title: Increased level of serum interleukin-1 receptor antagonist subsequent to resolution of clinical symptoms in patients with West syndrome.
abstract: The aim of this study was to evaluate whether proconvulsive interleukin-1β (IL-1β) and anticonvulsive IL-1 receptor antagonist (IL-1Ra) are markers of the effectiveness of treatment in patients with West syndrome (WS). We analyzed serum and cerebrospinal fluid (CSF) levels of IL-1β and IL-1Ra in 13 patients with WS. The serum IL-1Ra levels postimprovement (average, 384.6 pg/ml) in clinical and electroencephalographic (EEG) findings were significantly higher than the preimprovement values (average, 240.6 pg/ml). No significant difference in the preimprovement serum IL-1Ra levels was noted between the anticonvulsant (AED)-response and adrenocorticotropic hormone (ACTH)-response groups (260.0 pg/ml, n=7 vs. 218.0 pg/m, n=6) and the cryptogenic and symptomatic groups (290.1 pg/ml, n=4 vs. 218.3 pg/m, n=9), respectively; as for the preimprovement CSF levels, the AED-response group (114.5 pg/m; n=3) and ACTH-response groups (138.0 pg/m; n=6) and the cryptogenic (59.3 pg/m; n=3) and symptomatic groups (165.6 pg/m; n=6), respectively. Serum and CSF IL-1β levels were detected only in 3 patients preimprovement. Serum IL-1Ra levels were elevated subsequent to resolution of clinical and EEG findings in WS patients. A larger study should be conducted to clarify whether an immunological processes are concerned with the pathophysiology of WS.
authors.affiliation: Department of Pediatrics, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo, Japan. gaku@tokyo-med.ac.jp
authors.forename: Gaku
authors.initials: G
authors.lastname: Yamanaka
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kawashima
authors.forename: Shingo
authors.initials: S
authors.lastname: Oana
authors.forename: Yu
authors.initials: Y
authors.lastname: Ishida
authors.forename: Tasuku
authors.initials: T
authors.lastname: Miyajima
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Kashiwagi
authors.forename: Akinori
authors.initials: A
authors.lastname: Hoshika
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D004569:Electroencephalography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood* / Q000134:cerebrospinal fluid; D053583:Interleukin-1beta / Q000097:blood / Q000134:cerebrospinal fluid; D008297:Male; D013036:Spasms, Infantile / Q000097:blood* / Q000134:cerebrospinal fluid / Q000188:drug therapy*
chemical_list: D000927:Anticonvulsants; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; D000324:Adrenocorticotropic Hormone