Phoswa Wendy N, Mokgalaboni Kabelo
Department of Life and Consumer Sciences, University of South Africa (UNISA), Science Campus, Private Bag X6, Florida, Roodepoort 1710, South Africa.
Brain Sci. 2023 Apr 27;13(5):732. doi: 10.3390/brainsci13050732.
Type 2 diabetes mellitus (T2DM) is a global health burden that leads to an increased morbidity and mortality rate arising from microvascular and macrovascular complications. Epilepsy leads to complications that cause psychological and physical distress to patients and carers. Although these conditions are characterized by inflammation, there seems to be a lack of studies that have evaluated inflammatory markers in the presence of both conditions (T2DM and epilepsy), especially in low-middle-income countries where T2DM is epidemic. Summary findings: In this review, we describe the role of immunity in the seizure generation of T2DM. Current evidence shows an increase in the levels of biomarkers such as interleukin (IL-1β, IL-6, and IL-8), tumour necrosis factor-α (TNF-α), high mobility group box-1 (HMGB1), and toll-like receptors (TLRs) in epileptic seizures and T2DM. However, there is limited evidence to show a correlation between inflammatory markers in the central and peripheral levels of epilepsy.
Understanding the pathophysiological mechanism behind epileptic seizures in T2DM through an investigation of immunological imbalances might improve diagnosis and further counter the risks of developing complications. This might also assist in delivering safe and effective therapies to T2DM patients affected, thus reducing morbidity and mortality by preventing or reducing associated complications. Moreover, this review also provides an overview approach on inflammatory cytokines that can be targeted when developing alternative therapies, in case these conditions coexist.
2型糖尿病(T2DM)是一项全球性的健康负担,会导致微血管和大血管并发症引发的发病率和死亡率上升。癫痫会引发一些给患者及其护理人员带来心理和身体痛苦的并发症。尽管这些病症都具有炎症特征,但似乎缺乏针对同时患有这两种病症(T2DM和癫痫)时炎症标志物的研究,尤其是在T2DM呈流行态势的低收入和中等收入国家。总结发现:在本综述中,我们描述了免疫在T2DM癫痫发作中的作用。目前的证据表明,诸如白细胞介素(IL-1β、IL-6和IL-8)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)和Toll样受体(TLRs)等生物标志物的水平在癫痫发作和T2DM中均有所升高。然而,仅有有限的证据表明癫痫中枢和外周水平的炎症标志物之间存在关联。
通过研究免疫失衡来了解T2DM癫痫发作背后的病理生理机制,可能会改善诊断并进一步应对并发症发生的风险。这也可能有助于为受影响的T2DM患者提供安全有效的治疗,从而通过预防或减少相关并发症来降低发病率和死亡率。此外,本综述还提供了一种概述方法,介绍了在这些病症共存时开发替代疗法可以靶向的炎性细胞因子。