Abstract
The postpolio syndrome (PPS) is characterized by progressive disabilities decades after recovery from the acute paralytic disease. There are reports on intrathecal inflammatory reactions in PPS, including increased expression of cytokines by cerebrospinal fluid (CSF) mononuclear cells (CSF-MC). This is potentially of relevance for the clinical condition. We here explored if cytokine expression in the CSF of PPS patients could be modulated by high-dose intravenous immunoglobulins (IvIg). The expression of TNF-alpha, IFN-gamma, IL-10 and IL-4 mRNAs was measured by real-time RT-PCR in CSF and peripheral blood mononuclear cells (PBMC) of 16 PPS patients before, and 6-8 weeks after IvIg treatment, and in 26 patients with noninflammatory other neurological diseases (OND). TNF-alpha, IFN-gamma and IL-10 CSF mRNA levels were elevated in samples from untreated persons with PPS compared to OND. Upon IvIg treatment, IFN-gamma and TNF-alpha mRNA levels were dramatically reduced, while IL-10 remained unchanged. Placebo-controlled studies are now warranted to evaluate if IvIg treatment also has any effects on the clinical manifestations of PPS.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Aged
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Cytokines / antagonists & inhibitors*
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Cytokines / biosynthesis*
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Cytokines / cerebrospinal fluid
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Cytokines / genetics
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Female
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Humans
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Immunoglobulins, Intravenous / administration & dosage
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Immunoglobulins, Intravenous / therapeutic use*
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Inflammation Mediators / antagonists & inhibitors*
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Inflammation Mediators / cerebrospinal fluid
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Inflammation Mediators / metabolism
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Infusions, Intravenous
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Interferon-gamma / antagonists & inhibitors
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Interferon-gamma / biosynthesis
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Interferon-gamma / cerebrospinal fluid
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Interferon-gamma / genetics
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Interleukin-10 / biosynthesis
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Interleukin-10 / genetics
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Male
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Middle Aged
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Postpoliomyelitis Syndrome / immunology*
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Postpoliomyelitis Syndrome / pathology
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Postpoliomyelitis Syndrome / therapy*
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RNA, Messenger / antagonists & inhibitors
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RNA, Messenger / biosynthesis
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RNA, Messenger / cerebrospinal fluid
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Reverse Transcriptase Polymerase Chain Reaction
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Th1 Cells / immunology
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Th1 Cells / metabolism
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Th2 Cells / immunology
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Th2 Cells / metabolism
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
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Tumor Necrosis Factor-alpha / biosynthesis
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Tumor Necrosis Factor-alpha / cerebrospinal fluid
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Tumor Necrosis Factor-alpha / genetics
Substances
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Cytokines
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Immunoglobulins, Intravenous
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Inflammation Mediators
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RNA, Messenger
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Tumor Necrosis Factor-alpha
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Interleukin-10
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Interferon-gamma