Matsubara R, Utsugisawa K, Ngane Y
Department of Neurology, Iwate Medical University, Japan.
No To Shinkei. 1995 Jul;47(7):681-6.
We studied interleukin-1 beta (IL-1 beta) and interleukin-2 (IL-2) production by peripheral blood monocyte (PBM) from 7 patients with myasthenia gravis (MG) receiving plasmapheresis (PP) (PP therapy only, one patient; PP+high dose intravenous methylprednisolone therapy (pulse therapy: pu therapy), 6 patients) to evaluate the effects of PP therapy on cytokine synthesis of PBM from MG patients. Immediately after PP, PBM IL-2 production decreased and PBM IL-1 beta production increased. In a patient receiving PP only, PBM IL-2 production increased again and PBM IL-1 beta production maintained the high value through the next day. But in 6 patients receiving PP+pu therapy, PBM IL-2 production maintained significantly (p < 0.01) through the next day compared with a patient receiving PP only. In four patients receiving repeated PP+pu therapy, as PBM IL-2 production gradually reduced, the severity of MG improved. These findings suggest that PP in MG had the effects of down-regulation of PBM IL-2 production and up-regulation of PBM IL-1 beta production, and that PP+pu therapy combined with PP suppresses the enhanced PBM IL-1 beta synthesis in MG patients.
我们研究了7例接受血浆置换（PP）的重症肌无力（MG）患者外周血单核细胞（PBM）中白细胞介素-1β（IL-1β）和白细胞介素-2（IL-2）的产生情况（仅接受PP治疗的患者1例；接受PP + 大剂量静脉注射甲基强的松龙治疗（冲击疗法：pu疗法）的患者6例），以评估PP治疗对MG患者PBM细胞因子合成的影响。PP治疗后即刻，PBM的IL-2产生减少，而PBM的IL-1β产生增加。在仅接受PP治疗的1例患者中，PBM的IL-2产生在次日再次增加，PBM的IL-1β产生维持在较高水平。但在6例接受PP + pu疗法的患者中，与仅接受PP治疗的患者相比，次日PBM的IL-2产生显著维持在较低水平（p < 0.01）。在4例接受重复PP + pu疗法的患者中，随着PBM的IL-2产生逐渐减少，MG的严重程度有所改善。这些发现提示，MG患者的PP具有下调PBM的IL-2产生和上调PBM的IL-1β产生的作用，并且PP + pu疗法联合PP可抑制MG患者中增强的PBM的IL-1β合成。
