PDF(Pubmed)
Abstract：
Shunt infection is one of the most common complications of conventional hydrocephalus treatment. The route of invasion of a pathogen can modify the immune response of the CNS. The aim of the study is to analyze the immune response to shunt infection caused by S. epidermidis in children with hydrocephalus. The immune response to the pathogen will be analyzed on the basis of, inter alia, simple laboratory test results, such as changes in the pattern of white blood cells, including neutrophils, monocytes, and lymphocytes. The entire study analyzes changes in general parameters of the cerebrospinal fluid (pleocytosis, protein level, glucose level) and in levels of selected interleukins (IL-6, CXCL8 / IL-8, CCL3 / MIP-1a) in the cerebrospinal fluid. The clinical material analyzed in the study was collected in 2010-2014. The study group consisted of 30 patients, who were admitted to the hospital due to their first-ever episode of valve dysfunction caused by S. epidermidis infection. The control group consisted of 30 children who also suffered from congenital hydrocephalus but had not been operated on before. The most pronounced response to CSF infection in the study group was a significant increase in the counts of all investigated WBC lines in the samples collected immediately after the patients\' admission to the ward. The earliest aberration of the CSF was a significant increase in protein level. An infection of a ventriculoperitoneal shunt caused by S. epidermidis evokes a very early peripheral blood response. In children affected by a ventriculoperitoneal valve infection, the humoral immune response detected in the cerebrospinal fluid precedes the increase in the level of pleocytosis. The highest level of cytokines in the cerebrospinal fluid is achieved when the pathogens are cleared. Phagocytes, and, in particular, monocytes, play an important role in the normalization of the cerebrospinal fluid parameters after the elimination of S. epidermidis. The local immune response of the central nervous system plays an important role in extinguishment of the inflammatory process.
摘要：
分流感染是脑积水常规治疗最常见的并发症之一。病原体的侵入途径可以改变CNS的免疫应答。该研究的目的是分析脑积水儿童对表皮葡萄球菌引起的分流感染的免疫反应。对病原体的免疫反应将在此基础上进行分析，除其他外,简单的实验室测试结果，比如白细胞模式的改变，包括中性粒细胞,单核细胞,和淋巴细胞。整个研究分析了脑脊液一般参数的变化（细胞增多，蛋白质水平,葡萄糖水平）和脑脊液中选定的白细胞介素（IL-6，CXCL8/IL-8，CCL3/MIP-1a）的水平。该研究中分析的临床材料收集于2010-2014年。研究组由30名患者组成，他们因表皮葡萄球菌感染引起的瓣膜功能障碍首次发作而入院。对照组由30名儿童组成，这些儿童也患有先天性脑积水，但以前没有做过手术。研究组对CSF感染最明显的反应是在患者入院后立即收集的样本中所有调查的WBC系的计数显着增加。CSF的最早畸变是蛋白质水平的显着增加。由表皮葡萄球菌引起的脑室-腹腔分流术感染引起非常早期的外周血反应。在受脑室腹膜瓣感染影响的儿童中，在脑脊液中检测到的体液免疫反应先于细胞增多水平的增加。当病原体被清除时，脑脊液中细胞因子的水平最高。吞噬细胞,and,特别是,单核细胞,在消除表皮葡萄球菌后的脑脊液参数正常化中起重要作用。中枢神经系统的局部免疫反应在炎症过程的消退中起着重要作用。
