Miyata Rie, Tanuma Naoyuki, Hayashi Masaharu, Imamura Takuji, Takanashi Jun-ichi, Nagata Rieko, Okumura Akihisa, Kashii Hirohumi, Tomita Sunao, Kumada Satoko, Kubota Masaya
Department of Pediatrics, Tokyo-Kita Social Insurance Hospital, Kita-ku, Tokyo, Japan.
Brain Dev. 2012 Feb;34(2):124-7. doi: 10.1016/j.braindev.2011.04.004. Epub 2011 May 14.
We examined oxidative stress markers, tau protein and cytokines in the cerebrospinal fluid (CSF) in six patients with clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). In the CSF, 8-hydroxy-2'-deoxyguanosine (8-OHdG) and hexanoyl-lysine adduct levels increased over the cutoff index in four and one out of six MERS patients, respectively. The CSF IL-6 and IL-10 levels were increased in three out of six patients, two of which had extended lesion of the cerebral white matter. The CSF value of tau protein, marker of the axonal damage, was not increased, and neuron specific enolase (NSE) in the CSF was not increased. The increased 8-OHdG levels in the CSF, DNA oxidative stress marker, in four MERS patients, suggesting involvement of oxidative stress in MERS. MERS is occasionally accompanied with hyponatremia, although our patients lacked hyponatremia. It is possible that the disequilibrium of systemic metabolism including electrolytes may lead to facilitation of oxidative stress and reversible white matter lesion in MERS. The increase of cytokine production seems to be involved in the distribution of lesions in MERS.
我们检测了6例临床诊断为轻度脑炎/脑病伴可逆性胼胝体病变（MERS）患者脑脊液中的氧化应激标志物、tau蛋白和细胞因子。在脑脊液中，6例MERS患者中有4例的8-羟基-2'-脱氧鸟苷（8-OHdG）水平和1例的己酰赖氨酸加合物水平超过临界指数。6例患者中有3例脑脊液白细胞介素-6（IL-6）和白细胞介素-10（IL-10）水平升高，其中2例有脑白质病变扩展。轴突损伤标志物tau蛋白的脑脊液值未升高，脑脊液中的神经元特异性烯醇化酶（NSE）也未升高。4例MERS患者脑脊液中DNA氧化应激标志物8-OHdG水平升高，提示氧化应激参与了MERS的发病过程。MERS偶尔伴有低钠血症，尽管我们的患者未出现低钠血症。包括电解质在内的全身代谢失衡可能会促进MERS中的氧化应激和可逆性白质病变。细胞因子产生的增加似乎与MERS中病变的分布有关。
