title: Toll-like Receptor-4 Polymorphisms and Serum Matrix Metalloproteinase-9 in Newly Diagnosed Patients With Calcified Neurocysticercosis and Seizures.
abstract: We evaluated seizure profile, Toll-like receptor (TLR)-4 polymorphisms, and serum matrix metalloproteinases (MMPs) in patients with calcified neurocysticercosis.One-hundred nine patients with calcified neurocysticercosis with newly diagnosed seizures and 109 control subjects were enrolled. TLR-4 Asp299Gly and Thr399Ile polymorphisms and serum MMP-9 levels were evaluated. The patients were followed for 1 year.Asp/Gly (P = 0.012) and Thr/Ile (P = 0.002), Gly (Asp/Gly plus Gly/Gly) (P = 0.008) and Ile (Thr/Ile plus Ile/Ile) (P = 0.003) genotypes were significantly associated with calcified neurocysticercosis compared with controls. Gly/Gly and Ile/Ile genotypes were not significantly associated (P = 0.529 for Gly/Gly, P = 0.798 for Ile/Ile) with either group. The levels of MMP-9 were higher in calcified neurocysticercosis (P =  < 0.001). The levels of MMP-9 were higher in patients with multiple calcified neurocysticercosis compared with single calcified neurocysticercosis (P =  < 0.001).Headache (P = 0.031), status epilepticus (P = 0.029), Todd paralysis (P = 0.039), lesion size >10 mm (P = 0.001), and perilesional edema (P =  < 0.001) were significantly associated with seizure recurrence. Heterozygous form Asp/Gly (P =  < 0.001) and heterozygous form Thr/Ile (P =  < 0.001) were significantly associated with seizure recurrence. The Gly (Asp/Gly plus Gly/Gly) (P =  < 0.001) and Ile (Thr/Ile plus Ile/Ile) (P =  < 0.001) genotypes were also significantly associated with seizure recurrence. Higher serum MMP-9 levels were significantly associated with seizure recurrence (P =  < 0.001).The TLR-4 gene abnormalities may trigger inflammation around calcified neurocysticercosis leading to an increase in perilesional edema and provocation of seizures.
authors.affiliation: From the Department of Neurology (GL, RKG, HSM, NK, RV, PKS); and Department of Microbiology (AJ, AKS, BJ), King George Medical University, Uttar Pradesh, Lucknow, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Lachuriya
authors.forename: Ravindra Kumar
authors.initials: RK
authors.lastname: Garg
authors.forename: Amita
authors.initials: A
authors.lastname: Jain
authors.forename: Hardeep Singh
authors.initials: HS
authors.lastname: Malhotra
authors.forename: Arvind Kumar
authors.initials: AK
authors.lastname: Singh
authors.forename: Bhawna
authors.initials: B
authors.lastname: Jain
authors.forename: Neeraj
authors.initials: N
authors.lastname: Kumar
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D000483:Alleles; D002114:Calcinosis / Q000175:diagnosis* / Q000235:genetics*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression / Q000235:genetics*; D006580:Genetic Carrier Screening; D005838:Genotype; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D020019:Neurocysticercosis / Q000175:diagnosis* / Q000235:genetics*; D009460:Neurologic Examination; D011110:Polymorphism, Genetic / Q000235:genetics*; D012008:Recurrence; D012640:Seizures / Q000175:diagnosis* / Q000235:genetics*; D013223:Statistics as Topic; D013226:Status Epilepticus / Q000175:diagnosis / Q000235:genetics; D051197:Toll-Like Receptor 4 / Q000235:genetics*; D055815:Young Adult
chemical_list: C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9