Ukkonen Maritta, Wu Kingchen, Reipert Birgit, Dastidar Prasun, Elovaara Irina
Department of Neurology, Tampere University Hospital, Tampere, Finland.
Mult Scler. 2007 Jul;13(6):701-7. doi: 10.1177/1352458506075378. Epub 2007 Mar 15.
We evaluated the utility of adhesion molecule (AM) and cytokine/chemokine expressions in blood and cerebrospinal fluid (CSF) as markers of disease activity in primary progressive multiple sclerosis (PPMS).
The expressions of AMs and the levels of 17 cytokines in patients with PPMS (n = 25) were compared with those in secondary progressive MS (SPMS) (n = 18) and controls (n =11) and correlated with the volumes of focal and atrophic changes on MRI.
The expressions of very late activation antigen 4 (VLA-4), lymphocyte function-associated antigen 1 (LFA-1) and intercellular adhesion molecule 1 (ICAM-1) in blood and CSF were higher in PPMS than in controls. Comparison between PPMS and SPMS showed higher levels of ICAM-1 in blood and CSF in PPMS, while the level of the vascular adhesion molecule (VCAM-1) was higher only in blood. There was no difference in the levels of cytokines in serum or CSF between PPMS and SPMS or controls, but evidence suggesting intrathecal synthesis of interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) was found in PPMS. The expressions of CSF VLA-4 in PPMS correlated with the total volume of cerebral lesions and the number of diffuse brain lesions in MRI, while the amount of LFA-1 in CSF correlated with the number of spinal T2 lesions. The level of serum MIP-1beta correlated with the T2 lesion load and EDSS score in PPMS.
The upregulated expressions of AMs in blood and CSF and evidence for intrathecal synthesis of MCP-1 and IL-8 in PPMS indicate the importance of inflammatory changes in the pathogenesis of PPMS.
我们评估了血液和脑脊液（CSF）中黏附分子（AM）及细胞因子/趋化因子表达作为原发性进展型多发性硬化症（PPMS）疾病活动标志物的效用。
将PPMS患者（n = 25）的AM表达及17种细胞因子水平与继发进展型多发性硬化症（SPMS）患者（n = 18）及对照组（n = 11）进行比较，并与MRI上局灶性和萎缩性改变的体积相关联。
PPMS患者血液和脑脊液中极晚期活化抗原4（VLA - 4）、淋巴细胞功能相关抗原1（LFA - 1）和细胞间黏附分子1（ICAM - 1）的表达高于对照组。PPMS与SPMS的比较显示，PPMS患者血液和脑脊液中ICAM - 1水平较高，而血管黏附分子（VCAM - 1）水平仅在血液中较高。PPMS与SPMS或对照组之间血清或脑脊液中的细胞因子水平无差异，但在PPMS中发现有白细胞介素 - 8（IL - 8）和单核细胞趋化蛋白 - 1（MCP - 1）鞘内合成的证据。PPMS患者脑脊液中VLA - 4的表达与MRI上脑病变的总体积和弥漫性脑病变的数量相关，而脑脊液中LFA - 1的量与脊髓T2病变的数量相关。PPMS患者血清MIP - 1β水平与T2病变负荷和扩展残疾状态量表（EDSS）评分相关。
PPMS患者血液和脑脊液中AM表达上调以及MCP - 1和IL - 8鞘内合成的证据表明炎症变化在PPMS发病机制中的重要性。
