Engelborghs S, De Brabander M, De Crée J, D'Hooge R, Geerts H, Verhaegen H, De Deyn P P
Department of Neurology and Memory Clinic, Algemeen Ziekenhuis Middelheim, Born-Bunge Foundation, University of Antwerp, Belgium.
Neurochem Int. 1999 Jun;34(6):523-30. doi: 10.1016/s0197-0186(99)00031-5.
Several histopathological studies suggest that amyloidogenesis in dementia of the Alzheimer type is accompanied by activated glia and glia-derived cytokines, leading to chronic, self-propagating, cytokine-mediated molecular and cellular reactions. As studies regarding inflammatory changes in cerebrospinal fluid of patients with dementia of the Alzheimer type has been inconclusive, we set up a prospective study to assess cerebrospinal fluid levels of interleukin-1beta, interleukin-6, interleukin-10, interleukin-12, soluble interleukin-2 receptor, interferon-gamma, tumor necrosis factor-alpha and neopterin in 20 patients with dementia of the Alzheimer type and 20 age- and sex-matched controls. Comparing both groups, no significant differences in concentrations and specific activities could be revealed. An additional 22 patients were included to enlarge the study population. No statistically significant differences were shown comparing patients (n=42) with the control group (n=20). We conclude that the immune-mediated inflammatory changes found in histopathological studies are not reflected in cerebrospinal fluid of patients with dementia of the Alzheimer type. Probably, cytokine production appears very localized in the central nervous system, not allowing representative detection in cerebrospinal fluid. Further studies assessing cytokine levels in various regions of central nervous system of patients with dementia of the Alzheimer type will be of interest to confirm this hypothesis.
多项组织病理学研究表明，阿尔茨海默型痴呆中的淀粉样蛋白生成伴随着胶质细胞激活及胶质细胞衍生的细胞因子，从而导致慢性、自我传播、细胞因子介导的分子和细胞反应。由于关于阿尔茨海默型痴呆患者脑脊液炎症变化的研究尚无定论，我们开展了一项前瞻性研究，以评估20例阿尔茨海默型痴呆患者及20例年龄和性别匹配的对照者脑脊液中白细胞介素-1β、白细胞介素-6、白细胞介素-10、白细胞介素-12、可溶性白细胞介素-2受体、干扰素-γ、肿瘤坏死因子-α和蝶呤的水平。比较两组时，未发现浓度和比活性有显著差异。另外纳入22例患者以扩大研究人群。将患者（n = 42）与对照组（n = 20）比较，未显示出统计学上的显著差异。我们得出结论，组织病理学研究中发现的免疫介导炎症变化在阿尔茨海默型痴呆患者的脑脊液中未得到体现。可能细胞因子的产生在中枢神经系统中非常局限，无法在脑脊液中进行代表性检测。评估阿尔茨海默型痴呆患者中枢神经系统不同区域细胞因子水平的进一步研究，将有助于证实这一假设。
