Grygorczuk Sambor, Zajkowska Joanna, Swierzbińska Renata, Pancewicz Sławomir, Kondrusik Maciej, Hermanowska-Szpakowicz Teresa
Klinika Chorób Zakaźnych i Neuroinfekcji, Akademia Medyczna, ul. Zurawia 14, 15-540 Białystok.
Neurol Neurochir Pol. 2006 Mar-Apr;40(2):106-11.
In tick-borne encephalitis (TBE), perivascular infiltrates are formed within the central nervous system (CNS) and are accompanied by pleocytosis with a predominance of T CD4+ lymphocytes in cerebrospinal fluid (CSF). Factors responsible for leukocyte flow into CNS in TBE have not been investigated. We evaluated the concentration of the chemotactic factor for lymphocytes, chemokine CCL5 (RANTES, Regulated upon Activation, Normal T cell Expressed and Secreted) in CSF and serum of patients with TBE and assessed its correlation with CSF pleocytosis.
Group I consisted of 10 patients with TBE virus infection presenting as meningitis; group II included 11 patients with TBE presenting as encephalomeningitis or myeloencephalomeningitis. The control group consisted of 8 patients, in whom neuroinfection and infection with TBE virus was excluded. The concentration of CCL5 was measured by ELISA in CSF and serum samples taken within 24 hours after hospitalization (examination 1) and in the convalescence period, on average after 16 days (examination 2).
Mean CCL5 concentration in serum did not differ between the groups, while in CSF it was significantly increased in group I (64.3+/-75.5 pg/ml in examination 1 and 44.4+/-39.5 pg/ml in examination 2) and in group II (38.4+/-17.0 pg/ml in examination 1 and 48.8+/-24.7 pg/ml in examination 2) in comparison with controls (3.7+/-5.3 pg/ml). There was no significant difference regarding CCL5 concentration between groups I and II and between the examination 1 and 2. There was no correlation between the concentration of CCL5 and CSF parameters.
The concentration of CCL5 is increased in CSF, but not in serum of patients with TBE. This increase does not depend on the clinical form of the disease and is sustained after the disappearance of the symptoms of acute infection. Further studies are necessary to determine the source of CCL5, and its role in the pathogenesis of TBE and its sequelae.
在蜱传脑炎（TBE）中，中枢神经系统（CNS）内会形成血管周围浸润，并伴有脑脊液（CSF）中以T CD4 +淋巴细胞为主的细胞增多。TBE中负责白细胞流入CNS的因素尚未得到研究。我们评估了TBE患者脑脊液和血清中淋巴细胞趋化因子、趋化因子CCL5（调节激活正常T细胞表达和分泌因子，RANTES）的浓度，并评估其与脑脊液细胞增多的相关性。
第一组由10例表现为脑膜炎的TBE病毒感染患者组成；第二组包括11例表现为脑脊髓膜炎或脊髓脑脊髓膜炎的TBE患者。对照组由8例排除神经感染和TBE病毒感染的患者组成。通过酶联免疫吸附测定法（ELISA）测量住院后24小时内（检查1）以及恢复期（平均16天后，检查2）采集的脑脊液和血清样本中CCL5的浓度。
各组血清中CCL5的平均浓度无差异，而与对照组（3.7±5.3 pg/ml）相比，第一组（检查1时为64.3±75.5 pg/ml，检查2时为44.4±39.5 pg/ml）和第二组（检查1时为38.4±17.0 pg/ml，检查2时为48.8±24.7 pg/ml）脑脊液中的CCL5浓度显著升高。第一组和第二组之间以及检查1和检查2之间CCL5浓度无显著差异。CCL5浓度与脑脊液参数之间无相关性。
TBE患者脑脊液中CCL5浓度升高，但血清中未升高。这种升高不取决于疾病的临床形式，并且在急性感染症状消失后仍持续存在。需要进一步研究以确定CCL5的来源及其在TBE发病机制及其后遗症中的作用。
