Lalla Rakesh Shyam, Garg Ravindra Kumar, Malhotra Hardeep Singh, Jain Amita, Verma Rajesh, Pandey Chandra Mani, Singh Gyan Prakash, Sharma Praveen Kumar
Department of Neurology, King George Medical University, Uttar Pradesh, Lucknow, India.
Neurol India. 2015 Mar-Apr;63(2):190-6. doi: 10.4103/0028-3886.156279.
In patients with neurocysticercosis, perilesional inflammatory activity is thought to be responsible for seizures. This study was designed to evaluate the serum and cerebrospinal fluid (CSF) concentrations of cytokines as well as matrix metalloproteinase (MMP)-2 and MMP-9 in patients with a solitary cysticercus granuloma.
The study included 47 patients suffering from seizures in whom a solitary cysticercus granuloma was detected on a computed tomography (CT) scan. The study also included 47 control subjects. Their serum and cerebrospinal fluid (CSF) was analysed for cytokines and MMP levels. A follow-up CT was performed after 6 months.
The median levels of cytokines, interleukin (IL)-1β, IL-5, IL-6, IL-10 and tissue necrosis factor (TNF)-α, MMP-2 and MMP-9 were significantly elevated, both in the serum and CSF of patients having an intracerebral solitary cysticercus granuloma, in comparison to that of controls. The follow-up CT revealed that in 27 patients, the lesions were calcified and in 5 patients, there was complete resolution of the lesions. In 15 patients, the lesions remained unchanged. Higher baseline CSF MMP-2 and TNF-α level were seen in patients with persisting lesions. Higher serum baseline MMP-2, IL-6 and a low CSF IL-10 level were seen in patients with complete resolution of the granuloma. A high baseline IL-1β level was associated with a calcified lesion. Fourteen patients had recurrence of seizures. A high baseline serum TNF-α level was independently associated with seizure recurrence (P = 0.021, OR = 1.041, CI = 1.006 to 1.078).
In patients with a solitary cysticercus granuloma, cytokines and matrix metalloproteinases in the CSF and serum are elevated. Different patterns of immunological changes were observed in patients following resolution or calcification of the lesion.
在神经囊尾蚴病患者中，病灶周围的炎症活动被认为是癫痫发作的原因。本研究旨在评估孤立性囊尾蚴肉芽肿患者血清和脑脊液（CSF）中细胞因子以及基质金属蛋白酶（MMP）-2和MMP-9的浓度。
该研究纳入了47例有癫痫发作且在计算机断层扫描（CT）上检测到孤立性囊尾蚴肉芽肿的患者。研究还纳入了47名对照受试者。对他们的血清和脑脊液（CSF）进行细胞因子和MMP水平分析。6个月后进行随访CT检查。
与对照组相比，脑内有孤立性囊尾蚴肉芽肿患者的血清和脑脊液中，细胞因子白细胞介素（IL）-1β、IL-5、IL-6、IL-10和组织坏死因子（TNF）-α、MMP-2和MMP-9的中位数水平显著升高。随访CT显示，27例患者的病灶钙化，5例患者的病灶完全消退。15例患者的病灶保持不变。病灶持续存在的患者脑脊液基线MMP-2和TNF-α水平较高。肉芽肿完全消退的患者血清基线MMP-2、IL-6水平较高，脑脊液IL-10水平较低。基线IL-1β水平高与钙化病灶相关。14例患者癫痫复发。血清基线TNF-α水平高与癫痫复发独立相关（P = 0.021，OR = 1.041，CI = 1.006至1.078）。
在孤立性囊尾蚴肉芽肿患者中，脑脊液和血清中的细胞因子及基质金属蛋白酶升高。在病灶消退或钙化的患者中观察到了不同的免疫变化模式。
