Ichiyama Takashi, Suenaga Naoko, Kajimoto Madoka, Tohyama Jun, Isumi Hiroshi, Kubota Masaya, Mori Masato, Furukawa Susumu
Department of Pediatrics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
Brain Dev. 2008 Jan;30(1):47-52. doi: 10.1016/j.braindev.2007.05.008. Epub 2007 Jun 26.
It is well known that an acute encephalopathy occasionally follows prolonged febrile seizures. We measured the concentrations of interferon-gamma, tumor necrosis factor-alpha (TNF-alpha), interleukin-2 (IL-2), IL-4, IL-6, IL-10, and soluble TNF receptor 1 (sTNFR1) in serum and CSF during the acute stage in 13 children with acute encephalopathy following prolonged febrile seizures (AEPFS) and 23 with prolonged febrile seizures without encephalopathy (PFS) to investigate the pathogenesis of AEPFS. Serum IL-6, IL-10, sTNFR1, and CSF IL-6 levels were significantly higher in AEPFS and PFS compared with control subjects. CSF IL-6 levels in AEPFS were significantly higher than those in PFS, but not serum IL-6, IL-10, or sTNFR1. The CSF IL-6 levels were significantly higher than the serum levels in AEPFS, but not PFS. The serum levels of sTNFR1 and IL-10 were significantly higher than those in the CSF in AEPFS and PFS. The serum IL-10 and sTNFR1 levels in patients who did not experience a second seizure were significantly higher than those in patients who experienced a second seizure, which was characterized by clusters of complex partial seizures several days after the initial prolonged febrile seizure. Our results suggest that serum IL-6, IL-10, TNF-alpha, and CSF IL-6 are part of the regulatory system of cytokines in AEPFS.
众所周知，急性脑病偶尔会在长时间热性惊厥后出现。我们测量了13例长时间热性惊厥后急性脑病（AEPFS）患儿和23例无脑病的长时间热性惊厥（PFS）患儿急性期血清和脑脊液中γ-干扰素、肿瘤坏死因子-α（TNF-α）、白细胞介素-2（IL-2）、IL-4、IL-6、IL-10和可溶性TNF受体1（sTNFR1）的浓度，以研究AEPFS的发病机制。与对照组相比，AEPFS组和PFS组的血清IL-6、IL-10、sTNFR1以及脑脊液IL-6水平显著升高。AEPFS组的脑脊液IL-6水平显著高于PFS组，但血清IL-6、IL-10或sTNFR1并非如此。AEPFS组的脑脊液IL-6水平显著高于血清水平，但PFS组并非如此。AEPFS组和PFS组中，血清sTNFR1和IL-10水平显著高于脑脊液水平。未经历第二次惊厥的患者血清IL-10和sTNFR1水平显著高于经历第二次惊厥的患者，第二次惊厥的特征是在最初长时间热性惊厥几天后出现成串的复杂部分性发作。我们的结果表明，血清IL-6、IL-10、TNF-α和脑脊液IL-6是AEPFS中细胞因子调节系统的一部分。
