Reuben S, Sumi M G, Mathai A, Nair M D, Radhakrishnan V V
Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram-695011, India.
Neurol India. 2003 Dec;51(4):487-9.
Tumor necrosis factor a TNF-alpha has a possible role in the pathogenesis of the Guillain-Barre syndrome (GBS).
To study the effect of intravenous immunoglobulin (IVIg) on serum TNF-alpha concentrations in patients with GBS.
The effect of IVIg on TNF-alpha was evaluated in 36 patients with GBS. Serum TNF-alpha concentration was measured by enzyme-linked immunosorbent assay (ELISA). The sera of 22 (61%) patients with GBS showed elevated concentrations of TNF-alpha (35-182 pg/ml) and these sera were individually incubated in vitro with IVIg (0.25 mg/ml) at 37 degrees C for 24 hours.
The serum TNF-alpha concentrations in the 22 GBS patients with elevated levels showed a steady decline (60.34-19.78 pg/ml) following incubation with IVIg. These 22 patients also received IVIg therapy, and serum TNF-alpha concentrations showed a significant decline (65.5-9.75 pg/ml) at the end of the therapy. At the time of discharge from the hospital, there was a positive correlation between neurological recovery and decline in TNF-alpha concentrations in these 22 GBS patients.
The results of this study indicate that elevated levels of TNF-alpha occur in a proportion of patients with GBS and in these patients elevated serum TNF-alpha levels decline with IVIg therapy.
肿瘤坏死因子α（TNF-α）可能在吉兰-巴雷综合征（GBS）的发病机制中起作用。
研究静脉注射免疫球蛋白（IVIg）对GBS患者血清TNF-α浓度的影响。
对36例GBS患者评估IVIg对TNF-α的影响。采用酶联免疫吸附测定（ELISA）法检测血清TNF-α浓度。22例（61%）GBS患者血清TNF-α浓度升高（35 - 182 pg/ml），将这些血清在体外与IVIg（0.25 mg/ml）于37℃孵育24小时。
22例血清TNF-α水平升高的GBS患者在与IVIg孵育后，血清TNF-α浓度呈稳步下降（从60.34 pg/ml降至19.78 pg/ml）。这22例患者也接受了IVIg治疗，治疗结束时血清TNF-α浓度显著下降（从65.5 pg/ml降至9.75 pg/ml）。在这22例GBS患者出院时，神经功能恢复与TNF-α浓度下降之间存在正相关。
本研究结果表明，部分GBS患者存在TNF-α水平升高，在这些患者中，血清TNF-α水平升高会随着IVIg治疗而下降。
