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目的:探讨抗EB病毒(Epstein-Barr virus,EBV)抗体在多发性硬化症(multiple sclerosis,MS)患者脑脊液中的表达情况,以及细胞因子白细胞介素(interleukin,IL)-17、IL-23与其发病间的关联性,借以对MS发病机制进行研究,并为临床诊治和实验室检验提供进一步参考。方法:选取29例中枢神经免疫疾病患者(研究组,包括MS、视神经脊髓炎等)和43例同期非中枢神经免疫疾病患者(对照组,包括周围神经病、偏头痛等),采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)分别检测2组患者脑脊液中EBV-壳抗原(VCA)Ig M、EBV-核抗原(EBNA)-1 Ig G、IL-17、IL-23的表达水平。结果 :中枢神经免疫疾病患者(研究组)患者脑脊液中EBV-EBNA-1 Ig G、EBV-VCA Ig M和IL-23的表达水平显著高于非中枢神经免疫疾病患者(对照组)(P<0.01)。研究组中MS患者脑脊液(cerebrospinal fluid,CSF)IL-23表达水平较对照组显著增高(P<0.01),同时MS亚组患者CSF的IL-17表达水平较对照组显著增高(P<0.05)。结论:抗EBV抗体的表达预示着MS患者的发病可能与EBV感染相关,可能是MS的发病机制之一。同时,IL-17/IL-23轴的异常也可能与MS发病间存在一定的关联。MS的发病不仅与EB病毒感染有关,且与患者的免疫紊乱密切相关。
Objective: To investigate the expression of Epstein-Barr virus (EBV) antibody in cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) and the effect of cytokines interleukin (IL) -17 and IL-23 And its association with the incidence of disease in order to study the pathogenesis of MS, and provide further reference for clinical diagnosis and laboratory tests. Methods: Twenty-nine patients with CNS disease (study group, including MS, optic neuromyelitis, etc.) and 43 patients with non-CNS disease (control group, including peripheral neuropathy and migraine) were enrolled in this study. Enzyme-linked immunosorbent assay The levels of IgM, EBV-Ig Ig, IL-17 and IL-23 in cerebrospinal fluid of two groups were detected by enzyme-linked immunosorbent assay (ELISA) Results: The expression of EBV-EBNA-1 Ig G, EBV-VCA Ig M and IL-23 in cerebrospinal fluid of patients with CNS disease (study group) was significantly higher than that of non-central nervous system immunodeficiency patients (control group) (P < 0.01). The expression level of IL-23 in cerebrospinal fluid (CSF) of MS patients was significantly higher than that of control group (P <0.01), and the level of IL-17 in CSF of MS patients was significantly higher than that of control group (P <0.05) . Conclusion: The expression of anti-EBV antibody indicates that the pathogenesis of MS may be related to EBV infection and may be one of the pathogenesis of MS. At the same time, the abnormality of IL-17 / IL-23 axis may also be related to the onset of MS. The incidence of MS is not only related to Epstein-Barr virus infection, but also closely related to the patient’s immune disorders.