Poyraz Turan, Idiman Egemen, Uysal Sezer, Iyilikci Leyla, Ozakbaş Serkan, Coskuner Poyraz Esra, Idiman Fethi
Division of Neuroimmunology, Department of Neurology, Faculty of Medicine, Dokuz Eylül University, 35345 İzmir, Turkey.
ISRN Neurol. 2013 May 16;2013:964572. doi: 10.1155/2013/964572. Print 2013.
Multiple sclerosis (MS) is the most common inflammatory demyelinating disease of the central nervous system (CNS) in young adults. The proinflammatory cytokines such as interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), and nitric oxide (NO) which are known to be produced by inflammatory cells play a key role in the pathogenesis of MS. Some metabolic changes may have an effect on axonal transmission, and white blood cells NO and other inflammatory mediators such as cytokines may be affected from cooling process. In this study, we evaluated the effects of body cooling procedure on proinflammatory cytokines such as TNF-α, IFN-γ, and NO levels. Twenty patients with MS were evaluated. Thirteen of the patients were women, 7 were men (mean age: 33.6 ± 7.5 yrs.). Body temperature was reduced by an average of 1°C approximately in 1 hour with using the "Medivance Arctic Sun Temperature Management System" device. In our study, the decrease in TNF-α, IFN-γ levels after the cooling procedure has no statistical significance, whereas the decrease in the mean level of NO level after the cooling procedure is 4.63 ± 7.4 μmol/L which has statistical significance (P = 0.002). These results suggested that the decrease in NO level improves conduction block in demyelinated axonal segments after cooling procedure in multiple sclerosis.
多发性硬化症(MS)是年轻成年人中枢神经系统(CNS)最常见的炎性脱髓鞘疾病。已知由炎性细胞产生的促炎细胞因子,如干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)和一氧化氮(NO),在MS的发病机制中起关键作用。一些代谢变化可能会影响轴突传导,而白细胞NO和其他炎性介质如细胞因子可能会受到降温过程的影响。在本研究中,我们评估了身体降温程序对TNF-α、IFN-γ等促炎细胞因子水平以及NO水平的影响。对20例MS患者进行了评估。其中13例为女性,7例为男性(平均年龄:33.6±7.5岁)。使用“Medivance Arctic Sun温度管理系统”设备,在大约1小时内将体温平均降低1°C。在我们的研究中,降温程序后TNF-α、IFN-γ水平的降低无统计学意义,而降温程序后NO水平的平均降低为4.63±7.4μmol/L,具有统计学意义(P = 0.002)。这些结果表明,在多发性硬化症中,降温程序后NO水平的降低改善了脱髓鞘轴突节段的传导阻滞。