Grygorczuk S, Zajkowska J, Swierzbińska R, Pancewicz S, Kondrusik M, Hermanowska-Szpakowicz T
Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Poland.
Rocz Akad Med Bialymst. 2005;50:173-8.
Chronic inflammation in Lyme borreliosis may be sustained by aberrant inflammatory response, characterized by Th1 lymphocyte predominance, which in turn may be determined by chemokines synthesized in inflammatory focus. The aim of the study was to evaluate synthesis of chemokines: interferon-induced T cell chemoattractant (I-TAC--chemoattractant for Th1 lymphocytes), and monocyte chemotactic protein (MCP-1) in Lyme borreliosis.
Study group consisted of 13 patients with erythema migrans, 10 with Lyme arthritis and 6 with neuroborreliosis. Serum, as well as cerebrospinal fluid (CSF) in neuroborreliosis, was obtained before (examination 1) and during (examination 2) antibiotic treatment. Control serum was obtained from 8 healthy volunteers and control csf from 8 patients in whom meningitis and neuroborreliosis was excluded after diagnostic lumbar puncture. The samples were assayed for MCP-1 and I-TAC by ELISA.
Serum mean I-TAC concentration in examination 1 was 73.0 pg/ml in erythema migrans, 78.9 pg/ml in Lyme arthritis and 87.3 pg/ml in neuroborreliosis (29.9 pg/ml in controls, difference significant for neuroborreliosis) and did not change significantly in examination 2. MCP-1 serum concentration was significantly increased to 497.5 pg/ml in neuroborreliosis in examination 2. I-TAC concentration in csf remained low, while MCP-1 concentration in examination 1 was increased to 589.1 pg/ml, significantly higher than simultaneously in serum.
I-TAC synthesis is increased in Lyme borreliosis and may be a factor favoring predominance of Th1 lymphocyte subset. MCP-1 creates chemotactic gradient towards central nervous system and may contribute to csf pleocytosis in neuroborreliosis.
莱姆病的慢性炎症可能由异常炎症反应维持,其特征为Th1淋巴细胞占优势,而这反过来可能由炎症灶中合成的趋化因子决定。本研究的目的是评估趋化因子的合成:干扰素诱导的T细胞趋化因子(I-TAC——Th1淋巴细胞趋化因子)和单核细胞趋化蛋白(MCP-1)在莱姆病中的情况。
研究组包括13例游走性红斑患者、10例莱姆关节炎患者和6例神经莱姆病患者。在抗生素治疗前(检查1)和治疗期间(检查2)采集血清,神经莱姆病患者还采集脑脊液(CSF)。对照血清来自8名健康志愿者,对照脑脊液来自8名经诊断性腰椎穿刺排除脑膜炎和神经莱姆病的患者。通过酶联免疫吸附测定法(ELISA)检测样本中的MCP-1和I-TAC。
检查1时,游走性红斑患者血清中I-TAC平均浓度为73.0 pg/ml,莱姆关节炎患者为78.9 pg/ml,神经莱姆病患者为87.3 pg/ml(对照组为29.9 pg/ml,神经莱姆病差异显著),检查2时无显著变化。神经莱姆病患者检查2时MCP-1血清浓度显著升高至497.5 pg/ml。脑脊液中I-TAC浓度保持较低,而检查1时MCP-1浓度升高至589.1 pg/ml,显著高于同期血清浓度。
莱姆病中I-TAC合成增加,可能是有利于Th1淋巴细胞亚群占优势的一个因素。MCP-1向中枢神经系统形成趋化梯度,可能导致神经莱姆病患者脑脊液细胞增多。