Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, China.
Department of Surgical Intensive Care Unit, The First Affiliated Hospital of Chongqing Medical University, China.
Biomed Res Int. 2021 Mar 17;2021:7973123. doi: 10.1155/2021/7973123. eCollection 2021.
Previous studies have demonstrated that immune and inflammatory factors play an important role in recurrent seizures. The PD-1-PD-L pathway plays a central and peripheral immunosuppressive role by regulating multiple signaling pathways during the inflammatory and immunologic processes. This study is aimed at assessing PD-1 levels in cerebrospinal fluid (CSF) and serum samples from patients with intractable epilepsy.
PD-1 levels were assessed in CSF and serum samples from 67 patients with intractable epilepsy (41 and 26 individuals with partial seizure and intractable status epilepticus, respectively) and 25 healthy controls, using flow cytometric analysis and sandwich enzyme-linked immunosorbent assays (ELISA).
Serum-PD-1+CD4CD25 Treg levels in the experimental groups and the control group were 10.26 ± 2.53 (PS group), 35.95 ± 27.51 (ISE group), and 4.69 ± 2.44 (control group). In addition, CSF-PD-1 level in patients with epilepsy was higher than that in the control group (50.45 ± 29.56 versus 19.37 ± 4.51), indicating a statistically significant difference ( < 0.05). Interestingly, serum- and CSF-PD-1 levels in individuals with epilepsy were not affected by antiepileptic drug and treatment course, but by epilepsy onset level. Of note, the increase of CSF- and serum-PD-1 levels was more pronounced in subjects with intractable status epilepticus than those with partial seizure.
Serum- and CSF-PD-1 levels constitute a potential clinical diagnostic biomarker for intractable epilepsy and could also be used for differential diagnosis.
先前的研究表明，免疫和炎症因素在复发性癫痫发作中发挥着重要作用。PD-1-PD-L 通路通过在炎症和免疫过程中调节多个信号通路，发挥中枢和外周免疫抑制作用。本研究旨在评估难治性癫痫患者脑脊液（CSF）和血清样本中的 PD-1 水平。
采用流式细胞术分析和夹心酶联免疫吸附试验（ELISA）检测 67 例难治性癫痫患者（41 例部分性发作和 26 例难治性癫痫持续状态患者）和 25 例健康对照者的 CSF 和血清 PD-1 水平。
实验组和对照组血清-PD-1+CD4+CD25+Treg 水平分别为 10.26±2.53（PS 组）、35.95±27.51（ISE 组）和 4.69±2.44（对照组）。此外，癫痫患者的 CSF-PD-1 水平高于对照组（50.45±29.56 比 19.37±4.51），差异有统计学意义（<0.05）。有趣的是，癫痫患者的血清和 CSF-PD-1 水平不受抗癫痫药物和治疗疗程的影响，但与癫痫发作水平有关。值得注意的是，难治性癫痫持续状态患者的 CSF 和血清-PD-1 水平升高更为明显，高于部分性发作患者。
血清和 CSF-PD-1 水平可能成为难治性癫痫的潜在临床诊断生物标志物，也可用于鉴别诊断。
