van Deuren M, van der Ven-Jongekrijg J, Bartelink A K, van Dalen R, Sauerwein R W, van der Meer J W
Department of Internal Medicine, University Hospital Nijmegen, Netherlands.
J Infect Dis. 1995 Aug;172(2):433-9. doi: 10.1093/infdis/172.2.433.
Pro- and antiinflammatory cytokines and mediators were measured in 39 patients with acute life-threatening meningococcal infections classified into 3 groups: A, meningitis without shock (n = 20); B, meningitis with shock (n = 9); and C, shock without meningitis (n = 10). The plasma concentrations of proinflammatory endotoxin, tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, and IL-8 and antiinflammatory cytokines and mediators IL-1 receptor antagonist, IL-10, and soluble TNF receptors p55 and p75 were strongly associated with this classification; the highest concentrations were in group C. IL-4 was not measurable. IL-1 beta was increased only in rapidly fatal cases. In addition, cerebrospinal fluid (CSF) was analyzed in 21 patients for TNF-alpha and its soluble receptors. In CSF, these compounds were mainly increased in group A, reflecting an intrathecal compartmentalized cytokine production. It is concluded that both pro- and antiinflammatory mediators are simultaneously increased and are strongly associated with a classification based on simple clinical parameters.
对39例患有危及生命的急性脑膜炎球菌感染的患者进行了促炎和抗炎细胞因子及介质的检测，这些患者被分为3组：A组，无休克的脑膜炎（n = 20）；B组，伴有休克的脑膜炎（n = 9）；C组，无脑膜炎的休克（n = 10）。促炎内毒素、肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6和IL-8以及抗炎细胞因子和介质IL-1受体拮抗剂、IL-10和可溶性TNF受体p55和p75的血浆浓度与该分类密切相关；C组浓度最高。IL-4无法检测到。仅在快速致死病例中IL-1β升高。此外，对21例患者的脑脊液（CSF）进行了TNF-α及其可溶性受体分析。在脑脊液中，这些化合物主要在A组中升高，反映了鞘内局部细胞因子的产生。结论是促炎和抗炎介质同时升高，并且与基于简单临床参数的分类密切相关。
