Narita Mitsuo, Tanaka Hiroshi, Togashi Takehiro, Abe Shosaku
Department of Pediatrics, Sapporo Tetsudo (JR) Hospital, Sapporo, Japan.
Pediatr Neurol. 2005 Aug;33(2):105-9. doi: 10.1016/j.pediatrneurol.2005.03.003.
Mycoplasma pneumoniae sometimes causes central nervous system manifestations, which may involve the host immune response, as the organism does not directly damage neural cells, or release toxins. Therefore we measured the levels of interleukin-6, interleukin-8, interleukin-18, interferon-gamma, tumor necrosis factor-alpha, and transforming growth factor-beta1 in serum and cerebrospinal fluid samples from patients who manifested central nervous system manifestations during acute M. pneumoniae infection. The subjects were nine patients with early-onset encephalitis (central nervous system disease onset within 7 days from the onset of fever), four with late-onset encephalitis (onset at 8 days or later), three with encephalitis but without fever, and three with aseptic meningitis. Intrathecal elevations of interleukin-6 and interleukin-8 in all four types of central nervous system manifestations, and of interleukin-18 in late-onset encephalitis were observed. None of the cerebrospinal fluid samples contained detectable levels of interferon-gamma, tumor necrosis factor-alpha, or transforming growth factor-beta1. In conclusion, interleukin-6, interleukin-8, and interleukin-18 might be involved in the inflammatory process leading to the central nervous system manifestations caused by M. pneumoniae.
肺炎支原体有时会引起中枢神经系统表现,这可能涉及宿主免疫反应,因为该生物体不会直接损伤神经细胞,也不会释放毒素。因此,我们检测了急性肺炎支原体感染期间出现中枢神经系统表现的患者血清和脑脊液样本中白细胞介素-6、白细胞介素-8、白细胞介素-18、干扰素-γ、肿瘤坏死因子-α和转化生长因子-β1的水平。受试者包括9例早发性脑炎患者(发热起病7天内出现中枢神经系统疾病)、4例晚发性脑炎患者(8天或更晚起病)、3例有脑炎但无发热的患者以及3例无菌性脑膜炎患者。在所有四种类型的中枢神经系统表现中均观察到白细胞介素-6和白细胞介素-8的鞘内升高,在晚发性脑炎中观察到白细胞介素-18的鞘内升高。所有脑脊液样本中均未检测到可检测水平的干扰素-γ、肿瘤坏死因子-α或转化生长因子-β1。总之,白细胞介素-6、白细胞介素-8和白细胞介素-18可能参与了导致肺炎支原体引起的中枢神经系统表现的炎症过程。