Kivioja J, Ozenci V, Rinaldi L, Kouwenhoven M, Lindgren U, Link H
Karolinska Institutet, Division of Orthopedics, Huddinge University Hospital, Stockholm, Sweden.
Clin Immunol. 2001 Oct;101(1):106-12. doi: 10.1006/clim.2001.5086.
Whiplash injury and whiplash-associated disorders (WAD) are significant problems of modern society. Numerous attempts have been made to characterize the nature of whiplash injury. Whether the immune system is involved during the disease process is not known. In a prospective study, using enzyme-linked immunospot (ELISPOT) assays, we examined numbers of blood mononuclear cells (MNC) secreting pro- (IFN-gamma, TNF-alpha, IL-6) and anti-inflammatory (IL-10) cytokines in patients with WAD and, for reference, patients with ankle sprain and multiple sclerosis and healthy subjects. An immune response reflected by elevated numbers of TNF-alpha- and IL-10-secreting blood MNC was observed in patients with WAD examined within 3 days compared to 14 days after the whiplash injury. The patients with WAD examined within 3 days after the injury had also higher numbers of IL-6 and IL-10 secreting blood MNC compared to healthy subjects. The alterations of cytokine profiles observed in WAD were also observed in patients with ankle sprain when examined within 3 days after trauma. In contrast, there were no differences for cytokine profiles between patients with WAD examined 14 days after the whiplash injury and healthy subjects. Relatively minor trauma like WAD and ankle sprain are associated with a systemic dysregulation in numbers of cells secreting pro- as well as anti-inflammatory cytokines.
挥鞭样损伤和挥鞭样损伤相关疾病（WAD）是现代社会的重大问题。人们已多次尝试描述挥鞭样损伤的本质。疾病过程中免疫系统是否参与尚不清楚。在一项前瞻性研究中，我们使用酶联免疫斑点（ELISPOT）检测法，检测了WAD患者、踝关节扭伤患者、多发性硬化症患者以及健康受试者中分泌促炎细胞因子（干扰素-γ、肿瘤坏死因子-α、白细胞介素-6）和抗炎细胞因子（白细胞介素-10）的血液单核细胞（MNC）数量。与挥鞭样损伤后14天相比，在损伤后3天内接受检查的WAD患者中，观察到分泌肿瘤坏死因子-α和白细胞介素-10的血液MNC数量增加所反映的免疫反应。与健康受试者相比，损伤后3天内接受检查的WAD患者分泌白细胞介素-6和白细胞介素-10的血液MNC数量也更多。踝关节扭伤患者在创伤后3天内接受检查时，也观察到了WAD中细胞因子谱的改变。相比之下，挥鞭样损伤后14天接受检查的WAD患者与健康受试者的细胞因子谱没有差异。像WAD和踝关节扭伤这样相对轻微的创伤与分泌促炎和抗炎细胞因子的细胞数量的全身失调有关。
