1型单纯疱疹病毒性脑炎患儿的炎性细胞因子水平

Inflammatory cytokine levels of children with 1 type herpes simplex viral encephalitis

目的探讨1型单纯疱疹病毒(HSV-1)性脑炎患儿炎性细胞因子的表达情况。方法收集2014年5月至2015年4月因病毒性脑炎在郴州市儿童医院(郴州市第一人民医院北院)住院的183例患儿血液和CSF标本。使用PCR法检测患儿CSF标本中的HSV-1,并通过悬液芯片技术检测HSV-1脑炎患儿血液和CSF标本中的17种细胞因子。结果在183例病毒性脑炎患儿中检测出27例(14. 8%) HSV-1阳性。27例HSV-1脑炎患儿CSF中的IL-6、IL-8、单核细胞趋化蛋白1 (MCP-1)和粒细胞-巨噬细胞集落刺激因子(GM-CSF)表达水平明显高于血浆中的表达水平; CSF中的IL-17和巨噬细胞炎症因子-1β(MIP-1β)表达水平明显低于血浆中的表达水平(均P <0. 05)。Pearson相关分析结果显示,血浆和CSF中干扰素-γ(IFN-γ)分别与HSV-1脑炎的病程呈正相关(r=0. 920,P=0. 000; r=0. 961,P=0. 039);血浆和CSF中IL-10分别与HSV-1脑炎的病程呈负相关(r=-0. 990,P=0. 029; r=-0. 816,P=0. 048)。结论 IL-6、IL-8、IL-17、GM-CSF、MCP-1和MIP-1β可能在HSV-1脑炎的免疫病理机制中起重要作用。Th1细胞因子(IFN-γ)、Th2细胞因子(IL-10)失衡可能对HSV-1脑炎的进展起重要作用。

Objective To observe the inflammatory eytokine levels of children with 1 type herpes simplex viral （HSV-1） encephalitis. Methods Serum and CSF were obtained from 183 hospitalized children with viral encephalitis at the Children＇s Hospital of Chenzhou （the North Branch of the First People＇s Hospital of Chenzhou ） from May 2014 to April 2015. HSV-1 was detected in CSF by the method of PCR. The levels of 17 inflammatory cytokines were detected in paired serum and CSF samples of HSE patients. After referring to relevant medical record and the detection results, then analyzed cytokine expression levels in children with HSV-1 encephalitis. Results Twenty-seven （14.8%） of the 183 children with viral encephalitis were positive for HSV-1. In the 27 cases of children with HSV-1 encephalitis, expression levels of IL-6, IL-8, monoeyte chemokinin 1 （MCP-1） and granulocyte-maerophage colony stimulating factor （GM-CSF） in CSF were significantly higher than those in plasma, while expression levels of IL-17 and macrophage inflammatory protein 1 β （MIP-1β） in CSF were significantly lower than those in plasma （ all P 〈 0. 05 ）. Pearson＇s correlation analysis results show that plasma and CSF＇s interferon-γ （IFN-γ were positively correlated with the course of HSV-1 encephalitis （r =0. 920, P =0. 000; r =0. 961, P = 0. 039） ; Plasma and CSF＇s IL-10 were negatively correlated with the course of HSV-1 encephalitis （r = -0. 990, P=0.029; r= -0.816, P=0.048）. Conclusions IL-6, IL-8, IL-17, GM-CSF, MCP-1 and MIP-1β may be involved in the immune response to HSV-1 encephalitis. The imbalance of Thl eytokine （IFN-γ） , Th2 cytokine （IL- 10） may play a critical role in immunopathogenesis of HSV-1 encephalitis.