Department of Pediatrics, Konkuk University Medical Center, Seoul, Korea.
Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro (Hwayang-dong), Gwangjin-gu, Seoul, 05030, Korea.
J Neuroinflammation. 2017 Oct 10;14(1):200. doi: 10.1186/s12974-017-0974-7.
Febrile seizures are the most common form of childhood seizures. Fever generation involves many cytokines, including both pro- and anti-inflammatory cytokines. Some of these cytokines also induce febrile seizures. We compared cytokine production in children with a fever alone (healthy control group) and febrile seizure children group. Also, we evaluated the cytokine level of children with a fever alone and febrile seizure history.
Fifty febrile seizure patients and 39 normal control patients who visited the emergency department of Konkuk University Hospital from December 2015 to December 2016 were included in this study. Blood was taken from the peripheral vessels of children in all groups within 1 h of the seizure, and serum was obtained immediately. Serum samples from patients with only a fever and a febrile seizure history (N = 13) and afebrile seizure controls (N = 12) were also analyzed.
The serum IL-10 and IL-1Ra levels were significantly higher in the febrile seizure patients than in the fever-only control, fever only with a febrile seizure history, and afebrile seizure groups (p < 0.05). The serum IFN-γ and IL-6 levels were significantly higher in the febrile seizure patients than in the afebrile seizure group (p < 0.05). The serum IL-8 levels were higher in the febrile seizure patients than in the fever only controls (p < 0.05).
The serum levels of the IFN-γ, IL-6, and IL-8 pro-inflammatory cytokines and the serum levels of the IL-10 and IL-1Ra anti-inflammatory cytokines were significantly higher in the febrile seizure children. Furthermore, the serum level of IL-1Ra was more increased in the febrile seizure group than in the same patients with only a fever. Our data suggest that increased serum IL-10 and IL-1Ra may play potential roles as anti-inflammatory cytokines in a compensation mechanism that shortens the seizure duration or prevents a febrile seizure attack. Therefore, anti-inflammatory cytokines, including IL-10 and IL-1Ra, have potential as therapeutic targets for the prevention of seizures and nervous system development of children.
热性惊厥是儿童最常见的惊厥形式。发热的产生涉及许多细胞因子，包括促炎细胞因子和抗炎细胞因子。其中一些细胞因子也会引起热性惊厥。我们比较了单纯发热（健康对照组）和热性惊厥患儿组的细胞因子产生情况。此外，我们还评估了单纯发热和有热性惊厥病史患儿的细胞因子水平。
本研究纳入了 2015 年 12 月至 2016 年 12 月期间因发热就诊于韩国孔敬大学医院急诊科的 50 例热性惊厥患儿和 39 例正常对照组患儿。所有患儿在发作后 1 小时内均从外周血管采血，立即获得血清。还分析了单纯发热和有热性惊厥病史（N=13）以及无热性惊厥对照（N=12）患儿的血清样本。
与单纯发热对照组、单纯发热伴热性惊厥病史组和无热性惊厥对照组相比，热性惊厥患儿的血清白细胞介素 10（IL-10）和白细胞介素 1 受体拮抗剂（IL-1Ra）水平明显更高（p<0.05）。与无热性惊厥组相比，热性惊厥患儿的血清干扰素 γ（IFN-γ）和白细胞介素 6（IL-6）水平明显更高（p<0.05）。与单纯发热对照组相比，热性惊厥患儿的血清白细胞介素 8（IL-8）水平更高（p<0.05）。
热性惊厥患儿促炎细胞因子 IFN-γ、IL-6 和 IL-8 以及抗炎细胞因子 IL-10 和 IL-1Ra 的血清水平明显升高。此外，与单纯发热患儿相比，热性惊厥患儿血清中 IL-1Ra 的水平升高更为明显。我们的数据表明，血清中 IL-10 和 IL-1Ra 的增加可能作为一种抗炎细胞因子，在缩短癫痫发作持续时间或预防热性惊厥发作的代偿机制中发挥作用。因此，抗炎细胞因子，包括 IL-10 和 IL-1Ra，可能成为预防儿童癫痫发作和神经系统发育的治疗靶点。
