Markerów zapalnych we krwi w epilepsji: rozróżnianie pacjentów opornych na leki od pacjentów wrażliwych na leki
Inflammatory cytokine signatures in epilepsy: distinguishing drug-resistant from drug-responsive patients
W skrócie
Badacze zbadali poziomy pięciu substancji zapalnych we krwi (IL-1β, IL-6, IL-8, IL-17 i IL-18) u 90 osób: 30 z epilepsją oporną na leki, 30 z epilepsją wrażliwą na leki i 30 zdrowych ludzi. Okazało się, że osoby z epilepsją miały znacznie wyższe poziomy wszystkich badanych substancji, szczególnie te z opornością na leki, a substancja IL-6 najlepiej różniła grupę oporną na leki od wrażliwej na leki. Te substancje zapalne mogą być użyteczne do oceny ciężkości epilepsji i potencjalnie pomocne w opracowaniu nowych sposobów leczenia.
Oryginalny abstract (angielski)
BACKGROUND: Emerging evidence has positioned neuroinflammation as a central mechanism in the pathogenesis of epilepsy and in the development of drug resistance. Cytokines such as IL-1β, IL-6, IL-8, IL-17, and IL-18 have been implicated in epileptogenesis, yet their clinical significance in distinguishing drug-resistant epilepsy (DRE) from drug-responsive epilepsy (DREsp) remains underexplored. OBJECTIVE: This study aimed to evaluate the serum levels of IL-1β, IL-6, IL-8, IL-17, and IL-18 in patients with epilepsy and to investigate their association with treatment responsiveness and seizure frequency. METHODS: A total of 90 participants were enrolled, including 30 patients with DRE, 30 with DREsp, and 30 age- and sex-matched healthy controls. Serum cytokine levels were quantified using enzyme-linked immunosorbent assay (ELISA). Statistical comparisons, receiver operating characteristic (ROC) analyses, and Jonckheere-Terpstra trend tests were performed to assess intergroup differences and biomarker performance. RESULTS: All five cytokines were significantly elevated in epilepsy patients compared to controls (p < 0.001), and further increased levels were observed in the DRE group relative to the DREsp group. IL-6 and IL-8 showed perfect diagnostic performance in distinguishing epilepsy from healthy individuals (AUC = 1.00), while IL-6 remained highly accurate in differentiating DRE from DREsp (AUC = 0.99). IL-1β demonstrated the strongest correlation with seizure frequency and showed a progressive increase across control, DREsp, and DRE groups. Trend analysis confirmed a significant stepwise elevation of cytokine levels with increasing seizure frequency for all markers. CONCLUSION: Elevated serum levels of IL-1β, IL-6, IL-8, IL-17, and IL-18 in epilepsy-particularly in drug-resistant cases-support the role of neuroinflammation in epileptogenesis and treatment refractoriness. These cytokines may serve as valuable biomarkers for disease severity and potential targets for novel immunomodulatory therapies, especially in patients with DRE who are candidates for non-pharmacological interventions.