Hällgren R, Terént A, Venge P
Inflammation. 1982 Sep;6(3):291-304. doi: 10.1007/BF00916410.
The CSF levels of lactoferrin, lysozyme, and beta 2-microglobulin (beta 2 mu) were measured in patients with evident, probable, or possible inflammatory CNS reactions and compared to those found in neurologically apparently healthy patients. Patients with viral CNS infections had significantly raised beta 2 mu and lysozyme levels but normal lactoferrin levels, indicating a local activation of lymphocytes and monocytes but not of granulocytes. Patients with bacterial CNS infections had significantly raised levels of all three cell markers, but the increase of lysozyme and lactoferrin was relatively more pronounced than that of beta 2 mu, indicating that the inflammatory response to bacterial agents is dominated by monocytes and granulocytes. Patients with primary or secondary malignant brain tumors were characterized by a moderate increase of beta 2 mu and a considerable increase in both lysozyme and lactoferrin, i.e., the same protein pattern as observed in bacterial CNS infection. The lysozyme levels were moderately increased in half the patients with benign cerebral tumors while the levels of beta 2 mu and lactoferrin were normal, indicating that benign and malignant brain tumors induce different local inflammatory CNS reactions. Half the patients with pituitary gland adenoma had elevated beta 2 mu and lysozyme levels but normal lactoferrin levels, suggesting that immunological mechanisms are associated with the adenoma development. Patients with MS had moderately but significantly raised CSF levels of beta 2 mu and lysozyme and a third of them also had raised levels of lactoferrin, a protein pattern suggesting a low-active inflammatory process in CNS involving mononuclears and granulocytes. A similar protein pattern was found in Guillain-Barré syndrome. In cerebrosarcoidosis we noted considerably increased lysozyme and beta 2 mu but normal lactoferrin levels, consistent with the idea that the sarcoid granuloma mass is dominated by monocytic inflammatory cells. The data obtained indicate a clinical value of lactoferrin, lysozyme, and beta 2 mu as differential indices of inflammatory cell reactions taking place in various CNS processes.
对患有明显、可能或疑似炎症性中枢神经系统反应的患者测定了脑脊液中乳铁蛋白、溶菌酶和β2-微球蛋白（β2μ）的水平，并与神经功能明显健康的患者进行了比较。病毒性中枢神经系统感染患者的β2μ和溶菌酶水平显著升高，但乳铁蛋白水平正常，这表明淋巴细胞和单核细胞局部活化，但粒细胞未活化。细菌性中枢神经系统感染患者的所有三种细胞标志物水平均显著升高，但溶菌酶和乳铁蛋白的升高相对比β2μ更为明显，这表明对细菌病原体的炎症反应以单核细胞和粒细胞为主。原发性或继发性恶性脑肿瘤患者的特征是β2μ中度升高，溶菌酶和乳铁蛋白均显著升高，即与细菌性中枢神经系统感染中观察到的相同蛋白质模式。一半良性脑肿瘤患者的溶菌酶水平中度升高，而β2μ和乳铁蛋白水平正常，这表明良性和恶性脑肿瘤引发不同的局部炎症性中枢神经系统反应。一半垂体腺瘤患者的β2μ和溶菌酶水平升高，但乳铁蛋白水平正常，这表明免疫机制与腺瘤发展有关。多发性硬化症患者的脑脊液β2μ和溶菌酶水平中度但显著升高，其中三分之一患者的乳铁蛋白水平也升高，这种蛋白质模式表明中枢神经系统存在低度活跃的炎症过程，涉及单核细胞和粒细胞。格林-巴利综合征中也发现了类似的蛋白质模式。在脑结节病中，我们注意到溶菌酶和β2μ显著升高，但乳铁蛋白水平正常，这与结节性肉芽肿主要由单核细胞炎症细胞组成的观点一致。所获得的数据表明，乳铁蛋白、溶菌酶和β2μ作为各种中枢神经系统疾病中炎症细胞反应的鉴别指标具有临床价值。
