{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:07:49Z","timestamp":1790885269660,"version":"4.1.0"},"reference-count":15,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health, Italy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>As reported by the World Health Organization (WHO), about 10\u201320% of people have experienced mid- to long-term effects following SARS-CoV-2 infection, collectively referred to as post-COVID-19 condition or long-COVID, including some neurovegetative symptoms. Numerous findings have suggested that the onset of these neurovegetative symptoms upon viral infection may be caused by the production of autoantibodies through molecular mimicry phenomena. Accordingly, we had previously demonstrated that 22 of the human proteins sharing putatively immunogenic peptides with SARS-CoV-2 proteins are expressed in the dorsal motor nucleus and nucleus ambiguous. Therefore, if molecular mimicry occurs following severe forms of COVID-19, there could be transitory or permanent damage in some vagal structures, resulting in a lower vagal tone and all the related clinical signs. We investigated the presence of autoantibodies against two proteins of vagal nuclei sharing a peptide with SARS-CoV-2 spike glycoprotein using an immunoassay test on blood obtained from patients with cardiorespiratory symptoms in patients affected by ongoing symptomatic COVID-19 (long-COVID), subjects vaccinated without a history of SARS-CoV-2 infection, and subjects not vaccinated without a history of SARS-CoV-2 infection. Interestingly, putative autoantibodies were present in both long-COVID-19 and vaccinated groups, opening interesting questions about pathogenic mechanisms of the disease.<\/jats:p>","DOI":"10.3390\/biology13060359","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T05:40:47Z","timestamp":1716270047000},"page":"359","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Autoimmunity against Nucleus Ambiguous Is Putatively Possible in Both Long-COVID-19 and Vaccinated Subjects: Scientific Evidence and Working Hypothesis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1986-1495","authenticated-orcid":false,"given":"Silvestro Ennio","family":"D\u2019Anna","sequence":"first","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-4309","authenticated-orcid":false,"given":"Alessandra Maria","family":"Vitale","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-563X","authenticated-orcid":false,"given":"Giuseppa","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8260-8471","authenticated-orcid":false,"given":"Celeste","family":"Caruso Bavisotto","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, 90127 Palermo, Italy"},{"name":"Euro-Mediterranean Institute of Science and Technology (IEMEST), 90139 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9398-0428","authenticated-orcid":false,"given":"Pasquale","family":"Ambrosino","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9288-1148","authenticated-orcid":false,"given":"Francesco","family":"Cappello","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, 90127 Palermo, Italy"},{"name":"Euro-Mediterranean Institute of Science and Technology (IEMEST), 90139 Palermo, Italy"},{"name":"National Biodiversity Future Center (NBFC), Piazza Marina 61, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6751-9921","authenticated-orcid":false,"given":"Mauro","family":"Maniscalco","sequence":"additional","affiliation":[{"name":"Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy"},{"name":"Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II\u201d, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1683-3803","authenticated-orcid":false,"given":"Antonella","family":"Marino Gammazza","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.bbi.2021.12.020","article-title":"Fatigue and cognitive impairment in Post-COVID-19 Syndrome: A systematic review and meta-analysis","volume":"101","author":"Ceban","year":"2022","journal-title":"Brain. Behav. Immun."},{"key":"ref_2","unstructured":"(2024, May 09). Overview|COVID-19 Rapid Guideline: Managing the Long-Term Effects of COVID-19|Guidance|NICE. Available online: https:\/\/www.nice.org.uk\/guidance\/ng188."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e013602","DOI":"10.1161\/JAHA.119.013602","article-title":"Postural orthostatic tachycardia syndrome is associated with elevated G-protein coupled receptor autoantibodies","volume":"8","author":"Gunning","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1038\/s41569-023-00842-w","article-title":"Autonomic dysfunction and postural orthostatic tachycardia syndrome in post-acute COVID-19 syndrome","volume":"20","author":"Fedorowski","year":"2023","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e242","DOI":"10.1016\/S2666-5247(20)30147-6","article-title":"Cerebrospinal fluid findings in COVID-19 indicate autoimmunity","volume":"1","author":"Lucchese","year":"2020","journal-title":"Lancet Microbe"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e94","DOI":"10.1016\/S2666-5247(21)00033-1","article-title":"Molecular mimicry in the post-COVID-19 signs and symptoms of neurovegetative disorders?","volume":"2","author":"Fucarino","year":"2021","journal-title":"Lancet Microbe"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/S0966-842X(03)00006-4","article-title":"Mimicking the way to autoimmunity: An evolving theory of sequence and structural homology","volume":"11","author":"Kohm","year":"2003","journal-title":"Trends Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/BF02686087","article-title":"Molecular mimicry and auto-immunity","volume":"32","author":"Blank","year":"2007","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1164\/rccm.201908-1590ST","article-title":"Standardization of spirometry 2019 update. an official american thoracic society and european respiratory society technical statement","volume":"200","author":"Graham","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"180101","DOI":"10.1183\/16000617.0101-2018","article-title":"ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases","volume":"28","author":"Radtke","year":"2019","journal-title":"Eur. Respir. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1111\/imr.12091","article-title":"Virus infection, antiviral immunity, and autoimmunity","volume":"255","author":"Getts","year":"2013","journal-title":"Immunol. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.phrs.2015.08.003","article-title":"Vaccines, adjuvants and autoimmunity","volume":"100","author":"Baker","year":"2015","journal-title":"Pharmacol. Res."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Olivieri, B., Betterle, C., and Zanoni, G. (2021). Vaccinations and autoimmune diseases. Vaccines, 9.","DOI":"10.3390\/vaccines9080815"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Cappello, F., Marino Gammazza, A., Dieli, F., Conwey de Macario, E., and Macario, A.J.L. (2020). Does SARS-CoV-2 trigger stress-induced autoimmunity by molecular mimicry? A hypothesis. J. Clin. Med., 9.","DOI":"10.3390\/jcm9072038"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Barone, R., Marino Gammazza, A., Paladino, L., Pitruzzella, A., Spinoso, G., Salerno, M., Sessa, F., Pomara, C., Cappello, F., and Rappa, F. (2021). Morphological alterations and stress protein variations in lung biopsies obtained from autopsies of COVID-19 subjects. Cells, 10.","DOI":"10.3390\/cells10113136"}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/13\/6\/359\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:45:32Z","timestamp":1760107532000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/13\/6\/359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,21]]},"references-count":15,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["biology13060359"],"URL":"https:\/\/doi.org\/10.3390\/biology13060359","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,21]]}}}