Intrathecal release of pro- and anti-inflammatory cytokines during stroke
Intrathecal release of pro- and anti-inflammatory cytokines during stroke
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DOI：
10.1046/j.1365-2249.1997.4621483.x
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发表时间：
1997-12-01
影响因子：
4.6
通讯作者：
Tarkowski, A
中科院分区：
文献类型：
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作者：
Tarkowski, E;Rosengren, L;Tarkowski, A
越来越多的证据指出炎症机制在缺血性脑损伤的病理生理学中的潜在作用。我们最近已经证明，中风患者在症状开始后的前24小时内已经显示出促炎细胞因子如IL-1 β和IL-6的鞘内产生（Tarkowski等人，1995年）。本研究的目的是调查急性卒中后局部炎症反应的模式。在第0-3天、第7-9天、第21-26天和第90天后，对30名中风患者进行了前瞻性研究，进行了临床评价、放射学评估和脑脊液（CSF）细胞因子水平分析。此外，使用了15份健康对照CSF样本。在中风早期观察到IL-8、粒细胞-巨噬细胞集落刺激因子（GM-CSF）和IL-10的CSF水平显著增加，促炎细胞因子IL-8和GM-CSF在第2天达到峰值，免疫调节细胞因子IL-10在第3天达到峰值。脑梗死主要位于白色物质的患者的CSF中IL-8水平显著高于脑梗死主要位于灰质的患者。此外，鞘内肿瘤坏死因子-α（TNF-α）的高水平与白色疾病的存在有关。我们的研究表明，脑卒中患者鞘内产生促炎和免疫调节细胞因子，支持急性脑损伤局部免疫反应的概念。更好地了解中风中的炎症反应可能会导致新的治疗策略。
A growing body of evidence points out the potential role of inflammatory mechanisms in the pathophysiology of ischaemic brain damage. We have recently demonstrated that stroke patients display an intrathecal production of proinflammatory cytokines, such as IL-1 beta and IL-6 already within the first 24 h after the beginning of symptoms (Tarkowski et al., 1995). The aim of the present study was to investigate patterns of local inflammatory responses as a consequence of acute stroke. Thirty stroke patients were studied prospectively on days 0-3, 7-9, 21-26 and after day 90 with clinical evaluations, radiological assessments and analysis of cerebrospinal fluid (CSF) cytokine levels. In addition, 15 healthy control CSF samples were used. Significantly increased CSF levels of IL-8, granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-IO were observed early during the stroke with a peak on day 2 for the proinflammatory cytokines IL-8 and GM-CSF, and on day 3 for the immunoregulatory cytokine IL-10. Patients with a brain infarct predominantly located in the white matter showed significantly higher levels of IL-8 in CSF than patients with an infarct mainly located in the grey matter. Also, high levels of intrathecal tumour necrosis factor-alpha (TNF-alpha) were associated with the presence of white matter disease. Our study demonstrates an intrathecal production of proinflammatory and immunoregulatory cytokines in patients with stroke, supporting the notion of localized immune response to the acute brain lesion. A better understanding of the inflammatory response in stroke may lead to new treatment strategies.