炎性细胞因子IL-6、TNF与偏头痛关系的研究

Studies on Correlation between Inflammatory Cytokines (Interleukin-6,Tumor Necrosis Factor) and Migraine

采用桥联酶标APAAP染色技术检测无先兆偏头痛（MWA）患者淋巴细胞亚群CD3+、CD4+、CD8+、CD15+、CD19+的变化，用敏感细胞株杀伤试验及依赖细胞株增殖试验（MTT比色法）分别检测血浆TNF及IL－6水平的变化。结果显示：偏头痛患者外周血白细胞及淋巴细胞数均在正常范围内，发作期白细胞数较缓解期明显升高（P＜0．05）；而淋巴细胞数各组间差异无显著意义。CD3+、CD4+、CD8+、CD4+／CD8+比率MWA组与对照组间差异均无显著性意义，但CD15+以细胞数则显著低于对照组（P＜0．01）。MWA组血浆TNF、IL－6水平显著高于对照组（P＜0．01），且发作期高于缓解期（P＜0．05）。对4例患者进行连续检测结果显示，发作期、缓解期血浆TNF与IL-6水平之间呈正相关（r＝0．9232，P＜0．01）。以上结果提示MWA患者存在细胞免疫缺陷，炎性细胞因子IL－6、TNF在其发病中可能起一定作用。

Objective To measure plasma IL-6 and TNF levels in patients with migraine without aura (MWA), count of white blood cells and lymphocyte subsets CD3+, CD4+, CD8+, CD15+ and CD19+ in peripheral blood of migraine patients, were done and analyse the correlation ammong these variables, and study the roles they played in MWA. Methods Lymphocyte subsets CD3+, CD4+, CD8+, CD15+ (monocyte), and CD19+ (B cells ) were determined in 37 patients with MWA and 35 normal controls by bridge enzymatic labelling APAAP technique. Plasma interleukin-6 (IL-6) and tumor necrosis factor (TNF) levels in peripheral blood in these subjects were detected by the B9 hybridoma proliferation and L929, fibroma cytotoxicity assay respectively. Results White blood cells and lymphocytes in peripheral blood in MWA patients were in the normal range. Even when fluctuations in the percentage of CD3+, CD4+, CD8+ cellsand CD4+/CD8+ ratios were present, no significant differences were observed between patients and controls. CD15+ cells were remarkably decreased in MWA patients (P＜0. 01 ). Plasma IL-6, TNF levels in MWA patients were notably increased in comparision with the controls (P＜0. 01 ). Plasma IL-6 and TNF levels in patients during headache-attack periods werehigher than those during headache-free periods (P＜0. 05). In 4 MWA patients who weresampled twice (during a headache-attack period and a headache-free period respectively),plasma IL-6 and TNF levels were correlated positively (r=0. 9232, P＜0. 01), and the similar correlation was observed in plasma TNF or IL-6 levels between headache attack periods and headache-free periods in these 4 patients. Conclusion cellular immunity deficits was considered in MWA patients, and the inflammatory cytokines IL-6 and TNF might play arole in the pathogenesis of MWA.