comparison of CO2-emissions pathways between “zero-emissions stabilization (Z-stabilization)” and traditional stabilization is made under more realistic conditions that take into account the radiative forcings of other greenhouse gases and aerosols with the constraint that the temperature rise must not exceed 2 °C above the preindustrial level. It is shown that the findings in Part 1 on the merits of Z-stabilization hold under the more realistic conditions. The results clarify the scientific basis of the policy claim of 50% reduction of the world CO2 emissions by 2050. Since the highest greenhouse gas (GHG) concentration and temperature occur only temporarily in Z-stabilization pathways, we may slightly relax the upper limit of the temperature rise. We can then search for a scenario with larger emissions in the 21st century; such a scenario may have potential for practical application. It is suggested that in this Z-stabilization pathway, larger emissions in the near future may be important from a socioeconomic viewpoint.