神经免疫性疾病患者糖皮质激素治疗前后白细胞介素2和15变化的临床意义

Effects of glucocorticoid on IL-2 and IL-15 in the plasma and CSF of the patients with immuno-neurologic diseases

目的 探讨糖皮质激素 (GC)对神经免疫性疾病 (IND)患者血浆和脑脊液 (CSF)白细胞介素 (IL) 2和IL 15的影响。方法 用双抗体夹心酶联免疫法 (ELISA)检测 2 2例急性期IND患者GC治疗前后血浆和CSFIL 2、IL 15水平 ,与 2 0例脑梗死 (NIND)患者、18例手术 (OP)患者、11例未用GC的重症肌无力患者 (NMG)进行对比。结果 治疗前 4组 (IND ,NIND ,OP和NMG)组间血浆和CSF中IL 2和IL 15比较 ,差异有显著意义 (IL 2 :血浆P <0 0 5 ,CSFP <0 0 1;IL 15 :血浆P <0 0 5 ,CSFP <0 0 5 ) ;治疗前IND组显著高于NIND组和OP组 (P <0 0 1) ,而与NMG组比较 ,差异无显著意义 (P >0 0 5 ) ;GC治疗后IND组IL 2和IL 15低于治疗前 (P <0 0 5 )。结论 急性期IND患者血浆和CSF中的IL 2和IL 15有上升趋势 ,GC治疗后IL 2和IL 15水平降低。GC可能通过影响患者免疫细胞产生IL 2和IL 15 ,而发挥治疗IND的作用。

Objective To explore the effects of glucocorticoid(GC) on IL-2,IL-15 in the plasma and cerebrospinal fluid(CSF) of the patients suffering from immuno-neurologic diseases(IND). Methods Double antibody sandwich assay was used to test IL-2, IL-15 in the plasma and CSF of the 22 patients with IND before and after the GC treatment. The results were compared with the IL-2,IL-15 of 20 patients with cerebral infarction (non-Immuno-neurologic diseases, NIND), 18 operation patients (OP) who had no neurologic diseases and 11 patients of myasthenia gravis who were given anti-cholinesterase drugs but not GC (NMG). Results In plasma and CSF, IL-2 and IL-15 levels were markedly differences among the four groups before the treatment, and in q-test among each group. There were differences before and after the treatment in IND and NMG group. Conclusion IL-2 and IL-15 in the plasma and CSF of patients with acute IND showed a tendency of increase. IL-2 and IL-15 levels decreased after GC treatment.GC might play an important role in stopping the auto-immunological reaction of IND through affecting CKs such as IL-2 and IL-15 etc.