多发性硬化症与EB病毒及白细胞介素17/白细胞介素23关联性分析  

A study on correlation between multiple sclerosis and Epstein-Barr virus and IL-17/IL-23

作　　者：孟俊[1] 彭奕冰[1] 王学锋[1] 陈呢喃[2] 张冬青[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院检验科,上海200025 [2]上海交通大学医学院上海市免疫学研究所,上海200025

出　　处：《诊断学理论与实践》2017年第1期88-92,共5页Journal of Diagnostics Concepts & Practice

基　　金：国家自然科学基金面上项目(31270963);上海市科委重点连续资助项目(10JC1408500);上海交通大学医学院附属瑞金医院优青医技后备人才基金

摘　　要：目的:探讨抗EB病毒(Epstein-Barr virus,EBV)抗体在多发性硬化症(multiple sclerosis,MS)患者脑脊液中的表达情况,以及细胞因子白细胞介素(interleukin,IL)-17、IL-23与其发病间的关联性,借以对MS发病机制进行研究,并为临床诊治和实验室检验提供进一步参考。方法:选取29例中枢神经免疫疾病患者(研究组,包括MS、视神经脊髓炎等)和43例同期非中枢神经免疫疾病患者(对照组,包括周围神经病、偏头痛等),采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)分别检测2组患者脑脊液中EBV-壳抗原(VCA)Ig M、EBV-核抗原(EBNA)-1 Ig G、IL-17、IL-23的表达水平。结果 :中枢神经免疫疾病患者(研究组)患者脑脊液中EBV-EBNA-1 Ig G、EBV-VCA Ig M和IL-23的表达水平显著高于非中枢神经免疫疾病患者(对照组)(P<0.01)。研究组中MS患者脑脊液(cerebrospinal fluid,CSF)IL-23表达水平较对照组显著增高(P<0.01),同时MS亚组患者CSF的IL-17表达水平较对照组显著增高(P<0.05)。结论:抗EBV抗体的表达预示着MS患者的发病可能与EBV感染相关,可能是MS的发病机制之一。同时,IL-17/IL-23轴的异常也可能与MS发病间存在一定的关联。MS的发病不仅与EB病毒感染有关,且与患者的免疫紊乱密切相关。Objective： To study the expression of Epstein-Barr virus （EBV） autoantibodies and IL-17, IL-23 in cere- brospinal fluid of palients with multiple sclerosis （MS） and to define the relationship between IL-17/IL-23 and pathogenesis of MS for hoping to provide a diagnostic reference for clinical practice. Methods： Seventy-two patients with neurological diseases in Ruijin I-lospital were categorized into 2 groups： 29 cases with central nervous system autoimmune disease （study group） and 43 cases of non-central nervous system autoimmune disease （control group）. Enzyme-linked immnnosor- bent assay （ELISA） was used to assess the levels of EBV-VCA-IgM, EBV-EBNA-1IgG, IL-17, IL-23 in CSF. Results： The expressions of EBV-EBNA-11gG, EBV-VCA IgM and IL-23 in study group were significantly higher than those in control group （P〈0.01）. In study group, the expression of IL-23 in MS patients was significantly higher than that in control group （P〈0.O1）, and the expression of IL-17 in MS patients was higher than that in control group （P〈O.05）. Conclusions： EBV is related to MS and probably contributes to the pathogenesis of MS. Meanwhile, the abnormal inflammatory axis of IL-17/ IL-23 may also be related to the induction of MS. The study indicates a relationship of MS not only with viral infection, but also with a disordered autoimmune system.

关 键 词：脑脊液 多发性硬化 EB病毒抗体 白细胞介素 酶联免疫吸附试验 

分 类 号：R593.2[医药卫生—内科学]