The Changes Of Immunization Levels Of Children With Autoimmune Encephalitis

Objective: Autoimmune encephalitis refers that the immune system respondsto the central nervous system antigens and lead to disease, and is increasinglyrecognized as an important cause of non-infectious factors that can reverse theencephalitis. Since the beginning of the60’s of the twentieth Century, somescholars have found a variety of related autoantibodies, such as: Anti Huantibody, anti Ta/Ma2antibody, anti voltage-gated potassium channel (VGKC)antibody, anti N-methyl-D-aspartate receptor (NMDAR) antibody, antiglutamate dehydrogenase (GAD) antibody, anti thyroid antibody and otherrelated autoantibodies, but its pathogenesis is not clear. Neuropathologicalstudies show that it can find infiltrating T cells in the brain parenchyma，suggesting that autoimmune encephalitis is an autoimmune disease caused byT cell mediated.In this study，the detection of CD3, CD4, CD8, CD54, IgA,IgG, IgM, anti NMDAR-ab, anti GAD-ab in children with autoimmuneencephalitis，analysis the changes the immune level, and provide s directionfor further exploring the pathogenesis, diagnosis, and also to provide a theoretical basis for the treatment of clinical disease.Methods: This study belongs to open case-control study.34diagnosed children with AE, who were treated at neurology wards ofHebei Children’s Hospital from December2012to December2013,werechosen as case group. The pediatric neurological experts confirmed thediagnosis according to the clinical manifestation, CSF, EEG and head MRI.The diagnostic standard by the paraneoplastic neurological syndromediagnosis standard European network in2004. The group must meet3conditions:①with epilepsy or mental disorder clinical manifestation;②theCSF white blood cell is higher than that of normal or EEG suggested thatbrain cell dysfunction;③head MRI examination show that the brain parenchymal infiltrated. On the same time, Another36healthy check-upchildren from Children Health Care department of Hebei Children’s Hospitalwere chosen as normal control group.3-4ml coagulant venous blood with seperation gel and1ml anticoagulantvenous blood with EDTA-K2were collected from all the children with emptystomach on early morning. Applying automatic biochemical analyzer(Hitachi7060automatic biochemical analyzer) to detect levels of serumimmunoglobulins lgA、IgG and IgM through immune turbidimetry and flowcytometry(USA BECKMAN COULTER company,model Epics XL)to detectlevels of CD3,CD4,CD8and CD54.2-3ml separation gel venous blood isplaced in a clean, sealed，special test tube specimens. Then collect thesupernatant after centrifugation. Levels of anti NMDAR-ab, anti GAD-abwere measured by enzyme-linked immunosorbent assay(ELISA). In addition,1ml CSF of the children in the case group is placed in a clean，sealed，specialtest tube specimen. Then collect the supernatant after centrifugation. Levels ofanti NMDAR-ab, anti GAD-ab were measured by enzyme-linkedimmunosorbent assay(ELISA). The anti GAD-Ab and anti NMDAR-AbELISA kit were purchased from Shanghai Huyu biotechnology company.All datas were collated and collected, and then SPSS13.0statisticssoftware was used to carry on statistics processing，P<0.05(double side)hadstatistical significance.Result:1Compared with the normal control group,the levels of IgA increased inthe blood of children with AE.There was significantly statistical differencebetween them(P＜0.05)2Compared with the normal control group,the levels of IgM increased inthe blood of children with AE.There was significantly statistical differencebetween them(P＜0.05).3Compared with the normal control group,the levels of IgG increased inthe blood of children with AE.There was significantly statistical differencebetween them(P＜0.05) 4Compared with the normal control group,the levels of CD3decreasedin the blood of children with AE.There was significantly statistical differencebetween them(P＜0.05).5Compared with the normal control group,the levels of CD4decreasedin the blood of children with AE.There was significantly statistical differencebetween them(P＜0.05).6Compared with the normal control group, the levels of CD8had nosignificant difference between them(P>0.05).7Compared with the normal control group, the levels of CD54had nosignificant difference between them(P>0.05).8The testing of anti GAD-ab of the blood and CSF were all negative inthe Cases group; The testing of anti GAD-ab of the blood were all negative inthe normal control group.9The testing of anti NMDAR-ab of the blood and CSF were all negativein the Cases group; The testing of anti-NMDAR-ab of the blood were allnegative in the normal control group.Conclusion：Cell-mediated immunity and humoral immunity functions weredisordered in children with AE, it showed that levels of CD3and CD4decreased, IgA、IgM、IgG levels increased，levels of CD8and CD54did notchange. It suggests that Cell-mediated immunity and humoral immunity mayparticipate in the pathogenetic process. There is a close relationship betweenfunctional disorder of autoimmune encephalitis and nerve-endocrine-immunenetwork. The testing of anti NMDAR-ab and anti GAD-ab were all negativesuggests that autoantibodies are not the necessary factors that lead to AE. Dueto the limitation of experimental conditions, it could not detect all possibleautoantibodies. So it could not rule out all the possibility of the existence ofother autoantibodies. In a word, when meet the children with AE, give thesymptomatic treatment and pay attention to the changes of immune functionconcerns,then adjust the medication according to those changes,which mayhelp enhancing the treatment effect and then improving the prognosis. In addition, according to the changes of Cell-mediated immunity and humoralimmunity, It may be helpful to the diagnosis of AE.