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The role of neuroinflammation in the pathogenesis of epilepsy

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Over the past decade, there has been a large amount of evidence indicating neuroendocrine, biochemical, and immune disorders in many acute and chronic central nervous system (CNS) diseases,  including epilepsy, which made the authors consider the  inflammatory theory of epileptogenesis. The chronic inflammatory  process in epilepsy is believed to be facilitated by the activation of  microglia and astrogliosis, which are accompanied by neuronal  damage. The main postulate of this type of investigation is the  assumption that the basis for CNS inflammation is blood-brain barrier (BBB) damage. Cytokines are presumed to play the  greatest role in this process, mainly because they are natural pro-  and anticonvulsants.

Patients and methods. Examinations were made in 160 patients with epilepsy (drug-resistant epilepsy (n = 80) and controlled epilepsy (n = 80)) and 30 apparently healthy donors. The blood and  cerebrospinal fluid (CSF) levels of the cytokines interleukin (IL)-1β,  IL-2, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNF-α), IL-1 receptor  antagonist (IL-1RA), soluble IL-2 receptor (sIL-2R), brain- derived neurotrophic factor (BDNF), S100b protein, С-reactive  protein (CRP), and albumins were analyzed using a solid-phase  enzyme-linked immunoabsorbent assay. Statistical analysis was performed using Student’s t-test and Mann-Whitney U-test.  Differences at p <0.05 were regarded as statistically significant.

Results and discussion. The investigation showed that the patients with epilepsy had a substantially impaired plasma cytokine profile: higher levels of proinflammatory cytokines, such as Il-1β, IL-8, and  TNF, and a lower concentration of IL-1 RA. The elevated CSF levels of the cytokines Il-1β and IL8 in patients with epilepsy suggest that  BBB is impaired and a systemic inflammatory process exists while  the absence of IL-1RA indicates that protective inflammation factors  in blood and CSF are reduced.

About the Authors

L. V. Lipatova
V.M. Bekhterev National Medical Research Center of Psychiatry and Neurology, Ministry of Health of Russia
Russian Federation
3, Bekhterev St., Saint Petersburg 192019

N. B. Serebryanaya
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
Russian Federation
41, Kirochnaya St., Saint Petersburg 191015

N. A. Sivakova
V.M. Bekhterev National Medical Research Center of Psychiatry and Neurology, Ministry of Health of Russia
Russian Federation
3, Bekhterev St., Saint Petersburg 192019


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For citation:

Lipatova L.V., Serebryanaya N.B., Sivakova N.A. The role of neuroinflammation in the pathogenesis of epilepsy. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(1S):38-45. (In Russ.)

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