Liimatainen Suvi, Fallah Mahdi, Kharazmi Elham, Peltola Maria, Peltola Jukka
Department of Neurology and Rehabilitation, Tampere University Hospital, P.O. Box 2000, Tampere 33521, Finland.
J Neurol. 2009 May;256(5):796-802. doi: 10.1007/s00415-009-5021-x. Epub 2009 Feb 28.
Previous studies have reported activation of inflammatory cytokines in seizures, but clinical characteristics of epilepsy associated with cytokine activation have not been well established. In this study, serum levels of interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1RA) were measured, and clinical characteristics of epilepsy were assessed in 86 well-evaluated patients with refractory focal epilepsy and in 5 patients with controlled focal epilepsy. Epilepsy was evaluated based on patient histories, electroclinical findings, and high-resolution brain MRI scans. Sixty-three healthy blood donors served as controls. IL-6 concentrations were chronically increased in epilepsy patients (11%) compared with healthy controls (0%) (P = 0.007). Increased levels of IL-6 were more prevalent in patients with temporal lobe epilepsy (TLE) compared to patients with extra-TLE (P = 0.028). Also the mean and the median serum levels of IL-6 were higher in patients with TLE than in patients with extra-TLE (P = 0.042). Concentrations of IL-1RA were not significantly different in patients compared with controls. Indicated by increased levels of IL-6 in TLE, epilepsy type is important in determining chronic overproduction of cytokines in refractory focal epilepsy. The results may reflect a chronic immunological process in the brain in patients with refractory epilepsy.
以往研究报道了癫痫发作时炎性细胞因子的激活,但与细胞因子激活相关的癫痫临床特征尚未完全明确。在本研究中,我们检测了86例评估良好的难治性局灶性癫痫患者和5例局灶性癫痫得到控制的患者的血清白细胞介素-6(IL-6)和白细胞介素-1受体拮抗剂(IL-1RA)水平,并评估了癫痫的临床特征。根据患者病史、电临床检查结果和高分辨率脑部MRI扫描对癫痫进行评估。63名健康献血者作为对照。与健康对照(0%)相比,癫痫患者中IL-6浓度长期升高的比例为11%(P = 0.007)。与颞叶外癫痫患者相比,颞叶癫痫(TLE)患者中IL-6水平升高更为普遍(P = 0.028)。此外,TLE患者的IL-6血清平均水平和中位数水平均高于颞叶外癫痫患者(P = 0.042)。患者与对照相比,IL-1RA浓度无显著差异。TLE中IL-6水平升高表明,癫痫类型在决定难治性局灶性癫痫中细胞因子的慢性过度产生方面很重要。这些结果可能反映了难治性癫痫患者大脑中的慢性免疫过程。