title: Rasmussen's encephalitis: interleukin-10-dependent Tc2 cell polarization may explain its pathophysiology and clinical course.
abstract: Little is known about the cellular immune dynamics and pathophysiology of Rasmussen's encephalitis (RE). We investigated transcriptional expression of pro- and anti-inflammatory cytokines and characterized the T-cell subset types present in temporal and frontal lobe specimens obtained from a child with RE. Interleukin (IL)-10 and macrophage scavenger receptor type I mRNA assessed by semiquantitative reverse transcription polymerase chain reaction was found in temporal but not in affected frontal lobe tissue. Messenger RNA specific to tumor necrosis factor alpha, IL-l, IL-4, IL-6, IL-12, IL-15, IL-18, transforming growth factor beta, CD-14, and inducible nitric oxide synthase was not detected in either temporal or frontal tissue with histopathologically manifest evidence of disease. Virtually all lymphocytic infiltrate consisted of CD3+ CD8+ T cells. We speculate that RE is a disease mediated by Tc2 polarization of the immune response and that its immunohistopathology, natural history, and clinical evolution (chronic, staircase progression) reflect the dual/pleiotropic actions of IL-10, which, depending on the state of activation of the immune system, may be either cytolytic or immunosuppressant.
authors.affiliation: Department of Neurology and Comprehensive Epilepsy Center, University of Kansas Medical Center, Kansas City, KS, USA. iosorio@kumc.edu
authors.forename: Ivan
authors.initials: I
authors.lastname: Osorio
authors.forename: Alex
authors.initials: A
authors.lastname: Shnyra
authors.forename: Karen
authors.initials: K
authors.lastname: Santacruz
authors.forename: Ryan
authors.initials: R
authors.lastname: Brewington
authors.forename: David
authors.initials: D
authors.lastname: Morrison
mesh_terms: D017252:CD3 Complex / Q000378:metabolism; D002648:Child; D004660:Encephalitis / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism*; D018950:Lipopolysaccharide Receptors / Q000378:metabolism; D008297:Male; D013602:T-Lymphocytes, Cytotoxic / Q000502:physiology*
chemical_list: D017252:CD3 Complex; D018950:Lipopolysaccharide Receptors; D016753:Interleukin-10