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目的 通过计数促炎症性细胞因子IFN γ及抗炎症性细胞因子IL 10分泌性T细胞数目 ,观察多发性硬化 (MS)患者此两类细胞因子 (CK)的变化。方法 采用酶联免疫斑点 (Elispot)技术检测MS患者、其他神经疾病 (OND)患者及正常对照组 (NC)外周血 (PB)及脑脊液 (CSF)中MBP及其他抗原反应性IFN γ和IL 10分泌性T细胞数目 ,并对活动期与缓解期MS及甲基强的松龙 (MP)冲击疗法前后MS患者PB中两种CK分泌性T细胞数目进行了比较。结果 活动期MS患者PB及CSF中IFN γ及IL 10分泌性T细胞数目较OND及NC组明显增多 (P <0 0 5) ,CSF中MBP反应性T细胞差异更为显著 (P <0 0 1)。MS患者PB中IL 10分泌性T细胞数在缓解期较活动期明显升高 (P <0 0 5)。MP治疗后IFN γ分泌性T细胞数目明显减少 ,而IL 10分泌细胞数目明显增多 (P <0 0 1)。结论 在MS发病机制中IFN γ起促进作用 ,而IL 10有保护作用 ,是促、抗炎症性CK的比值而非按顺序的表达决定MS的活动性。MP疗法的部分机制可能是调节CK网络的平衡
Objective To observe the changes of these two cytokines (CK) in patients with multiple sclerosis (MS) by counting the number of proinflammatory cytokines IFNγ and anti-inflammatory cytokines IL 10 secreting T cells. Methods Elispot assay was used to detect MBP and other antigen-reactive IFNγ and IL-10 in peripheral blood (PB) and cerebrospinal fluid (CSF) of patients with MS, other neurological diseases (OND) and normal controls Secreted T cells, and compared the number of two CK-secreting T cells in MS patients with active and refractory MS before and after methylprednisolone (MP) shock therapy. Results The numbers of IFN γ and IL 10 secreting T cells in PB and CSF of active MS patients were significantly higher than those in OND and NC groups (P <0.05), and the differences of MBP reactive T cells in CSF were more significant (P <0 0 1). The number of IL-10 secreted T cells in MS PB patients was significantly higher than that in active stage (P <0.05). The number of IFNγ secreting T cells was significantly decreased after MP treatment, while the number of IL 10 secreting cells was significantly increased (P <0.01). Conclusions IFN γ plays a role in the pathogenesis of MS, while IL 10 has a protective effect. It is the ratio of pro-inflammatory and anti-inflammatory CK rather than sequential expression, which determines the activity of MS. Part of the mechanism of MP therapy may be to regulate the balance of the CK network