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。
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
Abstract: Objective Multiple sclerosis (MS) is a mainly cell-mediated autoimmune demyelinating disease in central nervous system (CNS), characterized by inflammatory demyelinating and infiltration of mononuclear cells around microvessels in CNS. It has been shown that MS is caused by the imbalance between 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 evaluate the status of cytokines from mononuclear T cells in MS patients and try to provide clues for clinical diagnosis and treatment. Methods Enzyme-linked immunospot assay (ELISPOT) was used to test the spontaneous and antigen-specific [concanavalin A (ConA), myelin basic protein (MBP) and acetyleholine receptor (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 immunological treatment over the last 3 months. Results Compared with normal controls and patients with non-immune neurological 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 exacerbating phase when compared with that in stable phase (P = 0.002), while MBP specific IL-4 and IL-10 levels did not differ significantly (P > 0.05, for all). Conclusions The examinations of IL-4, IL-10 and IFN-γ cytokines using ELISPOT are helpful for the differential diagnosis and the disease course of MS.
Key words:
Multiple sclerosis,
Interleukin-4,
Interleukin-10,
Interferon type Ⅱ,
Myelin proteins
乔立艳, 许贤豪, 侯世芳. 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[J]. 中国现代神经疾病杂志, 2014, 14(10): 867-872.
QIAO Li-yan, XU Xian-hao, HOU Shi-fang. The study on secretion of cytokine interleukin-4, interleukin-10 and interferon-γ in peripheral blood of multiple sclerosis patients[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2014, 14(10): 867-872.