GBS中枢病理改变及MMP-9、TNF-α的免疫表达

Neuropathological Changes and MMP-9, TNF-α Expression of Central Nervous System in Guillain-Barre Syndrome

目的 观察格林-巴利综合征中枢神经系统病理改变及MMP-9、TNF-α免疫表达。方法 5例剖检病人。常规取块,光镜观察。结果 (1)大脑锥体细胞多呈缺血性改变,海马锥体细胞轻微脱落,脑干运动神经核细胞染色质溶解。(2)桥脑小血管周围淋巴细胞浸润,1例额叶白质灶性脱髓鞘。(3)1例小脑分子层存在胶质结节。(4)MMP-9表达于血管内皮细胞大脑脑干神经元细胞。TNF-α表达于胶质细胞及神经元细胞。结论 (1)桥脑小血管周围淋巴细胞浸润是免疫应答在中枢内的典型表现。(2)胶质结节提示有嗜神经病毒感染的可能。(3)大脑灶性脱髓鞘表明GBS可以合并中枢病理改变。(4)MMP-9及TNF-α在GBS发病中扮演重要角色。

Objective To investigate the Neuropathological changes and MMP - 9, TNF -aexpression of central nervous system in Guillain - Barre syndrome. Methods Brain, spinal cord and sciatic nerve were obtained from 5 cases of Guillain- Barre syndrome HE,KB,Bielschowsky, Weil and immunohistochemical were carried out, the sections were observed by light microscopy. Results (1) Majority of cerebral neurons presented an ischemic change. Slight loss of hippocampal pyramidal neurons were found. There was chromatolysis of motor neurons of Brain stem. (2) Lymphocytic infiltration around the small vessels occurred in the medullary obiongata in one case. Focal demyelination was observed in frontal white matter in one case. (3) Glial nodules were observed in molecular layer of cerebellum. (4) MMP-9 presented in endothelium and neurons and TNF-αexpression presented in glial cell and Neurons. Conclusions (1) Lymphocytic infiltration in brain stem was the typical evidence of cellular immune responses in the central nervous system. (2) Glial nodules in the molecular layer of cerebellum suggested there be possibility of infection of neurotropic virus. (3) Guillain Barre syndrome may have pathological changes in the central nervous system. (4) MMP-9, TNF-αplay an important role in the pathology in Guillain Barre syndrome.