title: Cytokines, MMP-2, and MMP-9 levels in patients with a solitary cysticercus granuloma.
abstract: OBJECTIVE
  In patients with neurocysticercosis, perilesional inflammatory activity is thought to be responsible for seizures. This study was designed to evaluate the serum and cerebrospinal fluid (CSF) concentrations of cytokines as well as matrix metalloproteinase (MMP)-2 and MMP-9 in patients with a solitary cysticercus granuloma.
  
  
  METHODS
  The study included 47 patients suffering from seizures in whom a solitary cysticercus granuloma was detected on a computed tomography (CT) scan. The study also included 47 control subjects. Their serum and cerebrospinal fluid (CSF) was analysed for cytokines and MMP levels. A follow-up CT was performed after 6 months.
  
  
  RESULTS
  The median levels of cytokines, interleukin (IL)-1β, IL-5, IL-6, IL-10 and tissue necrosis factor (TNF)-α, MMP-2 and MMP-9 were significantly elevated, both in the serum and CSF of patients having an intracerebral solitary cysticercus granuloma, in comparison to that of controls. The follow-up CT revealed that in 27 patients, the lesions were calcified and in 5 patients, there was complete resolution of the lesions. In 15 patients, the lesions remained unchanged. Higher baseline CSF MMP-2 and TNF-α level were seen in patients with persisting lesions. Higher serum baseline MMP-2, IL-6 and a low CSF IL-10 level were seen in patients with complete resolution of the granuloma. A high baseline IL-1β level was associated with a calcified lesion. Fourteen patients had recurrence of seizures. A high baseline serum TNF-α level was independently associated with seizure recurrence (P = 0.021, OR = 1.041, CI = 1.006 to 1.078).
  
  
  CONCLUSIONS
  In patients with a solitary cysticercus granuloma, cytokines and matrix metalloproteinases in the CSF and serum are elevated. Different patterns of immunological changes were observed in patients following resolution or calcification of the lesion.
authors.forename: Rakesh Shyam
authors.initials: RS
authors.lastname: Lalla
authors.affiliation: Department of Neurology, King George Medical University, Uttar Pradesh, Lucknow, India.
authors.forename: Ravindra Kumar
authors.initials: RK
authors.lastname: Garg
authors.forename: Hardeep Singh
authors.initials: HS
authors.lastname: Malhotra
authors.forename: Amita
authors.initials: A
authors.lastname: Jain
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.forename: Chandra Mani
authors.initials: CM
authors.lastname: Pandey
authors.forename: Gyan Prakash
authors.initials: GP
authors.lastname: Singh
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: Sharma