Distinct CSF cytokine/chemokine profiles in atopic myelitis and other causes of myelitis
Distinct CSF cytokine/chemokine profiles in atopic myelitis and other causes of myelitis
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DOI：
10.1212/01.wnl.0000326589.57128.c3
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发表时间：
2008-09-23
期刊：
影响因子：
9.9
通讯作者：
Kira, J. -i.
中科院分区：
文献类型：
--
作者：
Tanaka, M.;Matsushita, T.;Kira, J. -i.
背景：我们报道了在全日本范围内的一项全国性调查中，特应性素质(特应性脊髓炎[AM])患者出现一种明显的脊髓炎。最近在高加索人中也报告了类似的病例。目的：探讨AM患者脑脊液中细胞因子/趋化因子的变化，并与其他原因进行比较。方法：用荧光微球免疫分析法同时检测22例AM患者、20例视神经多发性硬化(OSM)患者、11例HTLV-1相关性脊髓病(HAM)患者、9例干燥综合征相关性脊髓炎(SM)患者和20例其他非炎症性神经系统疾病(OND)患者脑脊液中的27种细胞因子、趋化因子和生长因子。结果：AM患者脑脊液中细胞因子、趋化因子和生长因子的变化与其他非炎症性神经疾病(OND)患者的脑脊液细胞因子、趋化因子和生长因子呈正相关。与OND和其他原因的脊髓炎患者相比，OSM患者的CCL11和IL-9水平显著升高，而OSMS患者的干扰素-γ和粒细胞集落刺激因子水平明显高于OND和其他原因引起的脊髓炎患者。与OND患者相比，无论是否存在水通道蛋白4(AQP4)抗体，OSM患者的IL-17水平均显著升高。HAM患者CXCL10和CCL5水平高于OND和其他脊髓炎患者。SM患者的CCL3和CCl4水平高于OND患者。在AM患者中，CCL11、IL-9和IL-1受体拮抗剂(IL-1ra)与Kurtzke扩展残疾状态量表最终评分呈正相关，而IL-1ra和IL-12(P70)与病程呈正相关。结论：鞘内CCL11和Th2细胞因子上调是特应性脊髓炎的特征，有别于白介素17/干扰素-γ相关的视神经多发性硬化症的自身免疫状态。
Background: We reported the emergence of a distinct myelitis in patients with atopic diathesis (atopic myelitis [AM]) by a nationwide survey throughout Japan. Similar cases have recently been reported in Caucasians. Pathologic studies of biopsied spinal cord specimens revealed chronic active inflammation with eosinophilic infiltration.Objective: To clarify the cytokine/chemokine alterations in CSF from patients with AM in comparison to other causes of myelitis.Methods: We measured 27 cytokines, chemokines, and growth factors simultaneously in CSF from 22 patients with AM, 20 with opticospinal multiple sclerosis (OSMS), 11 with HTLV-1 associated myelopathy (HAM), 9 with Sjogren syndrome-related myelitis (SM), and 20 with other noninflammatory neurologic diseases (OND), using a fluorescent bead-based immunoassay.Results: In patients with AM, CCL11 and interleukin (IL)-9 were significantly increased as compared with patients with OND and other myelitis while in patients with OSMS interferon-gamma and granulocyte-colony stimulating factor levels were significantly higher than in patients with OND and other causes of myelitis. Significant increase of IL-17 in comparison to patients with OND was found only in patients with OSMS, irrespective of presence or absence of anti-aquaporin- 4 (AQP4) antibody. In patients with HAM, CXCL10 and CCL5 were higher than in patients with OND and other myelitis. In patients with SM, CCL3 and CCL4 were higher than in patients with OND. In patients with AM, CCL11, IL-9, and IL-1 receptor antagonist (IL-1ra) showed positive correlations with the final Kurtzke Expanded Disability Status Scale scores while IL-1ra and IL-12(p70) had positive correlations with disease duration.Conclusion: Intrathecal upregulation of CCL11 and Th2 cytokines is characteristic of atopic myelitis, which is distinct from interleukin-17/interferon-gamma-related autoimmune condition of opticospinal multiple sclerosis.