Clinical Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia.
Eur J Paediatr Neurol. 2011 Nov;15(6):502-7. doi: 10.1016/j.ejpn.2011.05.008. Epub 2011 Jun 24.
Lymphocyte migration from the blood into the CNS is mediated by chemokines and chemokine receptors. Chemokines CXCL10 and CXCL11 are important for the recruitment of CXCR3-expressing Th1 lymphocytes to the site of inflammation.
To determine the concentrations of CXCL10 and CXCL11 in the CSF and plasma of children with enteroviral aseptic meningitis (EV AM) and controls and the contribution of these chemokines to the chemokine concentration gradient between the periphery and the CNS.
The study included 26 pediatric patients with EV AM and 16 controls in whom CNS infection is excluded by negative CSF examination. Chemokines were quantified by using enzyme immunoassay. Etiological diagnosis of EV AM was based on the detection of enteroviral RNA in the CSF using real-time PCR.
CXCL10 (median 12 725 pg/ml) and CXCL11 (median 187 pg/ml) concentrations in CSF of patients with meningitis were significantly higher compared to plasma (median 173 pg/ml and median 110 pg/ml; p < 0.001, p = 0.026 respectively). CXCL10 concentrations in the CSF (median 198 pg/ml) and plasma of controls (median 124 pg/ml) were not significantly different (p = 0.642). CXCL11 concentrations in the CSF of controls (median 89 pg/ml) were significantly lower compared with plasma (median 139 pg/ml, p = 0.004). Chemokine concentration gradient was not influenced by pleocytosis, nor dependent on cytologic CSF formula or the presence of proteinorrachia.
CXCL10 and CXCL11 concentration gradient between the CSF and plasma in children with EV AM suggests an important role of these chemokines in the T-cells recruitment into the CNS and local immunoreaction.
淋巴细胞从血液迁移到中枢神经系统是由趋化因子和趋化因子受体介导的。趋化因子 CXCL10 和 CXCL11 对于招募表达 CXCR3 的 Th1 淋巴细胞到炎症部位非常重要。
确定儿童肠道病毒无菌性脑膜炎 (EV AM) 患者和对照组患者 CSF 和血浆中 CXCL10 和 CXCL11 的浓度,以及这些趋化因子对周围和中枢神经系统之间趋化因子浓度梯度的贡献。
该研究包括 26 例儿科 EV AM 患者和 16 例对照组患者,他们的 CSF 检查均排除中枢神经系统感染。使用酶联免疫吸附试验定量检测趋化因子。EV AM 的病因诊断基于使用实时 PCR 在 CSF 中检测肠道病毒 RNA。
与对照组相比,脑膜炎患者 CSF 中 CXCL10(中位数 12725pg/ml)和 CXCL11(中位数 187pg/ml)浓度明显升高,而血浆中 CXCL10(中位数 173pg/ml)和 CXCL11(中位数 110pg/ml)浓度明显升高(p<0.001,p=0.026)。对照组 CSF(中位数 198pg/ml)和血浆(中位数 124pg/ml)中 CXCL10 浓度无显著差异(p=0.642)。对照组 CSF 中 CXCL11(中位数 89pg/ml)浓度明显低于血浆(中位数 139pg/ml,p=0.004)。趋化因子浓度梯度不受白细胞增多的影响,也不依赖于细胞形态 CSF 公式或蛋白质或脑积水的存在。
EV AM 患儿 CSF 与血浆之间的 CXCL10 和 CXCL11 浓度梯度提示这些趋化因子在 T 细胞募集到中枢神经系统和局部免疫反应中起重要作用。