Günther Göran, Haglund Mats, Lindquist Lars, Forsgren Marianne, Andersson Jan, Andersson Birger, Sköldenberg Birgit
Infectious Diseases, Department of Medical Sciences, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden.
Infect Ecol Epidemiol. 2011;1. doi: 10.3402/iee.v1i0.6029. Epub 2011 Feb 11.
Tick-borne encephalitis (TBE) is associated with higher morbidity and induces a stronger intrathecal immune activation than most other viral induced meningo-encephalitis. The aim of this study was to investigate cytokine concentrations in cerebrospinal fluid (CSF) and serum in relation to aetiology and clinical course. Cytokines were analysed by Enzyme-linked Immuno Assay (ELISA) from 44 patients with TBE and from 36 patients with aseptic meningo-encephalitis of other aetiology (non-TBE). Significantly increased CSF levels of Interferon-γ (IFN-γ), Interleukin-10 (IL-10), Interleukin-6 (IL-6), Interleukin-1 receptor antagonist (IL-1ra), and soluble CD8 receptor (sCD8) were detected in both cohorts. Tumour necrosis factor-α (TNF-α showed low levels or was not detected in CSF in any group in the acute stage. However, the CSF levels of IL-10 were significantly lower in TBE than in non-TBE cases 0-6 days after onset of encephalitis. The TBE patients with encephalitis had significantly lower IL-10 CSF levels later in the clinical course (day 7-18) than TBE patients with meningeal disease. Increased IFN-γ production, but low IL-10 secretion, may be of pathophysiological significance in TBE.
蜱传脑炎(TBE)的发病率较高,与大多数其他病毒引起的脑膜脑炎相比,它能诱导更强的鞘内免疫激活。本研究的目的是调查脑脊液(CSF)和血清中细胞因子浓度与病因及临床病程的关系。采用酶联免疫吸附测定(ELISA)法对44例TBE患者和36例其他病因(非TBE)的无菌性脑膜脑炎患者的细胞因子进行了分析。两个队列中均检测到脑脊液中干扰素-γ(IFN-γ)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、白细胞介素-1受体拮抗剂(IL-1ra)和可溶性CD8受体(sCD8)水平显著升高。急性期任何组的脑脊液中肿瘤坏死因子-α(TNF-α)水平均较低或未检测到。然而,脑炎发病后0至6天,TBE患者脑脊液中IL-10水平显著低于非TBE患者。临床病程后期(第7至18天),患脑炎的TBE患者脑脊液中IL-10水平显著低于患脑膜疾病的TBE患者。IFN-γ产生增加但IL-10分泌减少可能在TBE的病理生理过程中具有重要意义。