多发性硬化患者血清中可溶性白细胞介素-2受体的研究

目的：探讨多发性硬化（ＭＳ）患者血清中可溶性白细胞介素２受体水平的变化及临床意义。方法;采用双抗体夹心ＥＬＩＳＡ法检测了２８例ＭＳ患者和３５例正常对照组血清ｓＩＬ－２Ｒ水平。结果：ＭＳ患者中,急性复发组和缓解组血清中ｓＩＬ－２Ｒ水平均显著高于正常对照组（Ｐ〈０．０１）,而急性复发组患者ｓＩＬ－２Ｒ水平又较缓解组增高（Ｐ〈０．０５）,且与病情严重程度有关。结论：ＭＳ患者血清ｓＩＬ－２Ｒ水平异常增高,     

多发性硬化患者脑脊液蛋白质组学研究

目的 探讨多发性硬化(MS)发病的分子机制并寻找其脑脊液(CSF)蛋白质标志物.方法 对MS患者与紧张型头痛患者各6例的CSF蛋白质组学进行比较研究.将浓缩的CSF去除高丰度蛋白后行双向凝胶电泳,对凝胶图谱进行图像分析,探寻差异性蛋白点并经肽质量指纹质谱技术鉴定蛋白质点.结果 MS患者38种蛋白质的表达与对照组比较差异有统计学意义(P<0.05),部分差异性蛋白质经鉴定为白蛋白单体CRA_n、ATP合成酶、普通转录因子IIH、白蛋白单体CRA_j、四连接素、结合珠蛋白、丛生蛋白、富亮氨酸α-2糖蛋白、视黄醇结合蛋白与甲状腺素结合蛋白.结论 MS患者CSF多种蛋白质表达差异,可能存在能量代谢异常、炎症反应和组织修复机制.     

急性Guillain-Barre综合征患者血清sIL-2R和sIL-6R水平的测定

目的探讨可溶性白细胞介素2受体(sIL-2R)和可溶性白细胞介素6受体(sIL-6R)在急性Guillain-Barre综合征(GBS)发病中的作用.方法采用ELISA方法测定32例GBS患者和30名正常对照者血清sIL-2R及sIL-6R 水平. 结果 GBS患者血清sIL-2R和sIL-6R水平明显高于正常对照组(P<0.01,P<0.05),重型和极重型患者明显高于轻型及中型患者(P<0.01,P<0.05),且随着病情的好转,两种受体水平也逐渐下降,与治疗前比明显下降(均P<0.05).结论 sIL-2R和sIL-6R水平的高低可作为判断GBS病情变化的指标之一.     

多发性硬化患者血清和脑脊液中白细胞介素-6的变化及其意义

本研究应用生物学方法检测27例多发性硬化（MS）患者血清和脑脊液（CSF）白细胞介素-6（IL－6）水平，以探讨IL－6在MS发病中的作用。结果显示MS患者血清IL-6水平显著高于其他非炎症性神经病（NIND）组及正常对照（NC）组，其CSFIL－6水平亦显著高于NIND组；但MS患者血清与CSFIL-6水平不呈线性相关，血清IL-6水平随病情稳定而下降。本研究结果提示IL－6可能参与MS的免疫病理过程。     

多发性硬化患者白介素18的表达与临床相关研究

目的探讨IL-18在多发性硬化患者血清和脑脊液（CSF）中的含量变化及其在发病机制中的作用。方法采用酶联免疫吸附法（ELISA）测定多发性硬化患者和对照组血清及脑脊液IL-18水平。结果（1）MS患者血清及脑脊液IL-18水平均明显高于其他神经疾病组和对照组,并且血清高于脑脊液（P〈0．01）,但后两者差别无统计学意义（P〉0．05）。（2）MRI显示有增强病灶的MS患者其IL-18水平高于没有增强病灶的。结论IL-18可能在中枢神经脱髓鞘的病理损害的发病机制中起着十分重要的作用。     

多发性硬化患者脑脊液一氧化氮水平的检测及意义

目的探讨多发性硬化患者脑脊液(CSF)一氧化氮(NO)含量变化.方法采用硝酸还原酶法检测43例多发性硬化(MS)患者、25例吉兰-巴雷综合症(GBS)患者及39例对照者CSF的NO水平,同时进行其生化和细胞学成分及寡克隆IgG区带(IgG-OB)分析.结果MS组CSF的NO水平明显高于对照组(P＜0.01).结论硝酸还原酶法能快速、准确地检测CSF的NO含量;NO参与了MS的免疫发病机制,并在一定程度上反映机体细胞免疫的状态.     

多发性硬化患者血清中可溶性白细胞介素─2受体（SIL—2R）的动态观察

采用ＥＬＩＳＡ双抗体夹心法对２３例多发性硬化（ＭＳ）患者在急性复发期和缓解期血清的ＳＩＬ—２Ｒ水平进行了动态检测。结果显示急性复发期患者的ＳＩＬ—２Ｒ水平明显高于正常对照组（Ｐ＜０．００１）。缓解期的ＳＩＬ—２Ｒ水平患较急性复发期明显降低（Ｐ＜０．０５），但仍显著高于正常对照组（Ｐ＜０．００１）。提示ＭＳ患者不论急性复发期还是缓解期其Ｔ淋巴细胞处于活化状态。我们认为对ＭＳ患者血清中ＳＩＬ—２Ｒ水平的动态观察可能有助于复发的预测，及预后的判断。     

青年人脑梗塞患者血清sIL-2R和sIL-6R的研究

探讨可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）和可溶性白细胞介素６受体（ｓＩＬ－６Ｒ）在青年人脑梗塞发生、发展中的作用。方法采用双抗体夹心ＥＬＩＳＡ方法对２９例青年人急性脑梗塞患者血清ｓＩＬ－２Ｒ和ｓＩＬ－６Ｒ水平进行了测定。结果青年人脑梗塞的ｓＩＬ－２Ｒ和ｓＩＬ－６Ｒ水平明显高于中、老年脑梗塞组和正常对照组,随着病情的好转,该２种受体水平也逐渐下降。结论血清ＳＩＬ－２Ｒ和ｓＩＬ－６Ｒ水平的高低可作为判断青年人急性期脑梗塞病情变化的指标之一。     

脑脊液在多发性硬化诊断和研究中的意义

尽管近年来神经影像学技术如头颅ＣＴ和ＭＲＩ的长足进步，为多发性硬化（ＭＳ）临床诊断提供了有力的手段，但脑脊液（ＣＳＦ）检查在ＭＳ临床和研究方面的重要作用仍然是其他方法无法取代的。它不仅为ＭＳ的诊断和鉴别诊断提供依据，而且ＣＳＦ中免疫细胞和免疫分子的变...     

sIL-2R、mIL-2R及TNF-α在多发性硬化症免疫学发病机制中的作用

目的探讨可溶性白细胞介素-2受体（sIL－2R）、膜白细胞介素-2受体（mIL－2R）和肿瘤坏死因于-α（TNF－α）与多发性硬化（MS）免疫学发病机制、病程及病情的关系。方法采用ELkA法检测了临床确诊的48例MS患者血清、28例CSF中sIL－ZR水平，用免疫荧光法检测28例MS患者血中mIL－2R的表达，用生物活性测定法检测28例MS患者PBMCs体外诱生TNF－α水平。结果MS患者组激素治疗前血清及CSF中sIL－1R和血中TNF－α水平显著高于对照组（NC组）（P＜0．01），其中急性复发组MS显著高于缓解组（P＜0．01）；治疗后血清SIL－2R及TNF－α水平较治疗前显著下降（P＜0．01），且二者水平仍显著高于NC组（P＜0.01）。而缓解组TNF－α水平低于NC组（P＜0．05）。MS组血中mIL－2R表达，急性复发期MS患者显著高于缓解期（P＜0．01）及NC组（P＜0．01），缓解期MS患者则又显著低于NC组（P＜0．01）。MS患者血中sIL－2R及TNF－α水平与病情显著相关而与病程无关，sIL－2R与TNF－α显著相关。结论sIL－2R，mIL－2R、TNF－α在MS免疫发病中可能起重要作用，为探讨MS免疫发病机制进一步提供了理论依据。     

The relationship of interleukin-2 and soluble interleukin-2 receptors to intrathecal immunoglobulin synthesis in patients with multiple sclerosis

The in vivo relationship of interleukin-2 (IL-2) to the local humoral immune response within the central nervous system (CNS) in patients with multiple sclerosis (MS) is hitherto largely unknown. Intrathecal levels of IL-2 and soluble IL-2 receptors (sIL-2R) were correlated to the local CNS synthesis of immunoglobulin G, A, D, and M isotypes in 70 patients with clinically definite MS. Levels were also determined in 19 normal control subjects to establish normal reference limits. High cerebrospinal fluid levels of IL-2 and sIL-2R were detected mainly in patients with acute relapsing-remitting MS and were significantly higher than corresponding serum levels. Intrathecal levels of IL-2 significantly correlated with local CNS synthesis of IgD and IgM, while no correlation was found with either IgG or IgA. Similarly, intrathecal sIL-2R levels significantly correlated with local CNS production of IgD and IgM, but not IgG or IgA. These findings further extend previous reports and also suggest that IL-2 and sIL-2R are involved in the early intrathecal humoral immune response in MS.     

Prostaglandin levels in cerebrospinal fluid from multiple sclerosis patients in remission and relapse

Radioimmunoassay (RIA) techniques have been employed to determine prostaglandin (PG) levels in the cerebrospinal fluid (CSF) from multiple sclerosis (MS) patients in remission and relapse and in subjects with other neurological diseases (OND). PGE and PGF₂α concentrations in spinal fluid from MS patients in relapse were significantly lower than values estimated during remission and in individuals with OND of the central nervous system (CNS). These observations are discussed in relation to the clinical state of patients with demyelinating disease together with a consideration of the concept that disordered immune mechanisms contribute a central role in the pathogenesis of MS.     

Cerebrospinal fluid levels of myelin basic protein-like material and soluble interleukin-2 receptor in multiple sclerosis

The presence, level and disease activity relationships of soluble interleukin-2 receptor (sIL-2R) in the cerebrospinal fluid (CSF) of multiple sclerosis (MS) patients are unresolved. We measured CSF immunoreactive myelin basic protein (MBP), a marker of acute myelin damage, and sIL-2R levels in the CSF from 11 patients with active relapsing remitting (RR) MS, five with stable RR MS, eight with chronic progressive (CP) MS, five with other neurologic diseases, and three normal controls. No measurable (less than 100 units/ml) sIL-2R was present in any of the samples. Conversely, MBP levels were elevated in the active RR group compared to the other four groups. These results indicate that, at the sensitivity of assays currently available, levels of CSF sIL-2R do not correlate with the diagnosis or disease activity of MS.     

结核性脑膜炎患者脑脊液sIL-2R检测的临床意义

目的动态观察结核性脑膜炎患者脑脊液中的可溶性白介素-Ⅱ受体(sIL-2R)水平的变化,探讨结核性脑膜炎患者细胞免疫的发生机制并判断其预后,为今后针对性地提高免疫治疗寻找依据。方法采用双抗体夹心ELISA方法动态检测了28例结核性脑膜炎患者及26例非结核性脑膜炎患者脑脊液中的sIL-2R水平的变化。结果 28例结核性脑膜炎组患者sIL-2R水平较对照组明显升高,差异有统计学意义(P<0.05)。治疗后sIL-2R水平呈下降趋势与治疗前相比具有统计学意义(P<0.05)。其中细胞学改变明显者其前后对比具有统计学意义(P<0.05)。临床症状较重者与较轻者两组相比无明显统计学意义(P(0.05)。结论通过测定脑脊液中sIL-2R含量提示结核杆菌感染机体后主要启动T细胞免疫,并且机体处于一种免疫调节紊乱状态。通过动态观察其含量变化对结核性脑膜炎患者的病情监测及评估预后具有重要意义。     

IP-10 and MCP-1 levels in CSF and serum from multiple sclerosis patients with different clinical subtypes of the disease

Interferon-gamma-inducible Protein-10 (IP-10) and Monocyte Chemotactic Protein-1 (MCP-1) levels were measured by enzyme-linked immunosorbent assay (ELISA) in the CSF and in the serum from 74 patients affected by different clinical forms of Multiple Sclerosis (MS), including 39 patients with Relapsing Remitting (RR) MS in an active phase, 14 patients in a stable phase of the disease, 12 patients with Secondary Progressive (SP) MS and 9 patients with Primary Progressive (PP) MS. IP-10 and MCP-1 levels were also determined in 19 subjects with no neurological diseases or major systemic disorders, 18 patients with non-inflammatory neurological diseases, as well as in 15 patients with other inflammatory neurological diseases.IP-10 levels were significantly elevated in CSF and serum from RR and SP, but not PP-MS patients. On the contrary, MCP-1 levels were decreased in CSF and serum of all MS patients. CSF concentrations of IP-10 and MCP-1 did not significantly correlate neither with each other, nor with CSF mononuclear cell count, albumin quotient or CSF IgG index. No correlation between disease duration, clinical course or EDSS score and chemokine levels was found.IP-10 and MCP-1 undergo modifications in different subtypes of the disease: IP-10 levels in CSF and serum samples are markedly increased when inflammation is prominent, and not in PP--MS patients, where inflammation is less evident. MCP-1 decrease in CSF and serum from MS patients could be related to the regulation of T-cell polarization.     

Brain-stem auditory evoked potentials in multiple sclerosis: the relation to VEP,SEP and CSF immunoglobulins

Summary One hundred patients with multiple sclerosis (MS) were analysed retrospectively with respect to investigations of brain-stem auditory evoked potentials (BAEP), pattern reversal visual evoked potentials (VEP), somatosensory evoked potentials (SEP), and cerebrospinal fluid immunoglobulins (CSF-IG). BAEP were abnormal in 42% of those with normal VEP and SEP examinations, and in 38% of patients with normal CSF-IG. The chance of obtaining at least one abnormal EP was lower in patients with normal CSF-IG than in patients with abnormal CSF. When a dispersion ratio was included in the criteria for BAEP abnormality, the sensitivity increased compared with conventional BAEP criteria. We recommend that BAEP should still be included in the EP test battery for patients with suspected MS.     

CSF myelin basic protein in multiple sclerosis

Cerebrospinal fluid (CSF) from 221 patients with multiple sclerosis (MS) and 85 patients with other neurological disorders (OND) was examined using a competitive radioimmunoassay for myelin basic protein (MBP) immunoreactivity. MBP was found in 46 of 55 MS patients (84%) examined within six weeks of relapse but in only 11 of 85 patients (13%) with OND. There was a significant correlation between the concentration of MBP in the CSF and relapse severity in patients seen within four weeks of the onset of symptoms (p less than 0.01). Of 44 patients in remission, MBP was detected in 12, and these patients had a significantly higher tendency to subsequent relapse (p less than 0.05). In 72 patients with progressive disease the presence of MBP in the CSF reflected the confidence of clinical diagnosis. The results of this study suggest that measurement of MBP in the CSF gives an objective method of monitoring disease activity in patient with MS.     

Growth hormone and insulin growth factor-I levels in plasma and cerebrospinal fluid of patients with multiple sclerosis

Multiple sclerosis (MS) has several clinically different forms. Whereas the illness progresses slowly in most of the patients, 10% have an aggressively progressive course with fatal outcome without signs of remyelination capability. The process of remyelination depends on numerous interactive factors, including the presence of various growth factors, the most important of which in the adult is insulin growth factor-I (IGF-I). On the other hand, the most powerful postnatal regulator of IGF-I is growth hormone (GH), which also acts as a neuroprotective and an antiapoptotic agent, and has direct influence on myelination. Levels of these growth factors have never been examined in the cerebrospinal fluid (CSF) of patients with MS. The levels of IGF-I and GH were measured in serum and CSF of 46 MS patients and compared with those of 49 patients with no evidence of demyelinating disease. The only positive finding was a deficiency of GH in the CSF of MS patients. The possible implications of those findings in the etiopathogenesis of MS will be discussed.