多发性硬化患者外周血白细胞介素-4、10和干扰素-γ分泌临床研究  

The study on secretion of cytokine interleukin-4, interleukin-10 and interferon-γ in peripheral blood of multiple sclerosis patients

作　　者：乔立艳[1] 许贤豪[2] 侯世芳[2] 

机构地区：[1]清华大学玉泉医院神经内科,北京100040 [2]卫生部北京医院神经内科,100730

出　　处：《中国现代神经疾病杂志》2014年第10期867-872,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：目的从单个T细胞水平探讨多发性硬化患者病程不同阶段外周血细胞因子分泌变化,以为鉴别诊断和判断病情提供线索。方法采用酶联免疫斑点试验(ELISPOT)检测外周血单个核细胞在自分泌状态下和经外源性抗原(刀豆蛋白A、髓鞘碱性蛋白、乙酰胆碱受体)刺激后,外周血白细胞介素(IL)-4、10和干扰素-γ(IFN-γ)分泌变化。结果与正常对照组和其他非免疫性神经疾病组相比,多发性硬化组患者经髓鞘碱性蛋白刺激后外周血IL-4、IL-10和IFN-γ分泌水平升高(均P=0.000),其中髓鞘碱性蛋白特异性IFN-γ分泌水平在急性发作期或加重期高于稳定期(P=0.002),而IL-4和IL-10则无明显改变。结论在外源性抗原髓鞘碱性蛋白刺激下,采用ELISPOT法检测多发性硬化患者血清IL-4、IL-10和IFN-γ特异性分泌水平,具有鉴别诊断和判断疾病进展阶段的作用。Objective Multiple sclerosis（MS） is a mainly cell-mediated autoimmune demyelinatingdisease in central nervous system（CNS）, characterized by inflammatory demyelinating and infiltration ofmononuclear cells around microvessels in CNS. It has been shown that MS is caused by the imbalancebetween T helper cell 1（Th1） and Th2 or between inflammatory cytokines and anti-inflammatory cytokines.However, the profile of cytokine according to the published data is contradictory. This study is to evaluatethe status of cytokines from mononuclear T cells in MS patients and try to provide clues for clinicaldiagnosis and treatment.MethodsEnzyme- linked immunospot assay（ELISPOT） was used to test thespontaneous and antigen- specific [concanavalin A（ConA）, myelin basic protein（MBP） and acetyleholinereceptor（AChR）] Th1-related cytokine interferon-γ（IFN-γ） and Th2-related cytokines interleukin-4（IL-4）,IL-10 in the peripheral blood mononuclear cells in MS patients, who had not received any immunologicaltreatment over the last 3 months.ResultsCompared with normal controls and patients with non-immuneneurological diseases, MBP specific IL-4, IL-10 and IFN-γ of MS patients increased significantly（P = 0.000,for all）. In addition, MBP specific IFN-γ level of MS patients increased signicantly in acute or exacerbatingphase when compared with that in stable phase（P = 0.002）, while MBP specific IL-4 and IL-10 levels didnot differ significantly（P〉 0.05, for all）.ConclusionsThe examinations of IL- 4, IL- 10 and IFN- γcytokines using ELISPOT are helpful for the differential diagnosis and the disease course of MS.

关 键 词：多发性硬化 白细胞介素4 白细胞介素10 干扰素Ⅱ型 髓磷脂蛋白质类 

分 类 号：R744.51[医药卫生—神经病学与精神病学]