急性脑梗塞患者分泌γ-干扰素的特异性髓鞘素记忆性T细胞的研究

Elevation of myelin specific memory T cells secreted IFN γ in patients with acute cerebral infarct

通过计数分泌细胞因子γ－干扰素记忆性Ｔ细胞，观察急性脑梗塞（ＡＣＩ）患者的特异性Ｔ细胞免疫应答。方法采用酶联免疫斑点法（ＥＬＩＳＡ）检测了３２例ＡＣＩ、２４例炎症性神经疾病（ＯＩＮＤ）和２５例其他神经疾病（ＯＮＤ）患者髓鞘素抗原及其多肽应答性Ｔ细胞。结果ＡＣＩ患者外周血髓鞘素碱性蛋白（ＭＢＰ）及其多肽和含脂质蛋白（ＰＬＰ）自身抗原应答性Ｔ细胞数呈显著增高，脑脊液（ＣＳＦ）中ＭＢＰ应答性Ｔ细胞数约为外周血中的１１０倍。结论这种免疫应答可能是继发于急性缺血后的脑组织损伤，且在紧邻靶器官的ＣＳＦ中表现尤为明显，其病理意义还有待进一步探讨。

Objective It was documented in previous studies that a high level of B cell responses occurred in the cerebrospinal fluid (CSF) in patients with acute cerebral infarction (ACI), we examined CNS myelin antigen specific memory T cells which secrted IFN γ in patients with ACI and controls. Method Autoreactive IFN γ secreting T cells responded to myelin antigens and their peptides were detected by using enzyme linked immunosorbent assay (ELISA) in the peripheral blood and CSF of 32 patients with ACI and in the two controlled groups of patients with other inflammatory and non inflammatory neurological diseases. Results The numbers of IFN γ secreting cells responded to myelin basic protein (MBP). Its peptides and proteolipid protein (PLP) were very significantly elevated in the peripheral blood of the ACI patients compared with those of two control groups ( P <0.01) The number of MBP autoreactive T cells in CSF of patients with ACI also significantly higher than those of the two control groups. Moreover, the number of MBP specific memory T cells secreted IFN γ in CSF was much higher that that in peripheral blood. Conclusion A specific T cell responses with myelin antigen existed in the patients with acute cerebral infarct, the findings strongly suggest that acute ischemic brain damage may lead to an in vivo expansion of myelin antigen reactive T cells. Hypothetically such autoimmune responses most probably succeed ischemic brain damage and strongly occurred in CSF which was adjacent to target organ. The pathological effect of these autoreactive T cell responses remained unknown.