Stroke:训练免疫特征与进行性脑小血管病相关

2018-11-11 国际循环编辑部 国际循环

脑小血管病(cSVD)是导致认知衰退及痴呆症的主要血管性原因。尽管研究提示,系统性炎症在其中发挥了作用,但目前cSVD的发病机制在很大程度上仍不清楚。在某些病理生理情况下,单核细胞可重新编程为长期促炎表型,即训练免疫。Stroke发表的一项最新研究探讨了训练免疫在cSVD进展中所发挥的作用。

脑小血管病(cSVD)是导致认知衰退及痴呆症的主要血管性原因。尽管研究提示,系统性炎症在其中发挥了作用,但目前cSVD的发病机制在很大程度上仍不清楚。在某些病理生理情况下,单核细胞可重新编程为长期促炎表型,即训练免疫。Stroke发表的一项最新研究探讨了训练免疫在cSVD进展中所发挥的作用。

研究共计入选51例轻度至重度cSVD患者,根据2006年~2015年磁共振成像所示白质高信号(WMH)体积(ml)确定cSVD的严重程度,根据两次评估所得的ΔWMH 确定2006年~2015年的进展情况。对外周血单个核细胞及单核细胞进行离体刺激评估细胞因子的产生情况,采用流式细胞术对单核细胞亚群进行鉴定。

受试患者平均年龄为(70±6)岁,男性占60%,2006年~2015年ΔWMH为(5.1±6.4) ml。分析显示,循环中高敏白介素(hsIL)-6的水平与cSVD具有相关性(P=0.005,rs=0.40);单核细胞产生细胞因子的能力与cSVD进展具有相关性。基线单核细胞IL-8及IL-17的产生以及Pam3Cys刺激后单核细胞IL-6的产生均与cSVD具有相关性(P=0.08,rs=0.25;P=0.03,rs=0.30和P=0.008,rs=0.44)。相反,白色念珠菌刺激后外周血单个核细胞中干扰素(IFN)-γ的产生则与cSVD呈负相关(P=0.009,rs=−0.36)。流式细胞术分析显示,中间型单核细胞亚群与cSVD具有相关性(P=0.01,rs=0.36)。

综上可见,cSVD的严重程度及进展不仅与系统性炎症(hsIL-6)还与循环单核细胞的训练免疫特征即细胞因子产生能力的改变及向促炎的中间型单核细胞亚群转变具有相关性。

原始出处:
Marlies P. Noz, Annemieke ter Telgte, Kim Wiegertjes, et al. Trained Immunity Characteristics Are Associated With Progressive Cerebral Small Vessel Disease. Stroke. Nov 2018.

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