SOLUBLE INTERCELLULAR-ADHESION MOLECULE-1 IN CEREBROSPINAL-FLUID - AN INDICATOR FOR THE INFLAMMATORY IMPAIRMENT OF THE BLOOD CEREBROSPINAL-FLUID BARRIER
SOLUBLE INTERCELLULAR-ADHESION MOLECULE-1 IN CEREBROSPINAL-FLUID - AN INDICATOR FOR THE INFLAMMATORY IMPAIRMENT OF THE BLOOD CEREBROSPINAL-FLUID BARRIER
复制标题
DOI：
10.1016/0165-5728(93)90023-r
复制
发表时间：
1993-09-01
影响因子：
3.3
通讯作者：
FELGENHAUER, K
中科院分区：
文献类型：
--
作者：
RIECKMANN, P;NUNKE, K;FELGENHAUER, K
测定了123例不同神经系统疾病患者的成对脑脊液（CSF）/血液样本中可溶性细胞间粘附分子-1（sICAM-1）。血液中循环ICAM-1的平均水平为平均值+/- SD = 423 +/- 184.6 ng ml-1（范围44-1115 ng ml-1）。脑脊液中sICAM-1在不同疾病组间有显著差异。在急性细菌性脑膜炎中，CSF中检测到的sICAM-1水平高达血清浓度的115（n = 24;平均值+/- SD = 33.0 +/- 23.7 ng ml-1;范围：4.8-93.9 ng ml-1）。这些变化与重度血-CSF屏障功能障碍一致，如白蛋白的高CSF/血液比所示（平均值+/- SD = 46.7 +/- 52.2;范围：16.8-249.3）。在多发性神经根炎患者中（n = 9;平均值+/- SD = 14.5 +/- 11.9 ng ml-1;范围：2.6-43.7 ng ml-1），检测到白蛋白和sICAM CSF/血液比值之间存在相似的协变。多发性硬化患者（n = 9;平均值+/- SD = 5 +/- 4.3;范围：0-12.7 ng ml-1）或HIV感染伴神经系统症状（n = 18;平均值+/- SD = 4.9 +/- 3.2;范围; 1-11.9 ng ml-1）低水平的sICAM-1的检测与完整的血-CSF屏障功能在大多数患者的CSF中。在13例病毒性脑膜炎患者中，仅4例CSF中可检测到sICAM-1水平（平均值+/- SD = 1.0 +/- 1.5 ng ml-1;范围：0-3.7）。有趣的是，在一组患有CNS非炎性疾病的患者中，可溶性ICAM-1仅存在于50个CSF样品中的3个中，尽管在大多数情况下指示血液-CSF屏障功能障碍。反复腰椎穿刺显示，持续高CSF/血清sICAM-1比值与不良结局相关。在CNS炎性疾病患者中，白蛋白和sICAM-1的CSF/血清比值之间观察到显著的相关性（n = 169; r = 0.67; P < 0.001），而在非炎性疾病患者中检测到这些参数之间没有相关性。这些结果表明，sICAM-1是一个可靠的标志物，在中枢神经系统内的炎症过程，这是与血-脑脊液屏障障碍。
A soluble form of the intercellular adhesion molecule-1 (sICAM-1) was measured in paired cerebrospinal fluid (CSF)/blood samples from 123 patients with different neurological diseases. Mean levels of circulating ICAM-1 in the blood were mean +/- SD = 423 +/- 184.6 ng ml-1 (range 44-1115 ng ml-1). Considerable differences of sICAM-1 in the CSF of patients were observed between disease groups. In acute bacterial meningitis, sICAM-1 levels as high as 115 of the serum concentration were detected in the CSF (n = 24; mean +/- SD = 33.0 +/- 23.7 ng ml-1; range: 4.8-93.9 ng ml-1). These changes coincided with a severe blood-CSF barrier dysfunction as indicated by a high CSF/blood ratio for albumin (mean +/- SD = 46.7 +/- 52.2; range: 16.8-249.3). In patients with polyradiculitis (n = 9; mean +/- SD = 14.5 +/- 11.9 ng ml-1; range: 2.6-43.7 ng ml-1) a similar covariation between the albumin and sICAM CSF/blood ratios was detected. In patients with multiple sclerosis (n = 9; mean +/- SD = 5 +/- 4.3; range: 0-12.7 ng ml-1) or HIV infection with neurological symptoms (n = 18; mean +/- SD = 4.9 +/- 3.2; range; 1-11.9 ng ml-1) low levels of sICAM-1 were detected in the CSF associated with intact blood-CSF barrier function in most patients. Among 13 patients with viral meningitis, only four had detectable levels of sICAM-1 in their CSF (mean +/- SD = 1.0 +/- 1.5 ng ml-1; range: 0-3.7). Interestingly, in a group of patients with non-inflammatory disorders of the CNS soluble ICAM-1 was present only in three out of 50 CSF samples despite indication for blood-CSF barrier dysfunction in most cases. Repeated lumbar punctures revealed that persistent high CSF/serum ratios for sICAM-1 were associated with poor outcome. In patients with inflammatory diseases of the CNS, a significant correlation was observed between the CSF/serum ratios for albumin and sICAM-1 (n = 169; r = 0.67; P < 0.001), whereas no relation between these parameters was detected in patients with non-inflammatory diseases. These results indicate that sICAM-1 is a reliable marker for an inflammatory process within the CNS which is associated with blood-CSF barrier disturbance.