Central nervous system immunity associated with clinical outcome in acute encephalitis
Central nervous system immunity associated with clinical outcome in acute encephalitis
复制标题
DOI：
10.1016/j.jns.2004.09.022
复制
发表时间：
2004-12-15
影响因子：
4.4
通讯作者：
Kuroda, Y
中科院分区：
文献类型：
--
作者：
Matsui, M;Tanaka, K;Kuroda, Y
为了寻找可以提供准确预后或治疗选择线索的有用的中枢神经系统（CNS）免疫实验室测量方法，连续从14名急性脑炎患者的急性期、恢复期或慢性期采集脑脊液（CSF）样本，然后检查淋巴细胞的表面抗原表达和抗神经组织抗体的存在以及IgG相关参数和促炎细胞因子（包括IL-2、IL-6、 IFN-γ 和肿瘤坏死因子-α (TNF-α)。七名无菌病毒性脑膜炎患者作为非脑炎对照。 14 名急性脑炎患者中有 8 名完全康复，CD4(+)CD29(+)辅助诱导 T 细胞和 IL-2 受体阳性 CD4 的百分比下降。 CD4(+)CD26(+)记忆T细胞在急性期的低比例与辅助静脉皮质类固醇治疗后的不良结果相关。此外，四名表现出自身抗体的脑炎患者中的三名预后不良。这些发现表明，中枢神经系统免疫状态对预后有影响，而脑脊液CD4(+)辅助T细胞亚群的流式细胞术分析可能作为有效的评估手段。 (C) 2004 Elsevier B.V. 保留所有权利。
To search for useful laboratory measures of central nervous system (CNS) immunity that may provide an accurate prognosis or clues regarding treatment choice, cerebrospinal fluid (CSF) samples were obtained from 14 consecutive patients with acute encephalitis during acute as well as convalescent or chronic stages, and then examined for surface antigen expressions by lymphocytes and the presence of antineuronal tissue antibodies as well as the levels of IgG-related parameters and proinflammatory cytokines, including IL-2, IL-6, IFN-gamma, and tumor necrosis factor-alpha (TNF-alpha). Seven patients with aseptic viral meningitis served as nonencephalitic controls. Eight of the 14 acute encephalitis patients recovered fully, and reductions in the percentages of CD4(+)CD29(+) helper inducer T cells and IL-2 receptor-positive CD4. cells were associated with early recovery and favorable outcome, respectively, whereas a low percentage of CD4(+)CD26(+) memory T cells during an acute stage was associated with an unfavorable outcome following adjunctive intravenous corticosteroid treatment. Further, three of the four encephalitis patients who exhibited autoantibodies had a poor prognosis. These findings suggest that CNS immunity status has an effect on prognosis, while flow cytometric analyses of CSF CD4(+) helper T cell subsets may serve as effective means of assessment. (C) 2004 Elsevier B.V. All rights reserved.