阿尔茨海默病不同临床阶段脑脊液中炎前和抗炎细胞因子水平的变化

Pro-and anti-inflammatory cytokines in cerebrospinal fluid of patients with Alzheimer's disease

目的:观察不同临床阶段阿尔茨海默病(AD)患者脑脊液中炎前和抗炎细胞因子水平与神经病理损伤的关系。方法:用夹心式酶联免疫吸附法测定轻、中、重度AD患者,血管性痴呆(VD)患者与正常老年人脑脊液中白介素-1β(IL-1β)、肿瘤坏死因子α(TNFα)和白介素1受体拮抗剂(IL-1ra)的水平。结果:各AD组患者脑脊液中IL-1β、TNFα的水平较其他组有不同程度升高,而IL-1ra则有不同程度降低,各AD组组间比较,随着痴呆程度的加重,IL-1β与TNFα水平相应增高,IL-1ra却相应下降,其中重度AD患者这种改变与轻度AD患者比较差异有显著性(P<0.05)。结论:炎前和抗炎细胞因子表达失衡造成的级联反应在AD脑损害过程中起重要作用。

Objective： To investigate the relationship between the levels of pro- and anti-inflammatory eytokines and the neuropatbological damage in different clinical stages of Alzheimer＇s disease （AD）. Methods： The levels of interleukin-1 β （IL-1 β）, interleukin-1 receptor antagonist （IL-1ra） and tumor necrosis factor-α （TNF-α） in the cerebrospinal fluid （CSF） were determined by ELISA in 45 patients with AD, 30 patients with vascular dementia （VD） and 25 normal subjects. Rcsults： Compared with VD and control groups, IL-1 β and TNF-α contents increased, and IL-1ra concentration decreased in AD group. Levels of 1L-1 β and TNF-α were upregulated and that of IL-1ra downregulated with the aggravation of dementia. There was a significant difference m the change of thesecytokines between late stage and early stage of AD patients （P〈0.05）. Conclusion： The cascade reaction due to the imbalance of pro- and anti-inflammatory cytokines may play important roles in the brain damage in AD.