Melin Eva, Sohrabian Azita, Rönnelid Johan, Borg Kristian
Division of Rehabilitation Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Results Immunol. 2014 Jun 18;4:54-7. doi: 10.1016/j.rinim.2014.06.001. eCollection 2014.
The pathophysiology of the postpolio syndrome is not fully understood. Increased cytokine levels in cerebrospinal fluid and peripheral blood indicate a systemic inflammatory process. Decreased cytokine levels and the clinical effect of intravenous immunoglobulin treatment further indicate an inflammatory/immunological pathogenesis. The aim of the present study was to evaluate whether an autoimmune process follows the initial infection, by means of analyzing immune complexes.
Circulating immune complexes were analyzed from blood samples of 20 postpolio patients and 95 healthy controls. To compensate for differences in age between patients and controls, a sub-analysis was performed using only the 30 oldest controls. Tumor necrosis factor-inducing properties of polyethylene glycol-precipitated immune complexes were compared between the postpolio patients and 10 healthy controls.
When comparing levels in postpolio patients to the whole control group, including the 30 oldest investigated, there were no statistically significant differences. No difference was found in tumor necrosis factor levels induced by immune complexes when comparing patients and controls.
There was no increase in circulating immune complex or in tumor necrosis factor-inducing effects of circulating immune complex between postpolio patients and healthy controls, indicating that the postpolio syndrome is not due to an autoimmune reaction.
小儿麻痹后遗症的病理生理学尚未完全明确。脑脊液和外周血中细胞因子水平升高表明存在全身性炎症过程。细胞因子水平降低以及静脉注射免疫球蛋白治疗的临床效果进一步表明存在炎症/免疫发病机制。本研究的目的是通过分析免疫复合物来评估初次感染后是否会发生自身免疫过程。
对20例小儿麻痹后遗症患者和95例健康对照者的血样进行循环免疫复合物分析。为弥补患者与对照者年龄差异,仅对30例年龄最大的对照者进行亚分析。比较了小儿麻痹后遗症患者与10例健康对照者中聚乙二醇沉淀的免疫复合物诱导肿瘤坏死因子的特性。
将小儿麻痹后遗症患者的水平与整个对照组(包括30例年龄最大的受调查者)进行比较时,未发现统计学上的显著差异。比较患者与对照者时,免疫复合物诱导的肿瘤坏死因子水平未发现差异。
小儿麻痹后遗症患者与健康对照者之间循环免疫复合物或循环免疫复合物诱导肿瘤坏死因子的作用均未增加,表明小儿麻痹后遗症并非由自身免疫反应所致。