Hirohata Shunsei, Kikuchi Hirotoshi
Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Japan.
Intern Med. 2012;51(24):3359-65. doi: 10.2169/internalmedicine.51.8583. Epub 2012 Dec 15.
Neurological manifestations of Behçet's disease (NB) are serious complications. However, their pathogenesis remains unclear. The current study examined the levels of proinflammatory cytokines, including IL-1β, IL-6, IL-8 and TNF-α, in cerebrospinal fluid (CSF).
CSF cytokines were measured using an enzyme-linked immunosorbent assay. CSF was obtained from 17 patients with acute NB, 19 patients with chronic progressive NB and 20 patients with non-inflammatory neurological diseases, including cerebrovascular disease, cervical spondylosis and degenerative diseases.
CSF total cell counts and polymorph nuclear leukocyte counts were significantly lower in the patients with chronic progressive NB than in those with acute NB. The CSF levels of IL-6 and IL-8 were markedly elevated in the NB patients compared with those measured in the control patients. There were no significant differences in the CSF levels of IL-6 and IL-8 between the patients with acute NB and those with chronic progressive NB. In contrast, there were no significant differences in the CSF levels of IL-1β and TNF-α among the control, acute NB and chronic progressive NB patients. Consistently, the CSF levels of IL-6 and IL-8 were significantly decreased following successful treatment in both acute NB and chronic progressive NB patients, whereas the CSF levels of IL-1β and TNF-α were not changed significantly. Of note, the CSF levels of IL-6 were significantly correlated with the CSF levels of IL-8 in the patients with acute NB (r =0.7647, p =0.0003) but not in the patients with chronic progressive NB (r =0.1343, p =0.5835).
These results indicate that CSF IL-6 and IL-8 play important roles in the pathogenesis of NB. However, the data also suggest that the mechanisms underlying the elevation of CSF IL-6 and IL-8 might be different in patients with acute NB and those with chronic progressive NB.
白塞病的神经表现（NB）是严重的并发症。然而，其发病机制仍不清楚。本研究检测了脑脊液（CSF）中促炎细胞因子的水平，包括白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和肿瘤坏死因子-α（TNF-α）。
采用酶联免疫吸附测定法检测脑脊液细胞因子。从17例急性NB患者、19例慢性进行性NB患者和20例非炎性神经疾病患者（包括脑血管疾病、颈椎病和退行性疾病）中获取脑脊液。
慢性进行性NB患者的脑脊液总细胞计数和多形核白细胞计数显著低于急性NB患者。与对照组患者相比，NB患者脑脊液中IL-6和IL-8水平显著升高。急性NB患者和慢性进行性NB患者脑脊液中IL-6和IL-8水平无显著差异。相比之下，对照组、急性NB患者和慢性进行性NB患者脑脊液中IL-1β和TNF-α水平无显著差异。同样，急性NB和慢性进行性NB患者成功治疗后脑脊液中IL-6和IL-8水平显著降低，而脑脊液中IL-1β和TNF-α水平无显著变化。值得注意的是，急性NB患者脑脊液中IL-6水平与IL-8水平显著相关（r =0.7647，p =0.0003），而慢性进行性NB患者则无相关性（r =0.1343，p =0.5835）。
这些结果表明脑脊液IL-6和IL-8在NB发病机制中起重要作用。然而，数据也表明急性NB患者和慢性进行性NB患者脑脊液中IL-6和IL-8升高的机制可能不同。
