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目的 :检测流行性乙型脑炎 (乙脑 )患儿脑脊液及血清中白细胞介素 (IL) 10、IL 12和肿瘤坏死因子 (TNF) α水平 ,以探讨其在发病机制中的作用。方法 :3 1例乙脑患儿分别于急性期和恢复期留取血清及脑脊液 ,-2 0℃冻存。IL 10、IL 12和TNF α的检测采用ELISA法。结果 :急性期血清、脑脊液中IL 10、IL 12、TNF α水平均升高 ,而恢复期降低。急性期脑脊液中IL 10、IL 12和TNF α水平较同期血清中的高。TNF α的水平与疾病轻重程度呈正相关 ,而IL 10、IL 12水平与疾病严重程度无关。IL 10与TNF α的水平呈正相关 ,而其它细胞因子间未见明显相关性。结论 :(1)细胞因子IL 10、IL 12和TNF α参与乙脑的发病。(2 )TNF α可能直接参与并介导免疫损伤 ;内源性IL 10未显示出有效地抑制其它炎症因子释放的作用 ,可能也参与了炎症过程 ;IL 12可能具有抗病毒作用。 (3 )乙脑时IL 10、TNF α可能主要在中枢神经系统局部产生。 (4 )选用某些细胞因子或通过抑制某些细胞因子的释放可为临床治疗乙脑提供新的途径。
Objective: To detect the levels of interleukin (IL) 10, IL 12 and tumor necrosis factor (TNF) α in cerebrospinal fluid (CSF) and serum in children with Japanese encephalitis (JE) and to explore its role in pathogenesis. Methods: Serum and cerebrospinal fluid (CSF) were collected from 31 children with Japanese encephalitis at acute and convalescent stage, and frozen at -2 ℃. The detection of IL 10, IL 12 and TNF α was performed by ELISA. Results: The levels of IL-10, IL-12 and TNF-alpha in serum and cerebrospinal fluid of patients in acute phase increased, while the recovery period decreased. Cerebrospinal fluid levels of IL-10, IL-12 and TNF-alpha in acute phase were higher than those in the same period. The level of TNFα was positively correlated with the severity of the disease, while the levels of IL-10 and IL-12 were not related to the severity of the disease. There was a positive correlation between IL-10 and TNF-α, but no significant correlation between other cytokines. Conclusion: (1) The cytokines IL 10, IL 12 and TNF α are involved in the pathogenesis of JE. (2) TNFα may directly participate in and mediate immune damage. Endogenous IL-10 did not appear to effectively inhibit the release of other inflammatory cytokines, and may also participate in the inflammatory process. IL 12 may have antiviral effects. (3) IL 10 at the time of JE, TNFα may be mainly produced in the central nervous system. (4) The use of certain cytokines or by inhibiting the release of certain cytokines may provide a new approach for the clinical treatment of JE.