GM-CSF抗体在免疫正常格特隐球菌感染中的作用研究

Role of anti-granulocyte-macrophage colony-stimulating factor autoantibodies in cryptococcal meningoencephalitis by cryptococcus gattii in immunocompetent patients

目的探讨抗粒细胞-巨噬细胞集落刺激因子(GM-CSF)抗体在免疫正常格特隐球菌感染患者中的作用。方法分为两组,病例组为7例无免疫异常状态的隐球菌性脑膜脑炎患者,健康对照组为7名健康人,分别检测抗GM-CSF抗体。并对隐球菌性脑膜脑炎患者的脑脊液进行菌株分离培养及鉴定。结果 7例患者中6例为新生隐球菌感染,1例为格特隐球菌感染。抗GM-CSF抗体只在格特隐球菌感染的患者血浆中发现,而在新生隐球菌感染的患者中未发现。健康对照组中1例检测到抗GM-CSF抗体。结论在"免疫正常"的隐球菌脑膜脑炎患者中,抗GM-CSF抗体可能为格特隐球菌感染的危险因素,而与新生隐球菌感染无关。

Objective To discuss the role of anti-granulocyte-macrophage colony-stimulating factor （GM-CSF） autoantibodies in central nervous system infection by cryptococcus （ C, ） gattii in immunocompetent patients. Methods Group A included seven immunocompetent patients with cryptococcal menlngoencephalitis, Group B included seven healthy volunteers as controls. Results In group A, six patients were infected with C, neoformans, and the other one with C. gattii. Anti-GM-CSF autoantibodies were positive in the one infected by C. gattii and negative in those infected by C. neoformans, In Group B, the antibodies were found only in one volunteer. Conclusion It is suggested that anti-GM-CSF autoantibodies may predispose the immunocompetent individuals to meningoencephalitis caused by C. gattii but not necessarily to that caused by C. neoformans.