The relationship between interleukin-6 and epileptic seizure
İnterlökin-6 düzeyinin epileptik nöbet ile ilişkisi
Reyyan Ezer 1 * , Hülya Ertaşoğlu Toydemir 2, Fatma Münevver Gökyiğit 3
1 Nöroloji Kliniği, Aksaray Üniversitesi Eğitim ve Araştırma Hastanesi, Aksaray, Türkiye
2 Nöroloji Kliniği, İstanbul Bakırköy Dr.Sadi Konuk Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye
3 Nöroloji Kliniği, İstanbul Gaziosmanpaşa Taksim Eğitim ve Araştırma Hastanesi, İstanbul, Türkiye
* Corresponding Author
Ortadogu Tıp Derg, Volume 12, Issue 2, pp. 225-232
https://doi.org/10.21601/ortadogutipdergisi.651791
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Abstract
Aim: The aim of this study was to evaluate the relationship between interleukin-6 (IL-6) levels and the type of the seizure, etiology of the seizure and the infection parameters which were fever, leukocyte count and c-reactive protein (CRP) in epileptic patients.
Material and Methods: A total of 48 people were included in the study, containing a patient group of 24 and a control group of 24. IL-6, fever, leukocyte and CRP levels were measured and recorded. The patients were categorized according to the type and etiology of the seizures. The relationship between IL-6 levels and infection parameters, type and etiology of seizures were evaluated.
Results: IL-6 levels were significantly higher in epileptic patients than that of the control group. There were no correlations between IL-6 levels and fever, leukocyte and CRP. The patients were evaluated according to the seizure type. There was no significant relationship between IL-6 levels of control group and IL-6 levels of patients with partial epileptic seizures (p=0.270). However, there was significant relationship between IL-6 levels of the control group and that of patients with primary generalized, secondary generalized seizures and generalized status epilepticus (p=0.012, p=0.011 and p=0.040, respectively). Epilepsy etiology was not associated with levels of IL-6.
Conclusion: High levels of IL-6 after epileptic seizures might be detected independent from infection parameters and epilepsy etiology. IL-6 levels might be higher in patients with primary generalized, secondary generalized seizures and generalized status epilepticus than that of patients with partial seizures.
Öz
Amaç: Epileptik nöbet geçiren hastalarda interlökin-6 (IL-6) düzeyinin nöbet türü, etiyolojisi ile infeksiyon parametreleri olan ateş, lökosit ve c-reaktif protein (CRP) ile ilişkisinin incelenmesi amaçlandı.
Gereç ve Yöntem: Çalışmaya 24 kişiden oluşan hasta grubu ve 24 kişiden oluşan kontrol grubu olmak üzere toplam 48 kişi dahil edildi. Hastaların IL-6, ateş, lökosit ve CRP değerleri ölçülerek kaydedildi. Hastalar nöbet türüne ve etiyolojisine göre sınıflandırıldı. IL-6 düzeylerindeki yüksekliğin, infeksiyon parametreleri, nöbet türü ve etiyolojisiyle olan ilişkisi değerlendirildi.
Bulgular: IL-6 düzeyi nöbet hastalarında kontrol grubuna göre yüksek bulundu. Epilepsi hastalarında IL-6 düzeylerindeki yükselmenin ateş, lökosit ve CRP düzeylerindeki yükselme ile arasında korelasyon bulunmadı. Hastalar nöbet türüne göre değerlendirildi. Hasta grubu ve kontrol grubunun IL-6 düzeyleri karşılaştırıldığında kontrol grubu ile parsiyel nöbet geçiren hastalarla arasında anlamlı fark bulunmazken (p=0,270), primer jeneralize, sekonder jeneralize ve jeneralize status ile arasında anlamlı fark belirlendi (sırasıyla p=0,012, p=0,011, p=0,040). Nöbet etiyolojisi ile IL-6 düzeyleri arasında ilişki saptanmadı.
Sonuç: Epileptik nöbet geçiren hastalarda IL-6 düzeyi diğer infeksiyöz parametrelerden ve etiyolojiden bağımsız olarak yüksek saptanabilmektedir. IL-6 düzeyi, primer jeneralize, sekonder jeneralize nöbetlerde ve jeneralize statusta, parsiyel nöbetlere göre anlamlı olarak yüksek bulunabilir.
- Li G, Bauer S, Nowak M, ve ark. Cytokines and Epilepsy. Seizure 2011; 20: 249-56.
- Sinha S, Patil S A, Jayalekshmy V, Satishchandra P. Do cytokines have any role in epilepsy? J Epilepsy Res 2008; 82: 171-6.
- Lehtimäki K A, Karänen T, Palmio J, ve ark. Increased plasma levels of cytokines after seizures in localization-related epilepsy. Acta Neurol Scand 2007; 116: 226-30.
- Liimatainen S, Fallah M, Kharazmi E, Peltola M, Peltola J. Interleukin-6 levels are increased in temporal lobe epilepsy but not in extra-temporal lobe epilepsy. J Neurol 2009; 256: 796-802.
- Uludag IF, Bilgin S, Zorlu Y, Tuna G, Kirkali G Interleukin-6, interleukin-1 beta and interleukin-1 receptor antagonist levels in epileptic seizures. Seizure 2013; 22: 457-61.
- Nowak M, Bauer S, Haag A, et al. Interictal alterations of cytokines and leukocytes in patients with active epilepsy. Brain Behav Immun 2011; 25: 423-8.
- Alapirtti T, Rinta S, Hulkkonen J, Mäkinen R, Keränen T, Peltola J. Interleukin-6, interleukin-1 receptor antagonist and interleukin-1beta production in patients with focal epilepsy: A video-EEG study. J Neurological Sci 2009; 280: 94-7.
- Peltola J, Hurme M, Miettinen A, Keränen T Elevated levels of interleukin-6 may occur in cerebrospinal fluid from patients with recent epileptic seizures. Epilepsy Res 1998: 31; 129-33.
- Virta M, Hurme M, Helminen M Increased plasma levels of pro- and anti-inflammatory cytokines in patients with febrile seizures. Epilepsia 2002; 43: 920-3.
- Peltola J, Laaksonen J, Haapala AM, Hurme M, Rainesalo S, Keränen T. Indicators of inflammation after recent tonic-clonic epileptic seizures correlate with plasma interleukin-6 levels. Seizure 2002: 11: 44-6.
- Alapirtti T, Lehtimäki K, Nieminen R, Mäkinen R, Raitanen J, Moilanen E, Mäkinen J, Peltola J. The production of IL-6 in acute epileptic seizure: A video-EEG study. J Neuroimmunol. 2018 Mar 15; 316: 50-5.
- Wang Y, Wang D, Guo D. Interictal cytokine levels were correlated to seizure severity of epileptic patients: a retrospective study on 1218 epileptic patients. J Transl Med. 2015 Dec 1; 13: 378.
- de Vries EE, van den Munckhof B, Braun KP, van Royen-Kerkhof A, de Jager W, Jansen FE. Inflammatory mediators in human epilepsy: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2016 Apr; 63: 177-90.
- Carmeli E, Beiker R, Morad M. Nitric oxide and interlukin-6 levels in intellectual disability adults with epilepsy. Res Dev Disabil 2009; 30: 567-71.
- Shu HF, Zhang CQ, Yin Q, An N, Liu SY, Yang H. Expression of the interleukin 6 system in cortical lesions from patients with tuberous sclerosis complex and focal cortical dysplasia type IIb. J Neuropathol Exp Neurol 2010; 69: 838-49.
- Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia 2017; 58: 512-21.
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