Altıokka-Uzun Güneş, Tüzün Erdem, Ekizoğlu Esme, Ulusoy Canan, Yentür Sibel, Kürtüncü Murat, Saruhan-Direskeneli Güher, Baykan Betül
Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Department of Neuroscience, Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey.
Cephalalgia. 2015 Nov;35(13):1153-61. doi: 10.1177/0333102415570762. Epub 2015 Feb 19.
The pathogenesis of idiopathic intracranial hypertension (IIH) is currently unknown and there are speculations about the contribution of some immunologic factors. The aim of this study is to investigate the presence of oligoclonal bands (OCBs) and cerebrospinal fluid (CSF) and/or serum cytokine levels in patients with IIH.
Patients fulfilling revised diagnostic criteria for IIH were included. Their demographic, clinical, ophthalmologic and laboratory features were examined. Serum and CSF samples were detected by isoelectric focusing and immunoblotting for OCBs. The samples of IIH patients and control groups were investigated by ELISA for cytokine levels.
We detected OCBs in eight (30.77%) patients diagnosed with IIH. There were no other obvious clinical and laboratory differences of IIH profiles between the patients with and without OCBs, but frequency of vision loss was significantly higher in the group with OCBs in comparison to OCB negatives (p = 0.038). Patients with IIH had highly elevated TNF-α, IFN-γ, IL-4, IL-10, IL-12, IL-17 in their sera compared to patients with multiple sclerosis (MS) and healthy controls. Furthermore, all cytokines except TNF-α in the CSF were found significantly higher in IIH patients compared to MS controls.
The presence of OCBs and elevated cytokine levels in IIH patients may support an immunologic background in the pathophysiological pathway of this disorder.
特发性颅内高压（IIH）的发病机制目前尚不清楚，对于一些免疫因素的作用存在推测。本研究的目的是调查IIH患者中寡克隆带（OCB）的存在情况以及脑脊液（CSF）和/或血清细胞因子水平。
纳入符合IIH修订诊断标准的患者。检查他们的人口统计学、临床、眼科和实验室特征。通过等电聚焦和免疫印迹检测血清和脑脊液样本中的OCB。采用酶联免疫吸附测定法（ELISA）检测IIH患者和对照组样本中的细胞因子水平。
我们在8例（30.77%）诊断为IIH的患者中检测到OCB。有OCB和无OCB的IIH患者在其他临床和实验室特征方面无明显差异，但有OCB的组视力丧失发生率显著高于无OCB的组（p = 0.038）。与多发性硬化症（MS）患者和健康对照相比，IIH患者血清中的肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）、白细胞介素-4（IL-4）、白细胞介素-10（IL-10）、白细胞介素-12（IL-12）、白细胞介素-17水平显著升高。此外，与MS对照组相比，IIH患者脑脊液中除TNF-α外的所有细胞因子均显著升高。
IIH患者中OCB的存在和细胞因子水平升高可能支持该疾病病理生理途径中的免疫背景。
