探討腦部外傷病人腦脊髓液中細胞激素的變化
Cytokine profile in cerebrospinal fluid from patient with traumatic brain injury
中文摘要
腦部外傷是一項嚴重的臨床問題，不僅有較高死亡率，易引起長期性的神經行 為障礙，並且常造成家庭；社會經濟的負擔，特別是那些遭受嚴重腦部外傷的 病患。腦部外傷的病理生理機轉是複雜且互有關聯的。雖然在動物實驗及臨床上 對腦部外傷的研究使我們對腦部外傷的病理生理學有較多的認識，但目前仍未 有一神經保護製劑在減輕或預防因腦部外傷引起的腦部損傷方面有明顯的效果。
本研究著力於腦部外傷發生後，病人腦脊髓液中各種細胞激素的變化情形。此實 驗結合了抗體微陣列檢測分析 (Antibody microarray)還有酵素連結免疫吸附分析 法 (Enzyme linked immunosorbent assay, ELISA)，用以分析腦部外傷發生後不同 時間點所收集到的病人腦脊髓液中細胞激素的變化。觀察到了interleukin 8 (IL- 8)、macrophage-derived chemokine (MDC)、neutrophil activating protein-2 (NAP- 2) 、monocyte chemoattractant protein-1 (MCP-1)、interleukin 6 (IL-6)、soluble interleukin 6 receptor (sIL-6R)、intercellular adhesion molecule-1 (ICAM-1)、soluble Fas (sFas)、tissue inhibitor of metalloprotease-1 (TIMP-1) 在腦部外傷初期病人的腦 脊髓液中有濃度增加；matrix metalloproteinase-9 (MMP-9) 及 matrix
metalloproteinase-2 (MMP-2) 活性增加的表現。在本研究中所觀察的這些細胞激 素多和發炎反應，細胞凋亡有關，雖然這結果受限於本篇研究檢體數目，是需 要更多的實驗再加以觀察佐證的，但仍希望此一實驗，在未來對於腦部外傷的 研究上能有些微的貢獻。
英文摘要
Traumatic brain injury is a serious clinical problem connected with high mortality rate, long-term neurobehavioral disabilities, familial and socio-economic burden, in particular patients with severe neurotrauma. It should be realized that
pathophysiology processes involved in traumatic brain damage are complex and interrelated. Although more is known about the pathophysiology of traumatic brain injury, deriving from mechanistic studies in experimental models and clinical head injury, none of the neuroprotective drugs that have been tested to reduce or prevent brain damage have been shown clear benefit. This study focused on cytokine concentration in cerebrospinal fluid from patient with traumatic brain injury. This study used enzyme linked immunosorbent assay (ELISA) and antibody microarray to analyze cytokine variance in concentration in cerebrospinal fluid collected in different point of time from patient with traumatic brain injury. This study found interleukin 8 (IL-8); macrophage-derived chemokine (MDC); neutrophil activating protein-2
(NAP-2); monocyte chemoattractant protein-1 (MCP-1); interleukin 6 (IL-6); soluble interleukin 6 receptor (sIL-6R); intercellular adhesion molecule-1 (ICAM-1); soluble Fas (sFas); tissue inhibitor of metalloprotease-1 (TIMP-1), matrix metalloproteinase-9 (MMP-9), and matrix metalloproteinase-2 (MMP-2) increased their expression in the very beginning of brain trauma. In this study all cytokines used are associated with inflammatory response and apoptosis. Although in this study the sample number is limited and this finding need more experiments to prove it, I still hope this finding can offer some contribution toward traumatic brain injury.
