Department of Child Neurology, Carlo Besta Neurological Institute, Milan, Italy.
Epilepsia. 2011 May;52 Suppl 3(Suppl 3):5-11. doi: 10.1111/j.1528-1167.2011.03029.x.
A pathogenic role of immunity in epilepsies has long been suggested based on observations of the efficacy of immune-modulating treatments and, more recently, by the finding of inflammation markers including autoantibodies in individuals with a number of epileptic disorders. Clinical and experimental data suggest that both innate and adaptive immunity may be involved in epilepsy. Innate immunity represents an immediate, nonspecific host response against pathogens via activation of resident brain immune cells and inflammatory mediators. These are hypothesized to contribute to seizures and epileptogenesis. Adaptive immunity employs activation of antigen-specific B and T lymphocytes or antibodies in the context of viral infections and autoimmune disorders. In this article we critically review the evidence for pathogenic roles of adaptive immune responses in several types of epilepsy, and discuss potential mechanisms and therapeutic targets. We highlight future directions for preclinical and clinical research that are required for improved diagnosis and treatment of immune-mediated epilepsies.
长期以来，人们一直认为免疫在癫痫中起着致病作用，这基于免疫调节治疗的疗效观察，以及最近在许多癫痫疾病患者中发现的炎症标志物，包括自身抗体。临床和实验数据表明，固有免疫和适应性免疫都可能与癫痫有关。固有免疫通过激活驻留的大脑免疫细胞和炎症介质，对病原体产生即刻的、非特异性的宿主反应。据推测，这些反应会导致癫痫发作和癫痫形成。适应性免疫在病毒感染和自身免疫性疾病中，通过激活抗原特异性 B 和 T 淋巴细胞或抗体来发挥作用。在本文中，我们批判性地回顾了适应性免疫反应在几种类型癫痫中的致病作用的证据，并讨论了潜在的机制和治疗靶点。我们强调了为改善免疫介导性癫痫的诊断和治疗而需要进行的临床前和临床研究的未来方向。
