Zuliani G, Ranzini M, Guerra G, Rossi L, Munari M R, Zurlo A, Volpato S, Atti A R, Blè A, Fellin R
Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatrics, University of Ferrara, and Long Term Division, Ca' Foncello Hospital, Treviso, Italy.
J Psychiatr Res. 2007 Oct;41(8):686-93. doi: 10.1016/j.jpsychires.2006.02.008. Epub 2006 Apr 4.
Some cytokines have been involved in the pathogenesis of late onset Alzheimer's disease (LOAD). A possible increase in plasma cytokines levels has been reported in LOAD and vascular dementia (VD), but the results of previous studies are conflicting. We evaluated the plasma levels of IL-6, TNF-alpha, IL-1beta, and IL-10 in four groups of older individuals: 60 patients with LOAD, 80 patients with VD, 40 subjects with cerebrovascular disease but without dementia (CDND), and 42 controls (C). By analysis of covariance (adjustment for age, gender, coronary heart disease, diabetes, hypertension, smoking, and alcohol consumption) we found that: *IL-1beta was higher in VD, LOAD, and CDND compared with controls (p<0.005). *TNF-alpha was higher in VD and LOAD compared to C (p<0.05), and in VD compared to LOAD (p<0.03). *IL-6 was higher in VD compared with LOAD (p<0.03). No differences in IL-10 values were found (Kruskal-Wallis, Asymp. Sig. 0.14). By logistic regression analysis, we demonstrated that high levels (defined as above the median) of IL-1beta and TNF-alpha, but not of IL-6, were associated with increased likelihood of having VD and LOAD compared to C, while high IL-6 levels were associated with a increased probability of having VD, compared with LOAD. Our study support the notion of a low-grade systemic inflammation in older patients with LOAD or VD, characterized by an increase in plasma IL-1beta and TNF-alpha levels. The high IL-6 levels found in VD might be not a specific finding, as it might come from several conditions including atherosclerosis and related vascular risk factors, comorbidity, and frailty.
一些细胞因子参与了晚发型阿尔茨海默病（LOAD）的发病机制。据报道，LOAD和血管性痴呆（VD）患者血浆细胞因子水平可能升高，但以往研究结果相互矛盾。我们评估了四组老年个体中白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和白细胞介素-10（IL-10）的血浆水平：60例LOAD患者、80例VD患者、40例患有脑血管疾病但无痴呆的受试者（CDND）和42例对照者（C）。通过协方差分析（对年龄、性别、冠心病、糖尿病、高血压、吸烟和饮酒进行校正），我们发现：*与对照组相比，VD、LOAD和CDND组的IL-1β水平更高（p<0.005）。*与C组相比，VD和LOAD组的TNF-α水平更高（p<0.05），且VD组高于LOAD组（p<0.03）。*与LOAD组相比，VD组的IL-6水平更高（p<0.03）。未发现IL-10值存在差异（Kruskal-Wallis检验，渐近显著性为0.14）。通过逻辑回归分析，我们证明，与C组相比，IL-1β和TNF-α高水平（定义为高于中位数）而非IL-6高水平与患VD和LOAD的可能性增加相关，而与LOAD组相比，高IL-6水平与患VD的概率增加相关。我们的研究支持LOAD或VD老年患者存在低度全身炎症的观点，其特征为血浆IL-1β和TNF-α水平升高。VD中发现的高IL-6水平可能并非特异性发现，因为它可能来自多种情况，包括动脉粥样硬化及相关血管危险因素、合并症和身体虚弱。
