Mathiesen T, Andersson B, Loftenius A, von Holst H
Department of Neurosurgery, Karolinska Institute, Stockholm, Sweden.
J Neurosurg. 1993 Apr;78(4):562-7. doi: 10.3171/jns.1993.78.4.0562.
Serum and cerebrospinal fluid (CSF) samples from 12 patients were analyzed for interleukin (IL)-6, soluble IL-2 receptor (IL-2R), and soluble CD8 levels in order to determine the immune activation profile following subarachnoid hemorrhage (SAH). Dramatically increased levels of IL-6 and moderate increases of soluble IL-2R were detected in the CSF in 11 of the 12 patients; slightly elevated levels of soluble CD8 were observed in six patients. The IL-6 levels were higher on Day 6 than on Days 3 and 9. The increases in IL-6, soluble IL-2R, and soluble CD8 levels in the CSF samples were not paralleled by increased values in the serum samples, and thus probably reflected an intrathecal synthesis of the cytokine. Passive transfer of IL-6 across the blood-brain barrier seemed not to occur since the serum and CSF levels of IL-6 showed a negative correlation. The findings suggest a severe inflammatory affection of the central nervous system that could be of importance in understanding the clinical course in patients following SAH.
分析了12例患者的血清和脑脊液(CSF)样本中的白细胞介素(IL)-6、可溶性IL-2受体(IL-2R)和可溶性CD8水平,以确定蛛网膜下腔出血(SAH)后的免疫激活情况。12例患者中有11例的脑脊液中检测到IL-6水平显著升高,可溶性IL-2R中度升高;6例患者的可溶性CD8水平略有升高。IL-6水平在第6天高于第3天和第9天。脑脊液样本中IL-6、可溶性IL-2R和可溶性CD8水平的升高与血清样本中的升高值不平行,因此可能反映了细胞因子的鞘内合成。由于IL-6的血清和脑脊液水平呈负相关,IL-6似乎不会被动穿过血脑屏障。这些发现提示中枢神经系统存在严重炎症,这可能对理解SAH患者的临床病程具有重要意义。