迷走神经刺激对耐药性癫痫患儿血液炎症标志物的影响：一项初步研究。
Effect of Vagus Nerve Stimulation on Blood Inflammatory Markers in Children with Drug-Resistant Epilepsy: A Pilot Study.
作者信息
Baro Valentina, Bonavina Maria Vittoria, Saettini Francesco, D'Amico Giovanna, Trezza Andrea, Denaro Luca, Grioni Daniele, Landi Andrea
机构信息
Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy.
Department of Women's and Children's Health, University Hospital of Padova, 35128 Padova, Italy.
出版信息
Children (Basel). 2022 Jul 29;9(8):1133. doi: 10.3390/children9081133.
BACKGROUND
Since one of the suggested mechanisms of action of VNS on epilepsy is the reduction of central inflammation, we carried out a comprehensive analysis of blood inflammatory markers in children considered for VNS surgery.
MATERIALS AND METHODS
Five pediatric patients were studied. An extensive analysis of blood inflammatory markers was performed before surgery (T0) and six weeks after VNS implantation (T1). An epileptological outcome was obtained according to the McHugh score.
RESULTS
The variations of IgA, IgE, IgG, CD19, and PTX3 displayed a tendency toward a positive statistical correlation between T0 and T1. According to McHugh score, the patients were divided into Group 1 (i.e., Class I) and Group 2 (i.e., Classes II and III). IL-1β and PTX-3 tended to decrease more in Group 1, while TNF-α decreased in Group 2 (-56.65%) and slightly increased (+3.61%) in Group 1 at T1 without statistical correlation.
CONCLUSIONS
The variation of IL-1β and PTX-3 seem to be related to a better outcome; thus, they do not reach statistical significance. A larger series of patients is needed to determine whether biochemical changes could relay with the clinical improvement of epilepsy.
背景
由于迷走神经刺激术（VNS）治疗癫痫的一种可能作用机制是减轻中枢炎症，我们对考虑接受VNS手术的儿童的血液炎症标志物进行了全面分析。
材料与方法
研究了5例儿科患者。在手术前（T0）和VNS植入后6周（T1）对血液炎症标志物进行了广泛分析。根据麦克休评分获得癫痫学结果。
结果
IgA、IgE、IgG、CD19和PTX3的变化在T0和T1之间呈现出正相关的统计学趋势。根据麦克休评分，患者被分为第1组（即I类）和第2组（即II类和III类）。IL-1β和PTX-3在第1组中下降趋势更明显，而TNF-α在T1时第2组下降（-56.65%），第1组略有上升（+3.61%），无统计学相关性。
结论
IL-1β和PTX-3的变化似乎与更好的结果相关；因此，它们未达到统计学意义。需要更大规模的患者系列研究来确定生化变化是否与癫痫的临床改善相关。
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