【摘要】 目的探讨可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM-1)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及血脑屏障(blood-brain barrier,BBB)损害在复发-缓解型多发性硬化(relapsing remitting form of multiple sclerosis,RRMS)和细菌性脑膜炎(bacterial meningitis,BM)发生中的作用。方法应用酶联免疫吸附试验(enzyme-linked immunosorbent assa,ELISA)法对24例RRMS、12例非炎性神经系统疾病(non-inflammatory neurological disease,NIND)、8例BM患者血清及脑脊液中sICAM-1、TNF-α含量进行检测,并计算白蛋白比值(albumin quotient,QA)以评估BBB功能状态。结果①RRMS组QA异常者占67%,BM组则为100%。②与NIND组相比,RRMS组与BM组血清和脑脊液中的sICAM-1水平显著升高,RRMS组BBB异常者脑脊液中sICAM-1水平较NIND组显著升高,而BBB正常者差异则无显著性。③与NIND组相比,RRMS组血清TNF-α水平未见变化,脑脊液中TNF-α检测阳性率低,差异无显著性,而BM组血清及脑脊液中TNF-α水平显著升高。结论BBB损害及ICAM-1参与了多发性硬化与化脓性脑膜炎的免疫病理机制。更多还原

【Abstract】 【Objective】To investigate the pathophysiologic effect of damaged blood-brain barrier (BBB) and soluble intercellular adhesion molecule-1 (sICAM-1), tumor necrosis factor-α (TNF-α) in bacterial meningitis(BM) and relapsing remitting form of multiple sclerosis (RRMS). 【Methods】Levels of sICAM-1 and TNF-α in CSF and serum from 24 patients with RRMS in the active stages, 8 with BM, and to compare results with 12 patients with non-inflammatory neurological disease (NIND) were detected by ELISA, BBB function was evaluated by A1b CSF/serum ratio (QA). 【Results】There were 67% and 100% abnormal QA in RRMS and BM separately. Compared with NIND, the levels of sICAM-1 in Serum and CSF were significantly increased in RRMS and BM. The levels of sICAM-1 in CSF of RRMS with damaged BBB were increased, but there were no significant differences between the patients with normal BBB and NIND. Concentration of TNF-α in serum and CSF had no differences between patients of RRMS and NIND, but in patients with BM, the level of TNF-α was significantly increased compared to NIND. 【Conclusion】 The results suggest involvement of ICAM-1 and the lesion of BBB in immunopathogenesis of RRMS and BM.更多还原