| The pathogenesis of Guillain-Barre syndrome(GBS) is not very clear by now. In recent years more and more emphasis has been focused on the role of cytokines and adhesion molecules in the pathogenesis of autoimmune diseases. We studied the serumiand CSF levels of IL-18 and soluble vascular cellular adhesion molecule-1 (sVCAM-1) in GBS patients, to detect the roles of this two molecules in the pathogenesis of GBS.Subjects: (l)GBS: A total of 19 patients who met the Asburg diagnostic criterion were included, 10 males and 9 females. The age ranged from 12 to 64 with an average of 39. According to the severity of their diseases, they were classified into grade 1-5 refering to the clinical grading criterion of Hughes. (2)Noninflammatory neurologic diseases(NIND): The CSF of 17 patients were examined, 10 males and 7 females. (3)Normal control(NC): The serum of 25 healthy physical examining personnel were collected, 14 males and 11 females. The genders and ages of NIND and NC were matching to those of GBS. Before the samples were collected, none of the subjects had taken the corticosteroides or other immunosuppressive therapy.Methods: The serum and CSF samples of GBS patients were all collected in the acute phase (in 1-2 weeks from the onset). The blood samples were collected from the venous and then centrifuged to get the serum. The serum and CSF samples were all stored at -30癈 before assay.The extent of blood-brain barrier (BBB) damage: It was calculated as the ratio ofCSF-albumin/seruni-albumin(QA). QA being lower than 0.007 represented the BBB being complete, and QA being higher than 0.007 represented the BBB being damaged. The serum and CSF albumin were detected of 15 in 19 GBS patients, with 6 patients higher than 0.007 and 9 patients lower than 0.007.The serum and CSF levels of IL-18 and sVCAM-1 were measured by immunoassay using a commercially available enzyme-linked immunosorbent assay(ELISA) kit (Senxiong, Shanghai, China). It was used according to the manufacturer's instructions. The concentrations of IL-18 and sVCAM-1 were calculated by comparision with respective standard curve. The results were expressed by mean+SD, and the data were evaluated by means of the t test and linear correlation analysis.Results: (1)The serum IL-18 concentrations of GBS and NC were (249.8+116.3) and (150.8+75.8)pg/ml respectively, serum sVCAM-1 concentrations were (3868.1+ 1927.6) and (2306.6+1022.6) ng/ml respectively. Serum levels of IL-18 and sVCAM-1 in patients with GBS were significantly higher compared with subjects of NC(P less than 0.05 and 0.01 respectively). (2)The CSF IL-18 concentrations of GBS and NIND were (52.7+44.3) and (15.1+3.3)pg/ml respectively, CSF sVCAM-1 concentrations were (3.1+0.9) and (2.9+0.6)ng/ml respectively. CSF level of IL-18 in patients with GBS was much higher compared with subjects of NIND(P<0.01), while there was no significant difference between CSF level of sVCAM-1 in patients with GBS and patients with NIND. (3)The serum IL-18 concentrations in severe group and light group of GBS patiets were (368.7+164.1) and (142.8+64.5)pg/ml respectively, and serum sVCAM-1 concentrations were (5063.9+1415.9) and (2791.8+ 1676.3)ng/ml respectively. Serum levels of IL-18 and sVCAM-1 correlated with disease severity(P less than 0.01 and 0.001 respectively). (4)The CSF IL-18 concentrations in BBB-damaged and BBB-complete GBS patients were (93.6+59.0) and (31.2+11.8)pg/ml respectively, and CSF sVCAM-1 concentrations were (3.4+ 1.1) and (2.8+0.6)ng/ml respectively. CSF level of IL-18 was much higher in those with damaged BBB than those with complete BBB, while there was no significant difference between CSF sVCAM-1 levels in those with damaged BBB and those withcomplete BBB. (5)The correlation coefficient between serum levels of IL-18 and sVCAM-1 in GBS patients was r=0.483 (P<0.05), serum level of IL-18 correlated with sVCAM-1. While correlation coefficient between CSF levels of IL-18 and sVCAM-1 in GBS patients was r=0.270(P>0.05), CSF level of IL-18 did not correlate with...
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