背景:多发性硬化症(MS)的病理生理学主要由炎症和神经变性决定。先前已经提出了炎症和调节的细胞死亡之间的相关性。脑脊液(CSF)中的阴影细胞被认为是凋亡细胞。
目的:与其他神经系统疾病(OND)相比,评估MS患者阴影细胞的发生。
方法:我们对114例MS患者和125例OND患者进行了脑脊液细胞学检查,在神经内科做腰椎穿刺诊断,因斯布鲁克医科大学,实验室处理时间≤0.5h,显示CSF白细胞(WBC)计数≤50/μl,红细胞(RBC)计数≤500/μl。用两个盲法计数阴影细胞,独立,经验丰富的调查员,在显微镜载玻片上使用标准化的方法。
结果:MS患者(中位数:12,IQR:0-85)和OND患者(中位数:6,IQR:0-94;p=0.106)之间阴影细胞的数量没有统计学上的显着差异。多元回归分析,包括年龄,性别,实验室处理时间,脑脊液白细胞和红细胞计数,CSF/血清葡萄糖比,CSF/血清白蛋白商和疾病组作为独立变量,确定WBC计数是阴影细胞的显著预测因子(β[lnWBC计数]=0.73,p<10-9),而疾病组无影响(p=0.466)。
结论:CSF中阴影细胞的发生似乎取决于炎症细胞的程度,而不是MS疾病特异性机制。
BACKGROUND: Pathophysiology of multiple sclerosis (MS) is dominated by both inflammation and neurodegeneration. A correlation between inflammation and regulated cell death has been suggested previously. Shadow cells in the cerebrospinal fluid (CSF) are considered apoptotic cells.
OBJECTIVE: To assess the occurrence of shadow cells in MS patients in comparison to other neurological diseases (OND).
METHODS: We conducted cytological examination of CSF in 114 MS patients and 125 patients with OND, who had diagnostic lumbar puncture at the Department of Neurology, Medical University of Innsbruck, with time to laboratory processing ≤0.5 h, showed a CSF white blood cell (WBC) count ≤50/µl and a red blood cell (RBC) count ≤500/µl. Shadow cells were counted by two blinded, independent, experienced investigators, using a standardized approach on microscopic slides.
RESULTS: The number of shadow cells did not statistically significantly differ between patients with MS (median: 12, IQR: 0-85) and OND (median 6, IQR: 0-94; p = 0.106). Multivariable regression analysis including age, sex, time to laboratory processing, CSF WBC and RBC count, CSF/serum glucose ratio, CSF/serum albumin quotient and disease group as independent variables, identified WBC count as significant predictor of shadow cells (β [ln WBC count]=0.73, p<10-9), whereas the disease group had no impact (p = 0.466).
CONCLUSIONS: Occurrence of shadow cells in the CSF seems to depend on the extent of inflammatory cells rather than MS disease-specific mechanisms.