糖皮质激素对多发性硬化患者外周血淋巴细胞CD80和CD4+CD25+T细胞表达的影响

目的探讨糖皮质激素(GC)对多发性硬化(MS)患者外周血淋巴细胞CD80和CD4+CD25+T细胞表达的影响。方法利用流式细胞仪检测21例MS急性期患者GC治疗前后外周血淋巴细胞CD80和CD4+CD25+T细胞阳性率,并与正常对照组比较;比较MS患者治疗前后扩展功能障碍状况量表(EDSS)评分的变化。结果MS患者急性期外周血淋巴细胞CD80的阳性率[(5.031±1.782)%]较正常对照组[(6.436±2.035)%]明显下降(P<0.05),经GC治疗后CD80的阳性率[(6.467±1.882)%]明显增高(P<0.01);CD4+CD25+T细胞阳性率治疗前后与正常对照组间差异均无统计学意义;治疗后EDSS评分[(3.64±1.79)分]较治疗前[(4.26±1.68)分]明显下降(P<0.01)。结论GC可上调MS患者淋巴细胞CD80的表达,抑制细胞免疫,促进MS病情缓解。     

老年与中青年脑梗死患者淋巴细胞亚群的对比研究

目的探讨不同年龄阶段脑梗死患者与淋巴细胞亚群的关系。方法选择101例临床确诊的急性脑梗死(ACI)患者,分成老年ACI组(66例)和中青年ACI组(35例)。选择对照组50例,应用流式细胞分析仪检测ACI患者和对照组外周血中淋巴细胞亚群相对计数。结果①老年脑梗死患者与正常对照组比较:CD8+T和CD19+B细胞百分率升高差异有统计学意义(P<0.05);CD4/CD8和CD4+T细胞百分率降低差异有统计学意义(P<0.05);CD3+T细胞百分率变化不明显(P>0.05)。②中青年脑梗死患者与正常对照组相比较:CD4+T细胞百分率和CD4/CD8降低差异有统计学意义(P<0.05);而CD3+T、CD8+T和CD19+B细胞百分率变化不明显(P>0.05)。③老年ACI组患者与中青年ACI组患者比较:CD8+T和CD19+B细胞百分率升高差异有统计学意义(P<0.05);CD3+T、CD4+T细胞百分率和CD4/CD8比较变化不明显(P>0.05)。结论 ACI患者体内淋巴细胞亚群发生重新分布,尤其老年ACI淋巴细胞亚群变化显著,这为我们在临床治疗中提供了新的思路。     

载脂蛋白E拟肽对实验性自身免疫性脑脊髓炎小鼠脑脊髓CD4+、CD8+T淋巴细胞表达的影响

目的 探讨载脂蛋白(Apo)E拟肽对实验性自身免疫性脑脊髓炎(EAE)小鼠脑脊髓CD4+、CD8+T淋巴细胞表达的影响.方法 40只C57BL/6J雌性小鼠随机分成EAE组、EAE治疗组、正常对照组、正常治疗组;采用髓鞘少突胶质细胞糖蛋白制备的完全抗原诱导EAE模型小鼠.免疫诱导次日,EAE治疗组和正常治疗组小鼠每隔2d皮下注射ApoE拟肽,EAE组和正常对照组小鼠皮下注射等量的生理盐水.免疫诱导后各组每日进行神经功能缺损评分(NDS);35 d后用免疫组化检测各组小鼠脑脊髓CD4+T细胞、CD8+T细胞的表达.结果 EAE治疗组NDS的峰值及终末评分显著低于EAE组(均P＜0.05).与正常对照组及正常治疗组比较,EAE组大脑、脑干和脊髓中CD4+T细胞数明显增高,大脑CD8+T细胞数明显增高(均P＜0.05).EAE治疗组小鼠大脑、脑干、脊髓组织CD4+T细胞表达显著低于EAE组(均P＜0.05);两组间CD8+T细胞表达水平的差异无统计学意义.结论 ApoE拟肽可抑制CD4+T细胞的表达,减轻免疫炎症反应,对EAE小鼠有神经保护作用;而对CD8+T细胞的表达无明显影响.     

Dopamin促进出血性卒中大鼠恢复的作用机制研究

目的应用多巴胺(dopamine)对实验性脑出血大鼠进行腹腔注射,研究dopamine对出血性卒中的神经保护作用机制。方法 SD雄性大鼠60只,体质量300±20g,造脑出血模成功后随机分为dopamine治疗组、生理盐水(NS)对照组(n=30),同一条件下饲养。每天进行神经功能评分,不同亚组按相应时间点取材。分别测定出血周围脑组织胶质纤维酸性蛋白(GFAP)和脑源性神经营养因子(BDNF)的免疫组化评分。取脾组织制作匀浆,反转录聚合酶链式反应(RT-PCR),测定转录调节家族中叉头翼状双螺旋家族的一个独特的成员Foxp3与β-actin的相对密度值,表示CD4+、CD25+、T细胞的活性。结果 dopamine组大鼠与NS组在对应时间点进行神经功能评分,显示前者高于后者差异有统计学意义(P<0.05)。GFAP和BDNF在实验大鼠脑组织中的表达,dopamine组均高于相应对照组差异有统计学意义(P<0.01)。Foxp3mRNA在dopamine组的大鼠脾脏中的表达与相应的对照组比较,差异有统计学意义(P<0.01)。结论 dopamine能上调实验性脑出血大鼠脑内GFAP和BDNF蛋白表达水平,促进神经症状的好转。CD4+、CD25+、调节性T细胞对中枢神经系统损伤的恢复有抑制作用;dopamine可下调CD4+、CD25+、调节性T细胞对D4+Th1细胞的抑制作用,促进出血性卒中大鼠脑损伤的恢复。     

添加维生素D3治疗50例缓解复发型多发性硬化的研究

目的探讨维生素D3添加治疗缓解复发型多发性硬化(RRMS)患者的临床疗效和安全性。方法将50例缓解复发型多发性硬化(RRMS)患者随机分成维生素D3组和激素组,每组各25例,维生素D3组在激素治疗的基础上添加骨化三醇胶丸口服,治疗前后检测外周血T细胞亚群CD4+、CD8+、CD4+/CD8+、Th1、Th2数量,评定NIHSS分值,观察并记录治疗期间药物的安全性及副作用。结果治疗前维生素D3组与激素组在年龄、病程、性别以及NIHSS评分比较差异无统计学意义(P0.05),治疗后CD8+、CD4+/CD8+、Th2数与治疗前比较及治疗后2组间比较差异均无统计学意义(P0.05),治疗后CD4+、Th1数、NIHSS评分与治疗前比较及治疗后2组间比较差异有统计学意义(P0.05)。结论维生素D3添加治疗缓解复发型多发性硬化(RRMS)患者具有较好的临床疗效。     

瑞舒伐他汀钙对颈动脉粥样硬化患者CD4+CD25+调节性T细胞的干预作用

目的 探讨CD4~+CD25~+调节性T细胞在颈动脉粥样硬化发病中的作用,研究瑞舒伐他汀钙在颈动脉粥样硬化治疗中的免疫调节作用。方法 选取颈动脉粥样硬化患者42例为治疗组,以42例健康体检者为正常对照组;治疗组随机分为瑞舒伐他汀治疗组21例和安慰剂对照组21例。利用流式细胞术检测各组CD4~+CD25~+调节性T细胞变水平。结果 (1)与正常对照组(6.67±0.79)%比较,颈动脉粥样硬化患者组CD4~+CD25~+调节性T细胞水平(3.41±0.67)%明显下降,差异具有统计学意义(P0.05)。(2)瑞舒伐他汀钙干预治疗1个月后,与治疗前(3.38±0.64)%及安慰剂组(3.42±0.56)%比较,治疗组外周血CD4~+CD25~+调节性T细胞表达水平(6.02±0.84)%显著性升高,差异具有统计学意义(P0.05)。结论 颈动脉粥样硬化患者外周血CD4~+CD25~+调节性T细胞水平降低,瑞舒伐他汀钙可能通过上调CD4~+CD25~+调节性T细胞水平起到免疫调节作用,从而达到延缓颈动脉粥样硬化的进展。     

Miller-Fisher综合征患者免疫球蛋白治疗前后淋巴细胞亚群的变化

目的研究Miller-Fisher综合征(MFS)患者应用静脉注射免疫球蛋白(IVIG)治疗前后T、B淋巴细胞亚群的变化,探讨IVIG治疗MFS的免疫学机制。方法选择10例临床确诊的MFS患者,应用流式细胞分析仪检测MFS患者治疗前后外周血中T、B淋巴细胞相对计数。结果 MFS患者急性期治疗后与治疗前比较:CD4~+T细胞和CD4/CD8值显著升高(P0.05),CD8~+T和CD19~+B细胞百分率显著降低(P0.05)。结论急性期MFS患者应用IVIG治疗效果显著,并且患者体内淋巴细胞亚群发生了不同程度变化,有助于了解IVIG治疗MFS的免疫学机制。     

帕金森病大鼠CD4+CD25highFoxP3+调节性T细胞的变化

目的 研究帕金森病(Parkinson's disease,PD)大鼠外周血中调节性T细胞(regulatory T cells,Treg)的改变,并探讨其与脑内免疫炎症反应的相关性.方法 SD大鼠随机分为对照组、假手术组、PD 4周组、PD 2周组.PD 4周组和2周组定向注射6-羟多巴建立PD大鼠模型,假手术组注射PBS缓冲液,PD 2周组于术后第2 周,其他组于术后第4 周时,应用免疫荧光染色法观察各组大鼠黑质处酪氨酸羟化酶(Tyrosine hydroxylase,TH)阳性神经元、离子钙接头蛋白分子-1(Ionized calcium bindingadaptor molecule-1,iba-1)和胶原纤维酸性蛋白(Glial fibrillary acid protein,GFAP)阳性细胞数量及形态的改变,并通过流式细胞术(Flow cytometry,FCM)检测其外周血中CD4+CD25highFoxP3+ Treg 占T 淋巴细胞比例的变化.结果 PD4 周组TH 阳性神经元偏侧毁损率(91.33%±8.53%)较对照组和假手术组增加(P<0.01),且较PD2周组(64.56%±17.94%)毁损更为严重(P<0.05).PD4周组iba-1阳性细胞增加率(82.60%±11.52%)和GFAP阳性细胞增加率(86.62%±6.80%)较对照组及假手术组均增加(P<0.01),但PD 4 周组较2 周组iba-1 阳性细胞增加率(104.89%±13.39%)和GFAP 阳性细胞增加率(117.92%±15.34%)均减少(P<0.05).FCM示PD4周组大鼠外周血中CD4+CD25highFoxP3+ Treg占T淋巴细胞的比例(0.64%±0.08%)较对照组、假手术组及PD2周组均降低(P<0.01).另外,外周血T淋巴细胞中Treg比例变化与TH 阳性神经元毁损率(r=-0.59,P<0.01)、iba-1 阳性细胞增加率(r=-0.87,P<0.01)和GFAP 阳性细胞增加率(r=-0.89,P<0.01)均呈负相关.结论 PD大鼠外周血中Treg比例减少且可能与脑内免疫炎症反应相关.     

癫痫患儿外周血CD19+B、 CD20+B淋巴细胞和自然杀伤细胞的检测及意义

目的探讨儿童癫痫患者外周血CD 19+13、CD20+B淋巴细胞和自然杀伤(NK)细胞的表达及其意义。方法选择中山大学孙逸仙纪念医院自2008年1月至2010年12月收治的癫痫患儿458例为病例组,另设同期该院52例健康对照者为对照组。应用流式细胞仪对2组成员外周血CD19+B细胞、CD20+B细胞和NK细胞的表达进行检测及比较,同时分析92例应用静脉注射免疫球蛋白(IVIG)治疗的癫痫患儿治疗前后细胞表达的改变。 结果癫痫患儿CD19+B细胞和CD20+B细胞比例分别为(22.35％±6.54％)、(21.50％±8.41％),明显高于正常对照组(16.86％±4.02％)、(16.13％±4.19％),差异有统计学意义(P≤0.05); NK细胞比例为(9.11％±4.90％),明显低于正常对照组(14.72％±4.15％),差异有统计学意义(P≤0.05)。IVIG治疗6个月后癫痫患儿CD19+B细胞和CD20+B细胞比例分别为(18.26％±5.03％)、(16.74％±5.12％),较治疗前(22.74％±6.25％)、(21.61％±8.03％)明显降低,差异有统计学意义(P＜0.05);而NK细胞为(14.65％±4.58％),较治疗前(9.07％±4.76％)明显升高,差异亦有统计学意义(P＜0.05)。92例IVIG治疗患儿中,22例无效,70例有效,有效与无效患儿外周血CD19+B细胞和CD20+B细胞比例治疗前后差值差异具有统计学意义(P＜0.05),但外周血NK细胞比例治疗前后差值差异无统计学意义（P＞0.05）。 结论癫痫患儿存在B淋巴细胞和NK细胞功能异常,IVIG治疗能改善癫痫患儿的免疫功能紊乱;外周血CD19+B细胞、CD20+B细胞可做为癫痫IVIG治疗疗效的监测指标。     

急性脑梗死患者外周血CD34+细胞与血管内皮细胞生长因子动态变化及其临床意义

目的 探讨血管内皮生长因子(VEGF)和CD34+细胞在急性脑梗死发病中的变化及作用关系. 方法 分别采取流式细胞仪及酶联免疫法(ELISA)动态测定40例急性脑梗死患者及正常对照者起病后或入组后第3、7、10、14天外周血CD34+细胞和血清VEGF水平.分析其关系. 结果 脑梗死组外周血CD34+细胞水平在各时间点均明显高于对照组,第10天达峰值:脑梗死患者血清VEGF浓度在各时间点亦明显高于对照组,第7-10天达峰值,差异有统计学意义(P<0.05);CD34+细胞水平与血清VEGF浓度两者存在正相关(r=0.452,P<0.01). 结论 脑梗死后外周血VEGF及CD34+细胞水平的升高将促进血管生成,改善脑组织缺血缺氧状态.起到保护神经功能的作用.     

Astrocytic activation in relation to inflammatory markers during clinical exacerbation of relapsing-remitting multiple sclerosis

Summary The study aimed to assay the cerebrospinal fluid (CSF) levels of protein S100B, a biomarker of astrocyte activation in relation to kynurenic acid (KYNA) and nitric oxide (NO) metabolites, nitrate/nitrite (NOx) concentrations in acute relapse multiple sclerosis (MS) patients. Twenty relapsing-remitting MS (RR-MS) patients and 10 controls were enrolled. RR-MS patients were assessed on the expanded disability status scale (EDSS) and underwent lumbar puncture. The CSF KYNA, NOx and S100B levels were significantly higher in RR-MS group compared to controls (p = 0.01, 0.001, 0.04, respectively). There was a significant correlation between CSF S100B and KYNA (p = 0.01) but not NOx (p > 0.05) in RR-MS. CSF KYNA, NOx or S100B concentrations did not correlate with disease characteristics of MS patients. Our study suggests the activation of the kynurenine pathway leading to the increase of neuroprotective KYNA in the CSF of MS patients during acute relapse what contrasts with chronic phases of the disease.     

CD45RA+ ICAM-3+ lymphocytes in cerebrospinal fluid and blood as markers of disease activity in patients with multiple sclerosis

OBJECTIVES: Autoreactive T cells targeted against antigens of the myelin sheath are suggested to play an important role in the pathogenesis of multiple sclerosis (MS). Naive (CD45RA+) T cells and intercellular adhesion molecule-3 (ICAM-3) are markers for un-activated lymphocytes. This study was performed to investigate, whether the expression levels of these antigens both on cerebrospinal fluid (CSF) and peripheral blood lymphocytes can be used as activity markers in MS. MATERIALS AND METHODS: Corresponding blood and CSF samples were obtained from 31 patients with relapsing-remitting MS. Of the 31 MS patients 23 were suffering from acute relapses at the time of examination and all of them were treated with high-dose methylprednisolone (MP). Blood was collected again on the 10th day of therapy and after 3 months. The control group consisted of 12 healthy persons. Two-color flow cytometry was performed to evaluate the percentage of both CD45RA+ and ICAM-3+ cells within the lymphocyte population. RESULTS: The percentage of CD45RA+ ICAM-3+ cells in the CSF of MS patients with relapses was significantly increased compared to patients in remission (P<0.05). In blood, a significantly lower percentage of CD45RA+ ICAM-3+ lymphocytes was found in both patient groups compared to healthy controls (Relapse: P<0.05, Remission: P<0.10). Additionally, we found a significant increase (P < 0.01) in the percentage of CD45RA+ ICAM-3+ lymphocytes in blood of MS patients suffering from acute relapse on the 10th day of high-dose MP treatment. CONCLUSION: Our data suggest that the percentage of CD45RA+ ICAM-3+ lymphocytes in CSF can be used as marker of disease activity in MS patients.     

Cerebrospinal fluid brain specific proteins in relation to nitric oxide metabolites during relapse of multiple sclerosis

This study investigated the cerebrospinal fluid (CSF) levels of ferritin, S100B as biomarkers for glial activation and NfH(SM135)--a biomarker of axonal damage--in relation to nitric oxide (NO) metabolites: nitrate and nitrite (NOx) during acute multiple sclerosis (MS) relapse. Thirty-four relapsing-remitting MS (RR-MS) patients during acute relapse and 12 controls were enrolled. Patients were assessed on Expanded Disability Status Scale (EDSS) and underwent lumbar puncture within two weeks following relapse. Twenty patients were available for further follow-up and were assessed on EDSS 6-8 weeks since the relapse onset. The CSF NOx (P<0.0001), NfH(SM135) (P=0.01) and S100B (P=0.009) but not ferritin (P>0.05) were significantly raised in MS group. There was a significant correlation between CSF ferritin and S100B in RR-MS group (P=0.004). CSF NOx did not correlate with S100B and ferritin in study groups. RR-MS patients with detectable NfH(SM135) levels had higher NOx compared with subjects having undetectable NfH(SM135) (P=0.03). In the follow-up study, raised baseline levels of NOx (P=0.016) or NfH(SM135) (P=0.04) inversely correlated with the clinical recovery grade expressed as relative EDSS change between baseline and follow-up. In conclusion, NO metabolites were increased and because of their correlation with a biomarker of axonal degeneration (neurofilaments) and a measure for clinical disability (EDSS), relapse-related nitrosative stress is likely to be relevant to the development of sustained disability in an individual patient.     

Soluble and cell surface ICAM-3 in blood and cerebrospinal fluid of patients with multiple sclerosis: influence of methylprednisolone treatment and relevance as markers for disease activity

OBJECTIVE: The expression of intercellular adhesion molecule-3 (ICAM-3), a member of the Ig supergene family, is restricted to immune competent cells. Expression of soluble and cell surface ICAM-3 (s- and c-ICAM-3) is preferentially seen in the state of low activation of the immune system. We studied the relevance of the expression levels of s- and c-ICAM-3 in cerebrospinal fluid (CSF) and blood as markers for disease activity as well as the influence of high-dose methylprednisolone (MP) treatment upon the expression of s- and c-ICAM-3 in blood of patients with multiple sclerosis (MS). MATERIALS AND METHODS: A total of 33 patients (relapses n = 25, remission n = 8) with relapsing-remitting MS were included into the study. CSF and blood were acquired from all of them. Of the patients 24 were treated with high-dose MP. In those, blood was additionally collected at the 10th day of the therapy and after 3 months. Expression of c-ICAM-3 was determined by two colour FACS analysis, whereas the concentration levels of s-ICAM-3 were measured by ELISA. RESULTS: In CSF we detected a significant decrease of the expression levels of c-ICAM-3 on CD3+ T cells in 25 patients suffering from an acute relapse in contrast to 8 patients with remission (P= 0.04). In comparison to the levels before treatment and after 3 months, at the 10th day of MP treatment we obtained highly significant changes of the expression values of c-ICAM-3 both on CD3+ T cells (P = 0.0004; P= 0.005) and CD14+ monocytes/macrophages (P =0.0006; P=0.008) on the 10th day of high-dose MP treatment from 24 MS patients. CONCLUSION: The increase of ICAM-3 levels might indicate the anti-inflammatory effect of the MP treatment. It could be interesting to search for similar effects investigating the new immune modulatoring therapy forms of MS.     

T-cell subsets in the cerebrospinal fluid and peripheral blood of multiple sclerosis patients treated with high-dose intravenous methylprednisolne

To determine the effects of high-dose intravenous methylprednisolone (MP) on lymphocytes and lymphocyte subpopulations in the cerebrospinal fluid (CSF) and peripheral blood (PB) in multiple sclerosis (MS) patients, we studied 67 patients with definite MS treated with MP. They were classified according to the disease course: 32 chronic progressive (CP) patients, 25 relapsing-remitting (RR) patients, and 10 patients with a chronic progressive disease course accompanied by relapses and remissions (CP + RR). MS patients were treated with 1000 mgr intravenous MP daily for 10 consecutive days. Before and after MP treatment we simultaneously studied CSF and PB CD3 +, CD4 +, CD8 +, CD20 +, and Ial + cells subsets. Kurtzke's Expanded Disability Status Scale (EDSS) was used for clinical evaluation. Progression rate was defined as the ratio of EDSS to disease duration. Thirteen patients with lumbar disk herniation were investigated as controls. Before MP, we found in MS patients, especially in the CP group, significantly lower CD4 + T-cell percentages in the PB with respect to controls (P<0.05). The percentage of CD4 + T-cells in the CSF of MS patients was significantly higher compared with PB (p = 0.0001), and tended to be higher than in controls (p = 0.072). The CSF mononuclear cell counts were significantly correlated with higher percentages of CSF CD3 + (r = 0.40) and CD4 + (r = 0.47) T-cells and lower CSF CD8 + (r = -0.33) T-cell percentages. B-cell percentages in the CSF were significantly elevated compared with controls for all MS groups. No relation could be obtained between T- or B-cell subsets and EDSS or progression rate. After MP, a significant decrease in PB CD8 + T-cell percentage and simultaneously an increase of the percentage CD8 + T-cells in CSF was noted in the entire MS group and in the CP and RR MS patients. Except for the CP + RR MS patients, CD4 + T-cell percentages in the PB or CSF showed insignificant changes. Our findings support the view that in MS MP might affect the inflammatory process of demyelination by a selective and dissociative effect on T-suppressor/cytotoxic cells in the PB and CSF.     

T-cell phenotypic profiles in the cerebrospinal fluid and peripheral blood of multiple sclerosis patients.

Thirty-nine patients with clinically definite multiple sclerosis (MS) entered the study. Of 28 subjects with a relapsing-remitting course, 19 were classified in acute relapse, 9 in remission; 11 patients had a progressive course without remissions. Furthermore, 6 subjects with inflammatory neurological disease (IND), and 10 with non-inflammatory and non-neoplastic neurological disease (NIND) were investigated. We simultaneously studied cerebrospinal fluid (CSF) and peripheral blood (PB) T-, B- and NK-cell subsets, as defined by following monoclonal antibodies: anti-CD3, -CD4, -CD8, -CD19, -CD16, -HLA-DR and -IL-2-R. We found a significant increase of CD4+ T-cells compared with controls in CSF, with respect to PB, of MS patients, particularly in acute relapse. An increase of HLA-DR+ cell percentages in the CSF than in the PB in all MS groups, especially in attacks of MS but also in remission, was also observed, with a positive correlation between CD4+ T-cell and DR+ cell percentages both in the CSF as well as in the PB of relapsing MS patients. These findings, together with the increase of IL-2-R+ cells in the PB, particularly in relapsing MS, give further support for the presence of a systemic T-cell activation in MS.     

Immune surveillance in multiple sclerosis patients treated with natalizumab

OBJECTIVE: Our objective was to test whether natalizumab, an antibody against very late activating antigen (VLA)-4, interferes with central nervous system immune surveillance as assessed by leukocyte cell numbers and cellular phenotypes in cerebrospinal fluid (CSF) and peripheral blood. METHODS: Cell numbers and cellular phenotypes in CSF and peripheral blood were analyzed in multiple sclerosis (MS) patients treated with natalizumab, untreated MS patients, and patients with other neurological disease (OND). JC virus DNA in the CSF and peripheral blood was quantified by kinetic polymerase chain reaction. RESULTS: CSF leukocyte counts, CD4(+) and CD8(+) T cells, CD19(+) B cells, and CD138(+) plasma cells were significantly lower in natalizumab-treated MS patients compared with OND patients and untreated MS patients. JC virus DNA was not detected in CSF or peripheral blood from natalizumab-treated patients. Six months after cessation of natalizumab therapy, low lymphocyte counts in the CSF persisted. The patient with the highest total leukocyte and CD4(+) and CD8(+)T-cell counts in the CSF experienced a clinical relapse. INTERPRETATION: These data suggest that natalizumab treatment results in a prolonged decrease of lymphocytes in the CSF and are consistent with the hypothesis that natalizumab impairs immune surveillance of the central nervous system.     

Chemokine receptor expression on T cells in blood and cerebrospinal fluid at relapse and remission of multiple sclerosis: imbalance of Th1/Th2-associated chemokine signaling

The expression of chemokine receptors on lymphocytes in the blood and CSF of multiple sclerosis (MS) patients was analyzed at relapse and remission. Both CD4+ and CD8+ cells in CSF at relapse were enriched for Th1-type receptors CXCR3 and CCR5 expression, and were reduced for Th2-type receptors CCR3 and CCR4 expression compared with those of the blood. CCR1 and CCR2 expressions on T cells were increased in CSF and blood, respectively. At remission, CCR5 expression, but not CXCR3 expression, was reduced in CSF CD4+ cells. A biased Th1/Th2 balance may play a critical role in active inflammation and CCR5 on CSF CD4+ cells is a good marker of the disease activity.     

Cellular immunoregulatory mechanisms in the central nervous system: characterization of noninflammatory and inflammatory cerebrospinal fluid lymphocytes

Dual-label flow cytometric analysis of cerebrospinal fluid (CSF) and blood lymphocytes with combinations of monoclonal antibodies such as CD4 plus CD45R or Leu8, and CD8 plus CD11b was performed in 37 patients with noninflammatory neurological diseases (NINDs) to clarify the differences in cellular immunoregulatory mechanisms present in the central nervous system (CNS) and in the systemic circulation. In the CSF of patients with NINDs, the paucity of CD4+CD45R+ and CD8+CD11b+ cells was striking, whereas the same subsets accounted for substantial proportions in the blood. CD4+CD45R- and CD4+Leu8- cells as well as CD8+CD11b- cells increased in the CSF when compared with those in the blood. Seven patients with active multiple sclerosis (MS) and 10 patients with other inflammatory diseases in the CNS (CNS-infl) were also studied. Patients with active MS were characterized by a consistent increase in percentage of CD4+CD45R- cells in the CSF, whereas an increase of CD4- CD45R+ cells in the CSF was a feature of the patients with CNS-infl, when compared with patients with NINDs. These findings indicate that the CNS is routinely surveyed by particular subsets of lymphocytes different from those in the blood, and cellular immune reaction in the CNS varies according to the types of CNS inflammatory conditions.     

Relapses in multiple sclerosis are associated with increased CD8+ T-cell mediated cytotoxicity in CSF

MS is thought to be mediated by CD4(+) T-helper cells. To investigate the importance of CD8(+) cytotoxic T-cells in MS we analyzed peripheral blood T-cells by DNA microarray, and plasma and CSF levels of granzymes from MS patients and controls. Cytotoxic gene expression was decreased in peripheral T-cells from RRMS patients whereas plasma levels of granzymes were unchanged. However, granzyme levels were elevated in the CSF of RRMS patients at relapse compared with controls and remission. Thus, CD8+ T-cell-mediated cytotoxicity is confined to the CSF/CNS compartment in RRMS patients and may be involved in the immunopathogenesis of clinical relapses.