Youn Youngah, Sung In Kyung, Lee In Goo
Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Korean J Pediatr. 2013 Jul;56(7):271-4. doi: 10.3345/kjp.2013.56.7.271. Epub 2013 Jul 19.
Brain insults, including neurotrauma, infection, and perinatal injuries such as hypoxic ischemic encephalopathy, generate inflammation in the brain. These inflammatory cascades induce a wide spectrum of cytokines, which can cause neuron degeneration, have neurotoxic effects on brain tissue, and lead to the development of seizures, even if they are subclinical and occur at birth. Cytokines are secreted by the glial cells of the central nervous system and they function as immune system mediators. Cytokines can be proinflammatory or anti-inflammatory. Interleukin (IL)-1β and IL-8 are proinflammatory cytokines that activate additional cytokine cascades and increase seizure susceptibility and organ damage, whereas IL-1 receptor antagonist and IL-10 act as anti-inflammatory cytokines that have protective and anticonvulsant effects. Therefore, the immune system and its associated inflammatory reactions appear to play an important role in brain damage. Whether cytokine release is relevant for the processes of epileptogenesis and antiepileptogenesis, and whether epileptogenesis could be prevented by immunomodulatory treatment should be addressed in future clinical studies. Furthermore, early detection of brain damage and early intervention are essential for the prevention of disease progression and further neurological complications. Therefore, cytokines might be useful as biomarkers for earlier detection of brain damage in high-risk infants.
脑部损伤，包括神经创伤、感染以及围产期损伤（如缺氧缺血性脑病），会在脑部引发炎症。这些炎症级联反应会诱导多种细胞因子产生，这些细胞因子可导致神经元变性，对脑组织产生神经毒性作用，并引发癫痫发作，即便这些发作是亚临床的且发生在出生时。细胞因子由中枢神经系统的神经胶质细胞分泌，它们作为免疫系统的介质发挥作用。细胞因子可以是促炎的或抗炎的。白细胞介素（IL）-1β和IL-8是促炎细胞因子，它们会激活更多的细胞因子级联反应，增加癫痫易感性和器官损伤，而IL-1受体拮抗剂和IL-10则作为抗炎细胞因子，具有保护和抗惊厥作用。因此，免疫系统及其相关的炎症反应似乎在脑损伤中起着重要作用。细胞因子释放是否与癫痫发生和抗癫痫发生过程相关，以及免疫调节治疗是否可以预防癫痫发生，这些问题应在未来的临床研究中加以探讨。此外，早期发现脑损伤并进行早期干预对于预防疾病进展和进一步的神经并发症至关重要。因此，细胞因子可能作为生物标志物，用于早期检测高危婴儿的脑损伤。
