Do cytokines have any role in epilepsy?
OBJECTIVE
We analyzed cytokines levels in patients with epilepsy and new onset seizure and correlated it with various parameters.


METHODS
After obtaining consent, serum samples from 100 patients with epilepsy or new onset seizure were prospectively collected in the immediate post-ictal phase. In 16 patients, a second sample was collected during the seizure-free period. The serum cytokine levels [TNF-alpha, IFN-gamma, IL-1beta, IL-2, IL-4, and IL-6] were assessed (ELISA) in these patients and 100 matched healthy controls. CSF analysis was carried out in 9 patients of this cohort, when clinically indicated.


RESULTS
The type of seizures (n=100) was major (45), partial (41) and status epilepticus (SE=14), while the epilepsy syndromes were idiopathic generalized (53) and localization related (47). The detectable serum cytokines in the patient group (n=100) were: IL-6 (42), TNF-alpha (36), IL-2 (22), IL-4 (22), IFN-gamma (20) and IL-1 (11) compared to the controls. CSF IL-6 and IL-1 was detectable in 4/9 and 2/9 patients, respectively while, IL-2, IL-4, IFN-gamma was detectable 1 in each patient. Correlations were noted between male gender and IL-1beta (p=0.04), positive family history and IL-1beta (p=0.001), "no alcohol use" and TNF-alpha (p=0.05), more than one year history of epilepsy and IL-1beta (p=0.02), status epilepticus (SE) and IL-6 (p=0.04). There was no difference between the new onset seizures vs. epilepsy group. Serial analysis during the seizure-free period revealed a decrease in cytokine levels: TNF-alpha (25% to 12.5%), IFN-gamma (12.5% to 0%), IL-1 (25% to 0) and IL-2 (6.2% to 6.2%), IL-4 (18.8% to 0%) and IL-6 (18.8% to 6.2%).


CONCLUSIONS
We found increased post-ictal serum cytokine levels in patients with several epilepsy syndromes.
Sinha
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S
Department of Neurology, NIMHANS, Bangalore, India. sanjib_sinha2004@yahoo.co.in
Patil
S A
SA
Jayalekshmy
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Satishchandra
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P
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood / Q000134:cerebrospinal fluid / Q000502:physiology*; D004828:Epilepsies, Partial / Q000097:blood / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D004827:Epilepsy / Q000097:blood / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000097:blood / Q000453:epidemiology; D007371:Interferon-gamma / Q000097:blood / Q000134:cerebrospinal fluid; D007378:Interleukins / Q000097:blood / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013226:Status Epilepticus / Q000097:blood / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000134:cerebrospinal fluid; D055815:Young Adult
D016207:Cytokines; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma