流行性乙型脑炎患儿IL-10、IL-12和TNF-α变化的临床意义  

Clinical significance of IL-10,IL-12,TNF-α change in patients with Japanese encephalitis

作　　者：赵红[1] 姚文虎[1] 范春蕾 刘新钰[2] 

机构地区：[1]东南大学医学院附属南京第二医院传染科,江苏南京210003 [2]东南大学医学院附属南京第二医院肝病研究室,江苏南京210003

出　　处：《东南大学学报（医学版）》2002年第3期235-238,共4页Journal of Southeast University(Medical Science Edition)

摘　　要：目的 :检测流行性乙型脑炎 (乙脑 )患儿脑脊液及血清中白细胞介素 (IL) 10、IL 12和肿瘤坏死因子 (TNF) α水平 ,以探讨其在发病机制中的作用。方法 :3 1例乙脑患儿分别于急性期和恢复期留取血清及脑脊液 ,-2 0℃冻存。IL 10、IL 12和TNF α的检测采用ELISA法。结果 :急性期血清、脑脊液中IL 10、IL 12、TNF α水平均升高 ,而恢复期降低。急性期脑脊液中IL 10、IL 12和TNF α水平较同期血清中的高。TNF α的水平与疾病轻重程度呈正相关 ,而IL 10、IL 12水平与疾病严重程度无关。IL 10与TNF α的水平呈正相关 ,而其它细胞因子间未见明显相关性。结论 :(1)细胞因子IL 10、IL 12和TNF α参与乙脑的发病。(2 )TNF α可能直接参与并介导免疫损伤 ;内源性IL 10未显示出有效地抑制其它炎症因子释放的作用 ,可能也参与了炎症过程 ;IL 12可能具有抗病毒作用。 (3 )乙脑时IL 10、TNF α可能主要在中枢神经系统局部产生。 (4 )选用某些细胞因子或通过抑制某些细胞因子的释放可为临床治疗乙脑提供新的途径。Objective To evaluate the role of cytokines in Japanese encephalitis (JE) and its function of pathogenesis,we measured the concentration of IL?10,IL?12,TNF? α in serum and cerebrospinal fluid (CSF) from patients with JE.Methods Serum and CSF specimens were obtained from 31 patients with JE in an acute stage and a convalescent stage,then frozen at -20?℃ to be tested later.The concentration of IL?10,IL?12 and TNF? α had been tested by ELISA.Results The level of IL?10,IL?12,TNF? α raised in acute stage and decreased in convalescent stage.The concentration of IL?10,IL?12,TNF? α in CSF were significantly higher than that in serum.The level of TNF? α correlated with the severity of disease.Positive correlation were found between IL?10 and TNF? α ,IL?12 also had positive correlation.But we couldn't find any positive correlation among other cytokines.Conclusions (1)Cytokines such as IL?10,IL?12,TNF? α participate the pathogenesis of JE.(2)TNF? α may participate and mediate the immune injury directly.Endogenous IL?10 does not appear to effectively reduce the release of other cytokines,and may participate the course of the inflammation.IL?12 may play a role of antivirus.(3)IL?10,TNF? α may be produced within the local central nervous system in JE.(4)To make use of some cytokines or to use something to block the functions of some cytokines may provide a way to our clinical therapy.

关 键 词：流行性乙型脑炎 白细胞介素 肿瘤坏死因子 儿童 发病机制 ELISA法 

分 类 号：R725.1[医药卫生—儿科]