结核性脑膜炎脑脊液抗干扰素-γ自身抗体的检测

Measurement of anti-interferon-gamma autoantibody in cerebrospinal fluid of patients with tuberculosis meningitis

目的:建立检测脑脊液中抗干扰素-γ(IFN-γ)自身抗体的ELISA方法,并检测结核性脑膜炎患者脑脊液中抗IFN-γ自身抗体水平,初步探讨抗IFN-γ自身抗体与结核性脑膜炎发病机制的关系。方法:通过对封闭条件、抗原用量等条件进行优化,建立检测脑脊液中抗IFN-γ自身抗体的ELISA检测方法。采用建立的最佳检测条件对21例结核性脑膜炎患者和6例正常对照者的脑脊液进行抗IFN-γ自身抗体检测。结果:在14例重症结核性脑膜炎患者的脑脊液中测到高滴度的抗IFN-γ自身抗体,平均值和阳性比例明显高于正常对照者和7例轻症患者(P<0.01),轻症患者的阳性比例高于正常对照者(P<0.05)。结论:检测方法简便、可靠,结核性脑膜炎患者脑脊液中存在抗IFN-γ自身抗体,与病情程度相关,对抗IFN-γ自身抗体的研究有助于进一步探讨结核性脑膜炎的免疫病理机制。

Objective To establish an immune enzyme assay for detecting anti-interferon-gamma autoantibody in cerebrospinal fluid （CSF） and to investigate the relationship between anti-IFNγ autoantibody levels and tuberculosis meningitis. Methods An ELISA was established by optimizing the condition of blocking and concentration of antigen. The cerebrospinal fluid samples from 21 patients with tuberculosis meningitis were assayed for anti-IFN-γ autoantibody and was compared with samples from 6 healthy control subjects. Results The median level and positive percentage in the severe cases were higher than mild cases and healthy controls. The positive percentage in mild cases was higher than the healthy controls. Conclusions In this study, anti-IFN-γ autoantibody in the CSF detected by enzyme-linked immunosorbent assay （ELISA） is reliable and simple. The level of anti-IFN-γ, autoantibody is significantly elevated and correlated with the pathogenetic condition of tuberculosis meningitis. The further research will promote the understanding about the immunopathogenesis mechanism of the tuberculosis meningitis.