Department of Pediatrics, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo, Japan.
J Neurol Sci. 2010 Nov 15;298(1-2):106-9. doi: 10.1016/j.jns.2010.07.018.
The aim of this study was to evaluate whether proconvulsive interleukin-1β (IL-1β) and anticonvulsive IL-1 receptor antagonist (IL-1Ra) are markers of the effectiveness of treatment in patients with West syndrome (WS). We analyzed serum and cerebrospinal fluid (CSF) levels of IL-1β and IL-1Ra in 13 patients with WS. The serum IL-1Ra levels postimprovement (average, 384.6 pg/ml) in clinical and electroencephalographic (EEG) findings were significantly higher than the preimprovement values (average, 240.6 pg/ml). No significant difference in the preimprovement serum IL-1Ra levels was noted between the anticonvulsant (AED)-response and adrenocorticotropic hormone (ACTH)-response groups (260.0 pg/ml, n=7 vs. 218.0 pg/m, n=6) and the cryptogenic and symptomatic groups (290.1 pg/ml, n=4 vs. 218.3 pg/m, n=9), respectively; as for the preimprovement CSF levels, the AED-response group (114.5 pg/m; n=3) and ACTH-response groups (138.0 pg/m; n=6) and the cryptogenic (59.3 pg/m; n=3) and symptomatic groups (165.6 pg/m; n=6), respectively. Serum and CSF IL-1β levels were detected only in 3 patients preimprovement. Serum IL-1Ra levels were elevated subsequent to resolution of clinical and EEG findings in WS patients. A larger study should be conducted to clarify whether an immunological processes are concerned with the pathophysiology of WS.
本研究旨在评估促惊厥性白细胞介素-1β（IL-1β）和抗惊厥性 IL-1 受体拮抗剂（IL-1Ra）是否为 West 综合征（WS）患者治疗效果的标志物。我们分析了 13 例 WS 患者的血清和脑脊液（CSF）中 IL-1β和 IL-1Ra 水平。在临床和脑电图（EEG）发现改善后的血清 IL-1Ra 水平（平均 384.6pg/ml）明显高于改善前（平均 240.6pg/ml）。改善前血清 IL-1Ra 水平在抗惊厥药物（AED）反应和促肾上腺皮质激素（ACTH）反应组（260.0pg/ml，n=7 与 218.0pg/ml，n=6）和隐源性和症状性组（290.1pg/ml，n=4 与 218.3pg/ml，n=9）之间无显著差异；改善前 CSF 水平，AED 反应组（114.5pg/ml；n=3）和 ACTH 反应组（138.0pg/ml；n=6）以及隐源性组（59.3pg/ml；n=3）和症状性组（165.6pg/ml；n=6）。改善前仅检测到 3 例患者的血清 IL-1β 水平。在 WS 患者的临床和 EEG 发现得到解决后，血清 IL-1Ra 水平升高。应该进行更大的研究来阐明免疫过程是否与 WS 的病理生理学有关。
