Grygorczuk Sambor, Pancewicz Sławomir, Kondrusik Maciej, Swierzbińska Renata, Zajkowska Joanna, Hermanowska-Szpakowicz Teresa
Kliniki Chorób Zakaźnych i Neuroinfekcji Akademii Medycznej w Białymstoku.
Neurol Neurochir Pol. 2003 Jan-Feb;37(1):73-87.
Chemokines constitute a group of cytokines with a strong chemotactic action, playing an important role in the pathogenesis of inflammatory responses, including infectious meningitis. The results of in vitro experiments suggest synthesis of chemokines during Borrelia burgdorferi infection. The aim of this study was to investigate serum and cerebrospinal fluid (CSF) concentrations of the following chemokines: interleukin-8 (Il-8) and macrophage inflammatory protein 1 alpha and 1 beta (MIP-1 alpha and MIP-1 beta) in patients with neuroborreliosis. The study group consisted of 20 patients admitted to Neuroinfections and Infectious Diseases Department of the Medical University in Białystok. The control group consisted of 12 healthy persons from whom blood samples were obtained, and 10 patients without meningitis, from whom CSF samples were taken for diagnostic purposes. Chemokine concentrations were measured with ELISA kits before treatment (baseline) and after 2 weeks of antibiotic therapy (post-treatment). Mean serum concentrations of chemokine were elevated in neuroborreliosis patients at baseline (Il-8--mean +/- SD = 668.25 +/- 661.51 pg/ml, MIP-1 alpha--124.90 +/- 89.37 pg/ml, MIP-1 beta--233.40 +/- 298.40 pg/ml) as compared to these in the control group (Il-8-23.72 +/- 7.68 pg/ml, MIP-1 alpha--36.81 +/- 4.74 pg/ml, MIP-1 beta--70.41 +/- 16.41 pg/ml). Post-treatment mean concentrations of Il-8 (197.70 +/- 285.56 pg/ml) and MIP-1 beta (102.70 +/- 42.56 pg/ml) remained significantly elevated, while the mean concentration of MIP-1 alpha (53.65 +/- 38.50 pg/ml) was insignificantly higher than that in the control group. The Il-8 mean concentration was the most elevated comparing to the controls and has decreased most significantly during the treatment. CSF concentrations of chemokines were significantly elevated both at baseline (Il-8--754.95 +/- 535.83 pg/ml, MIP-1 alpha--24.35 +/- 4.88 pg/ml, MIP-1 beta--27.6 +/- 8.38 pg/ml) and post-treatment (Il-8--98.20 +/- 74.74 pg/ml, MIP-1 alpha--18.60 +/- 2.87 pg/ml, MIP-1 beta--16.90 +/- 4.38 pg/ml) in comparison with the controls (Il-8--10.43 +/- 2.70 pg/ml, MIP-1 alpha--8.17 +/- 1.54 pg/ml, MIP-1 beta--7.27 +/- 1.58 pg/ml). MIP-1 alpha and MIP-1 beta CSF concentrations were significantly lower than their concentrations in serum. The Il-8 CSF concentration did not differ significantly from its serum concentration. However, in some patients Il-8 CSF concentration was much higher than that in the serum, which suggests its significant synthesis within the cns and its role in the pathogenesis of B. burgdorferi meningitis. Chemokine CSF concentrations were not correlated with cytosis and CSF protein concentration. The results indicate the induction of Il-8, MIP-1 alpha and MIP-1 beta synthesis in the course of neuroborreliosis and a decrease of their concentrations during 2 weeks of treatment, however, without reaching the normal values.
趋化因子是一类具有强大趋化作用的细胞因子,在包括感染性脑膜炎在内的炎症反应发病机制中发挥重要作用。体外实验结果表明,在伯氏疏螺旋体感染期间会合成趋化因子。本研究的目的是调查神经莱姆病患者血清和脑脊液(CSF)中以下趋化因子的浓度:白细胞介素-8(Il-8)、巨噬细胞炎性蛋白1α和1β(MIP-1α和MIP-1β)。研究组由20名入住比亚韦斯托克医科大学神经感染与传染病科的患者组成。对照组包括12名提供血样的健康人以及10名因诊断目的而采集脑脊液样本的无脑膜炎患者。在治疗前(基线)和抗生素治疗2周后(治疗后),使用酶联免疫吸附测定试剂盒测量趋化因子浓度。与对照组相比,神经莱姆病患者基线时趋化因子的平均血清浓度升高(Il-8——平均值±标准差=668.25±661.51 pg/ml,MIP-1α——124.90±89.37 pg/ml,MIP-1β——233.40±298.40 pg/ml)(Il-8——23.72±7.68 pg/ml,MIP-1α——36.81±4.74 pg/ml,MIP-1β——70.41±16.41 pg/ml)。治疗后,Il-8(197.70±285.56 pg/ml)和MIP-1β(102.70±42.56 pg/ml)的平均浓度仍显著升高,而MIP-1α的平均浓度(53.65±38.50 pg/ml)虽高于对照组,但差异不显著。与对照组相比,Il-8的平均浓度升高最为明显,且在治疗期间下降最为显著。CSF中趋化因子的浓度在基线时(Il-8——754.95±535.83 pg/ml,MIP-1α——24.35±4.88 pg/ml,MIP-1β——27.6±8.38 pg/ml)和治疗后(Il-8——98.20±74.74 pg/ml,MIP-1α——18.60±2.87 pg/ml,MIP-1β——16.90±4.38 pg/ml)均显著升高(Il-8——10.43±2.70 pg/ml,MIP-1α——8.17±1.54 pg/ml,MIP-1β——7.27±1.58 pg/ml)。MIP-1α和MIP-1β的CSF浓度显著低于其血清浓度。Il-8的CSF浓度与其血清浓度无显著差异。然而,在一些患者中,Il-8的CSF浓度远高于血清浓度,这表明其在中枢神经系统内大量合成,并在伯氏疏螺旋体脑膜炎发病机制中发挥作用。CSF中趋化因子的浓度与细胞计数和CSF蛋白浓度无关。结果表明,在神经莱姆病病程中会诱导Il-8、MIP-1α和MIP-1β的合成,且在2周治疗期间其浓度会降低,但未恢复到正常水平。