Immune cell subtyping in the cerebrospinal fluid of patients with neurological diseases
Immune cell subtyping in the cerebrospinal fluid of patients with neurological diseases
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DOI：
10.1007/s00415-013-7145-2
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发表时间：
2014-01-01
影响因子：
6
通讯作者：
Hemmer, B.
中科院分区：
文献类型：
--
作者：
Kowarik, M. C.;Grummel, V.;Hemmer, B.
脑脊液分析结合脑脊液细胞计数和蛋白质的测定是神经系统疾病诊断的重要手段。作为这一标准方法的补充，我们在这里提供了常见神经疾病中脑脊液免疫细胞亚群分布的数据，并提供了罕见神经疾病病例的参考值。应用七色流式细胞术对319例炎症性和非炎症性神经系统疾病患者脑脊液中的T细胞、T细胞、B细胞、浆母细胞、单核细胞和NK细胞进行了检测。诊断包括头痛、特发性颅内高压、格林-巴利综合征、多发性硬化症、莱姆神经疏螺旋体病、细菌性和病毒性脑膜炎、人类免疫缺陷病毒(HIV)感染、中风和中枢神经系统恶性肿瘤等。脑脊液中以T细胞为主，其中CD4+T细胞较CD8+T细胞占优势。大多数HIV患者在其他免疫抑制条件下，CD4+和CD8+T细胞明显改变，CD4/CD8比值降低。B细胞和浆母细胞在非炎症性疾病中几乎检测不到，但在炎症性疾病中持续升高。单核细胞在神经炎症中减少，并与B细胞呈负相关。NK细胞在神经炎性疾病中轻度升高。单核细胞和NK细胞在中枢神经系统恶性肿瘤中均有轻度升高。脑脊液中免疫细胞亚群的分析为临床医生提供了有价值的信息，是神经疾病鉴别诊断的一种有前途的工具。
The analysis of cerebrospinal fluid (CSF) with the assessment of CSF cell counts and proteins is an important method in the diagnostic workup of neurological diseases. As an addition to this standard approach, we here present data on the distribution of CSF immune cell subsets in common neurological diseases, and provide reference values along with cases of rare neurological diseases. CD4+ and CD8+ T cells, the CD4/CD8 ratio, B cells, plasmablasts, monocytes and NK cells in the CSF of 319 patients with inflammatory or non-inflammatory neurological diseases were analysed by seven-color flow cytometry. Diagnoses included headache, idiopathic intracranial hypertension, Guillain-Barre syndrome, multiple sclerosis, Lyme neuroborreliosis, bacterial and viral meningitis, human immunodeficiency virus (HIV) infection, stroke, and CNS malignancies, among others. T cells were the predominant population in the CSF with CD4+ T cells being more prevalent than CD8+ T cells. Mostly in HIV patients, and under other conditions of immunosuppression, CD4+ and CD8+ T cells were significantly altered and the CD4/CD8 ratio reduced. B cells and plasmablasts could hardly be detected in non-inflammatory diseases but were consistently elevated in inflammatory diseases. Monocytes were reduced in neuroinflammation and showed a negative correlation with B cells. NK cells were slightly elevated in neuroinflammation. Both monocytes and NK cells were slightly elevated in CNS malignancies. The analysis of immune cell subsets in the CSF adds valuable information to clinicians and is a promising tool for the differential diagnosis of neurological diseases.