Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany.
Institute of Clinical Radiology, Medical Faculty, University of Münster and University Hospital Münster, Münster, Germany.
Epilepsia. 2020 Oct;61(10):e153-e158. doi: 10.1111/epi.16688. Epub 2020 Sep 7.
Inflammation plays a role in the pathogenesis of immune-mediated epilepsy, but also in epilepsy of other etiology such as hippocampal sclerosis. This study aimed to characterize immune cell signatures in the peripheral blood (PB) and cerebrospinal fluid (CSF) in temporal lobe epilepsy (TLE) of different etiologies. We retrospectively evaluated CSF routine parameters and immune cell profiles using flow cytometry in a cohort of 51 patients and 45 age-matched controls with functional disorders. Groups were comprised of patients with nonlesional TLE (n = 26), TLE due to hippocampal sclerosis (n = 14), or limbic encephalitis with antibodies against the 65-kDa isoform of glutamic acid decarboxylase (GAD65-LE; n = 11). TLE patients showed increased proportions of human leukocyte antigen-DR isotype (HLA-DR)-expressing CD4 T lymphocytes in the CSF. Furthermore, they were characterized by a shift in monocyte subsets toward immature CD14 CD16 cells in the PB and blood/CSF-barrier dysfunction. Whereas TLE patients in general showed similar immune cell profiles, patients with GAD65-LE differed from other TLE patients by increased proportions of HLA-DR-expressing CD8 T lymphocytes and type 2/3 oligoclonal bands. These findings point to a role of innate and adaptive immunity in TLE. CSF parameters may help to discriminate epilepsy patients from controls and different forms of TLE from each other.
炎症在免疫介导性癫痫的发病机制中起作用，但也在其他病因的癫痫中起作用，如海马硬化。本研究旨在描述不同病因的颞叶癫痫（TLE）患者外周血（PB）和脑脊液（CSF）中的免疫细胞特征。我们使用流式细胞术回顾性评估了 51 例 TLE 患者和 45 例年龄匹配的功能性疾病对照者的 CSF 常规参数和免疫细胞谱。这些患者分为非病变性 TLE（n=26）、海马硬化性 TLE（n=14）和抗谷氨酸脱羧酶 65kDa 同工型（GAD65-LE）抗体性边缘性脑炎（n=11）。TLE 患者的 CSF 中 HLA-DR 表达的 CD4 T 淋巴细胞比例增加。此外，它们的特征是 PB 和血液/CSF 屏障功能障碍中单核细胞亚群向不成熟的 CD14 CD16 细胞转移。尽管 TLE 患者的免疫细胞谱总体相似，但 GAD65-LE 患者与其他 TLE 患者的区别在于 HLA-DR 表达的 CD8 T 淋巴细胞和 2/3 型寡克隆条带的比例增加。这些发现表明先天和适应性免疫在 TLE 中起作用。CSF 参数可能有助于将癫痫患者与对照者以及不同形式的 TLE 区分开来。
