Department of Clinical Neuroscience (T.F., N.M., K.F., H.N., Y.I., R.K.), Institute of Health Biosciences, Tokushima University, Tokushima, Japan; Department of Neurology and Clinical Neuroscience (F.S., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Japan; Department of Neurology (K.M., S.K.), Kinki University School of Medicine, Osaka, Japan; and National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
Neurol Neuroimmunol Neuroinflamm. 2015 Aug 6;2(5):e138. doi: 10.1212/NXI.0000000000000138. eCollection 2015 Oct.
We aimed to compare the cytokine and chemokine profiles of patients with multifocal motor neuropathy (MMN) with those of patients with progressive muscular atrophy (PMA) and amyotrophic lateral sclerosis (ALS) to investigate immunologic differences in the CNS.
CSF from 12 patients with MMN, 8 with PMA, 26 with sporadic ALS, and 10 with other noninflammatory neurologic disorders was analyzed for 27 cytokines and chemokines using the multiplex bead array assay. Cytokine titers of the 4 groups were compared, and correlations between the titers of relevant cytokines and clinical parameters were evaluated.
There were no obvious intrathecal changes except for interleukin (IL)-1 receptor antagonist in patients with MMN. In contrast, IL-4, IL-7, IL-17, eotaxin/CCL11, fibroblast growth factor-2 (FGF-2), granulocyte colony-stimulating factor (G-CSF), and platelet-derived growth factor BB titers were significantly elevated in patients with PMA and ALS; of these, FGF-2 and G-CSF titers were elevated compared with those in patients with MMN. IL-4 and IL-10 titers were high in patients with ALS, particularly patients with possible ALS presenting with a slowly progressive course or mild symptoms.
The CSF cytokine profile of patients with MMN is distinct from that of patients with PMA and ALS. The similarity of the cytokine profiles between patients with PMA and ALS suggests that PMA shares common immunologic features with ALS in the CNS, even without clinical evidence of upper motor neuron involvement.
我们旨在比较多灶性运动神经病（MMN）患者与进行性肌萎缩（PMA）和肌萎缩侧索硬化（ALS）患者的细胞因子和趋化因子谱，以研究中枢神经系统中的免疫差异。
采用多重微珠分析检测 12 例 MMN 患者、8 例 PMA 患者、26 例散发性 ALS 患者和 10 例其他非炎症性神经疾病患者的 CSF 中 27 种细胞因子和趋化因子。比较 4 组细胞因子的滴度，并评估相关细胞因子的滴度与临床参数之间的相关性。
除白细胞介素（IL）-1 受体拮抗剂外，MMN 患者的鞘内变化不明显。相比之下，PMA 和 ALS 患者的 IL-4、IL-7、IL-17、嗜酸性粒细胞趋化因子/CCL11、成纤维细胞生长因子-2（FGF-2）、粒细胞集落刺激因子（G-CSF）和血小板衍生生长因子 BB 滴度显著升高；其中，FGF-2 和 G-CSF 的滴度高于 MMN 患者。ALS 患者的 IL-4 和 IL-10 滴度较高，尤其是具有可能的 ALS 且表现为缓慢进展或轻度症状的患者。
MMN 患者的 CSF 细胞因子谱与 PMA 和 ALS 患者的不同。PMA 和 ALS 患者的细胞因子谱相似，表明 PMA 在 CNS 中与 ALS 具有共同的免疫特征，即使没有上运动神经元受累的临床证据。
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