重症肌无力患者血浆置换过程中血清细胞因子水平的变化。

Changes in serum cytokine levels during plasmapheresis in patients with myasthenia gravis.

机构信息

Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

出版信息

Eur J Neurol. 2009 Dec;16(12):1318-22. doi: 10.1111/j.1468-1331.2009.02729.x. Epub 2009 Jul 14.

DOI:10.1111/j.1468-1331.2009.02729.x

PMID:19614971

Abstract

BACKGROUND

The effect of plasmapheresis on cytokine levels in patients with myasthenia gravis (MG) has not been well established.

METHODS

Cytokine levels were measured in 19 patients with MG before and after treatment with one course of double-filtration plasmapheresis (DFP). The control group comprised 6 age- and sex-matched healthy volunteers.

RESULTS

At baseline, patients with MG had higher levels of IL-10 than normal controls. The levels of IL-2, IL-4, IL-5, and tumor necrosis factor-alpha were almost undetectable in MG patients. After a single session of DFP treatment, IL-10 levels were significantly increased. After three sessions, IL-10 levels were still higher than those at baseline. Elevated IL-10 level was significantly associated with use of immunosuppressant drugs, thymectomy, and good response to DFP treatment.

CONCLUSIONS

Interleukin-10 might play a crucial role in the pathogenesis and perpetuation of MG.

摘要

背景

血浆置换对重症肌无力（MG）患者细胞因子水平的影响尚未得到充分证实。

方法

19 例 MG 患者在接受一个疗程的双重滤过血浆置换（DFP）治疗前后，检测细胞因子水平。对照组由 6 名年龄和性别匹配的健康志愿者组成。

结果

MG 患者在基线时的 IL-10 水平高于正常对照组。MG 患者的 IL-2、IL-4、IL-5 和肿瘤坏死因子-α水平几乎检测不到。单次 DFP 治疗后，IL-10 水平显著升高。三次治疗后，IL-10 水平仍高于基线。升高的 IL-10 水平与免疫抑制剂药物的使用、胸腺切除术和 DFP 治疗的良好反应显著相关。