Clinical characteristics and expression of Th1 - Th2 cytokines in the cerebrospinal fluid of patients with cryptococcal meningitis.

Background Cryptococcal meningitis (CM) is the most common fungal infection of central nervous system, caused by Cryptococcus neoformans infection of the meninges. The development and prognosis of CM depend on the patient's own immune function to some extent, and are relative to the imbalance of hel...

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Published in:Chinese Journal of Contemporary Neurology & Neurosurgery Vol. 14; no. 8; pp. 680 - 687
Main Authors: BU Hui, WANG Yun-can, DING Wen-ting, HE Jun-ying, ZHAO Yue, LÜ Wen-jing
Format: pictorial research tables/charts Journal Article
Published: Chinese Journal of Contemporary Neurology & Neurosurgery Aug2014
Online Access:View this record in EBSCOhost
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      jtl: Chinese Journal of Contemporary Neurology & Neurosurgery
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      dt: Aug2014
      vid: 14
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      pub: Chinese Journal of Contemporary Neurology & Neurosurgery
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        10.3969/j.issn.1672-6731.2014.08.007
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        atl: Clinical characteristics and expression of Th1 - Th2 cytokines in the cerebrospinal fluid of patients with cryptococcal meningitis.
      aug:
        au:
          BU Hui
          WANG Yun-can
          DING Wen-ting
          HE Jun-ying
          ZHAO Yue
          LÜ Wen-jing
        affil: Department of Neurology, Second Hospital of Hebei Medical University, Hebei Key Laboratory of Neurology, Shijiazhuang 050000, Hebei, China
      sug:
        subj:
          Meningitis, Cryptococcal Diagnosis
          Gene Expression
          T Lymphocytes Physiology
          Cytokines
          Cerebrospinal Fluid Analysis
          Patient Assessment
          Neurology
          Neurosurgery
          Human
          Mycoses
          Meninges Anatomy and Histology
          Brain Anatomy and Histology
          Interferons
          Interleukins
          Cell Physiology
          Cytology
          Tumor Necrosis Factor Blood
      ab: Background Cryptococcal meningitis (CM) is the most common fungal infection of central nervous system, caused by Cryptococcus neoformans infection of the meninges. The development and prognosis of CM depend on the patient's own immune function to some extent, and are relative to the imbalance of helper T lymphocyte (Th1/Th2). This study aims to explore the hidden role of the local Th1/ Th2 immune response in the pathophysiological process of CM. Methods The levels of Th1 cytokines interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α) and Th2 cytokine interleukin-10 (IL-10) in the cerebrospinal fluid (CSF) were detected by enzyme - linked immunosorbent assay (ELISA). CSF cytology changes were monitored dynamically to understand the outcome status of patients with CM. Results The levels of IFN - γ and TNF - α in CM patients [(11.17 ± 1.50) and (18.74 ± 2.97) pg/ml, respectively] were significantly lower than that in control patients [(17.69 ± 2.34) and (28.83 ± 3.55) pg/ml; P = 0.000, for all]. However, the levels of IL-10 in CM patients [(43.65 ± 10.12) pg/ml] were significantly higher than that in control patients [(7.80 ± 1.30) pg/ml, P = 0.000]. The CSF IFN-γ and TNF-α levels in acute phase of CM patients [(11.17 ± 1.50) pg/ml and (18.74 ± 2.97) pg/ml, respectively] were significantly lower than that in stable phase of CM patients [(17.70 ± 2.34) and (22.93 ± 1.53) pg/ml;P = 0.000, for all]. On the other hand, the levels of IL-10 were significantly higher in the acute phase than that in stable phase [(43.65 ± 10.12) and (22.93 ± 7.39) pg/ml, respectively; P = 0.000]. The ratios of Th1/Th2 were used to assess the contribution of Th1/Th2 immunity in acute and stable phase of CM patients. The ratios of IFN-γ/IL-10 and TNF-α/IL-10 measured in acute phase of CM patients were significantly lower than that in control patients (P = 0.000, for all). These ratios in acute phase patients were also significantly lower than that in stable phase patients (P = 0.000, for all). Conclusions In acute phase, the Th2 response is dominant in patients with CM. However, the immune response shifts towards to Th1 response in the stable phase, providing direct evidence that the imbalance of Th1-Th2 cytokines is related to the pathogenesis of CM.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: Chinese
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