Härle Peter, Möbius Daniel, Carr Daniel J J, Schölmerich Jürgen, Straub Rainer H
University Hospital Regensburg, Regensburg, Germany.
Arthritis Rheum. 2005 Apr;52(4):1305-13. doi: 10.1002/art.20987.
The sympathetic nervous system (SNS) seems to play a proinflammatory role in the early asymptomatic phase of arthritis, but its role in the late stages of chronic arthritis is not well known. The purpose of this study was to examine the effects of the SNS on late-stage chronic arthritis in mice with type II collagen-induced arthritis (CIA).
We tested the effects of the SNS by ablating sympathetic nerves at different time points in mice with CIA. Early sympathectomy was performed 7 days before immunization. Late sympathectomy was performed on day 56. Cytokine stimulation assays were performed on local lymph node cells and spleen cells, and levels of interleukin-10 (IL-10), IL-4, tumor necrosis factor alpha (TNFalpha), and interferon-gamma (IFNgamma) were determined.
Animals with CIA that underwent early sympathectomy showed significantly lower arthritis scores than the controls. In contrast, animals that underwent late sympathectomy had significantly increased arthritis scores compared with controls. On day 0, lymph node cells from animals subjected to early sympathectomy had increased levels of IL-10 and IL-4 and unchanged levels of TNFalpha and IFNgamma compared with those from untreated animals. This indicates an immune-stimulating property of the SNS in draining lymph nodes. On day 80, lymph node cells and spleen cells from animals subjected to late sympathectomy showed increased levels of TNFalpha and IFNgamma compared with those from nonsympathectomized controls with CIA. This indicates an immune-depressing property of the SNS in draining lymph nodes and spleen. Arthritis per se largely diminished sympathetic nerve fiber density in synovium on day 80 (P < 0.01).
The effect of the SNS is bimodal, enhancing or depressing levels of proinflammatory and antiinflammatory cytokines. This feature is dependent on the time point of immune system activation and the respective compartment. The SNS supports inflammation during the asymptomatic phase of CIA, whereas it inhibits inflammation during the chronic symptomatic phase.
交感神经系统(SNS)似乎在关节炎的早期无症状阶段发挥促炎作用,但其在慢性关节炎晚期的作用尚不清楚。本研究的目的是探讨SNS对II型胶原诱导性关节炎(CIA)小鼠晚期慢性关节炎的影响。
我们通过在CIA小鼠的不同时间点切除交感神经来测试SNS的作用。早期交感神经切除术在免疫前7天进行。晚期交感神经切除术在第56天进行。对局部淋巴结细胞和脾细胞进行细胞因子刺激试验,并测定白细胞介素-10(IL-10)、IL-4、肿瘤坏死因子α(TNFα)和干扰素-γ(IFNγ)的水平。
早期接受交感神经切除术的CIA动物的关节炎评分显著低于对照组。相比之下,晚期接受交感神经切除术的动物与对照组相比关节炎评分显著增加。在第0天,与未处理动物相比,早期接受交感神经切除术的动物的淋巴结细胞中IL-10和IL-4水平升高,TNFα和IFNγ水平未改变。这表明SNS在引流淋巴结中具有免疫刺激特性。在第80天,与未接受交感神经切除术的CIA对照组相比,晚期接受交感神经切除术的动物的淋巴结细胞和脾细胞中TNFα和IFNγ水平升高。这表明SNS在引流淋巴结和脾中具有免疫抑制特性。在第80天,关节炎本身在很大程度上降低了滑膜中交感神经纤维密度(P < 0.01)。
SNS的作用是双峰的,可提高或降低促炎和抗炎细胞因子的水平。这一特征取决于免疫系统激活的时间点和相应的区域。SNS在CIA的无症状阶段促进炎症,而在慢性症状阶段抑制炎症。