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Published in: Journal of Neurology 5/2009

01-05-2009 | Original Communication

Interleukin-6 levels are increased in temporal lobe epilepsy but not in extra-temporal lobe epilepsy

Authors: Suvi Liimatainen, Mahdi Fallah, Elham Kharazmi, Maria Peltola, Jukka Peltola

Published in: Journal of Neurology | Issue 5/2009

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Abstract

Previous studies have reported activation of inflammatory cytokines in seizures, but clinical characteristics of epilepsy associated with cytokine activation have not been well established. In this study, serum levels of interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1RA) were measured, and clinical characteristics of epilepsy were assessed in 86 well-evaluated patients with refractory focal epilepsy and in 5 patients with controlled focal epilepsy. Epilepsy was evaluated based on patient histories, electroclinical findings, and high-resolution brain MRI scans. Sixty-three healthy blood donors served as controls. IL-6 concentrations were chronically increased in epilepsy patients (11%) compared with healthy controls (0%) (P = 0.007). Increased levels of IL-6 were more prevalent in patients with temporal lobe epilepsy (TLE) compared to patients with extra-TLE (P = 0.028). Also the mean and the median serum levels of IL-6 were higher in patients with TLE than in patients with extra-TLE (P = 0.042). Concentrations of IL-1RA were not significantly different in patients compared with controls. Indicated by increased levels of IL-6 in TLE, epilepsy type is important in determining chronic overproduction of cytokines in refractory focal epilepsy. The results may reflect a chronic immunological process in the brain in patients with refractory epilepsy.
Literature
1.
go back to reference Penkowa M, Molinero A, Carrasco J, Hidalgo J (2001) Interleukin-6 deficiency reduces the brain inflammatory response and increases oxidative stress and neurodegeneration after kainic acid-induced seizures. Neuroscience 102:805–818CrossRefPubMed Penkowa M, Molinero A, Carrasco J, Hidalgo J (2001) Interleukin-6 deficiency reduces the brain inflammatory response and increases oxidative stress and neurodegeneration after kainic acid-induced seizures. Neuroscience 102:805–818CrossRefPubMed
2.
go back to reference Kalueff AV, Lehtimaki KA, Ylinen A, Honkaniemi J, Peltola J (2004) Intranasal administration of human IL-6 increases the severity of chemically induced seizures in rats. Neurosci Lett 22:106–110CrossRef Kalueff AV, Lehtimaki KA, Ylinen A, Honkaniemi J, Peltola J (2004) Intranasal administration of human IL-6 increases the severity of chemically induced seizures in rats. Neurosci Lett 22:106–110CrossRef
3.
go back to reference De Simoni MG, Perego C, Ravizza T, Moneta D, Conti M, Marchesi F, De Luigi A, Garattini S, Vezzani A (2000) Inflammatory cytokines and related genes are induced in the rat hippocampus by limbic status epilepticus. Eur J Neurosc 12:2623–2633CrossRef De Simoni MG, Perego C, Ravizza T, Moneta D, Conti M, Marchesi F, De Luigi A, Garattini S, Vezzani A (2000) Inflammatory cytokines and related genes are induced in the rat hippocampus by limbic status epilepticus. Eur J Neurosc 12:2623–2633CrossRef
4.
go back to reference Vezzani A, Moneta D, Conti M, Richichi C, Ravizza T, De Luigi A, De Simoni MG, Sperk G, Andell-Jonsson S, Lundkvist J, Iverfeldt K, Bartfai T (2000) Powerful anticonvulsant action of IL-1 receptor antagonist on intracerebral injection and astrocytic overexpression in mice. Proc Natl Acad Sci USA 10:11534–11539CrossRef Vezzani A, Moneta D, Conti M, Richichi C, Ravizza T, De Luigi A, De Simoni MG, Sperk G, Andell-Jonsson S, Lundkvist J, Iverfeldt K, Bartfai T (2000) Powerful anticonvulsant action of IL-1 receptor antagonist on intracerebral injection and astrocytic overexpression in mice. Proc Natl Acad Sci USA 10:11534–11539CrossRef
5.
go back to reference Allan S, Rothwell N (2007) Cytokines and acute neurodegeneration. Nat Rev Neurosci 2:734–744CrossRef Allan S, Rothwell N (2007) Cytokines and acute neurodegeneration. Nat Rev Neurosci 2:734–744CrossRef
6.
go back to reference Vezzani A, Moneta D, Richichi C (2002) Functional role of inflammatory cytokines and antiinflammatory molecules in seizures and epileptogenesis. Epilepsia 43:30–35CrossRefPubMed Vezzani A, Moneta D, Richichi C (2002) Functional role of inflammatory cytokines and antiinflammatory molecules in seizures and epileptogenesis. Epilepsia 43:30–35CrossRefPubMed
7.
go back to reference Vezzani A, Granata T (2005) Brain inflammation of epilepsy: experimental and clinical evidence. Epilepsia 46:1724–1743CrossRefPubMed Vezzani A, Granata T (2005) Brain inflammation of epilepsy: experimental and clinical evidence. Epilepsia 46:1724–1743CrossRefPubMed
8.
go back to reference Peltola J, Hurme M, Miettinen A, Keränen T (1998) Elevated levels of interleukin-6 may occur in cerebrospinal fluid from patients with recent epileptic seizures. Epilepsy Res 31:129–133CrossRefPubMed Peltola J, Hurme M, Miettinen A, Keränen T (1998) Elevated levels of interleukin-6 may occur in cerebrospinal fluid from patients with recent epileptic seizures. Epilepsy Res 31:129–133CrossRefPubMed
9.
go back to reference Peltola J, Palmio J, Korhonen L, Suhonen J, Miettinen A, Hurme M, Lindholm D, Keränen T (2000) Interleukin-6 and interleukin-1 receptor antagonist in cerebrospinal fluid from patients with recent tonic-clonic seizures. Epilepsy Res 41:205–211CrossRefPubMed Peltola J, Palmio J, Korhonen L, Suhonen J, Miettinen A, Hurme M, Lindholm D, Keränen T (2000) Interleukin-6 and interleukin-1 receptor antagonist in cerebrospinal fluid from patients with recent tonic-clonic seizures. Epilepsy Res 41:205–211CrossRefPubMed
10.
go back to reference Woiciechowsky C, Schöning B, Daberkow N, Asche K, Stoltenburg G, Lanksch WR, Volk HD (1999) Brain-IL-1beta induces local inflammation but systemic anti-inflammatory response through stimulation of both hypothalamic–pituitary-adrenal axis and sympathetic nervous system. Brain Res 23:563–571CrossRef Woiciechowsky C, Schöning B, Daberkow N, Asche K, Stoltenburg G, Lanksch WR, Volk HD (1999) Brain-IL-1beta induces local inflammation but systemic anti-inflammatory response through stimulation of both hypothalamic–pituitary-adrenal axis and sympathetic nervous system. Brain Res 23:563–571CrossRef
11.
go back to reference Esch T, Stefano G (2002) Proinflammation: a common denominator or initiator of different pathophysiological disease processes. Med Sci Monit 8:HY1-9PubMed Esch T, Stefano G (2002) Proinflammation: a common denominator or initiator of different pathophysiological disease processes. Med Sci Monit 8:HY1-9PubMed
12.
go back to reference Hulkkonen J, Koskikallio E, Rainesalo S, Keränen T, Peltola J (2004) The balance of inhibitory and excitatory cytokines is differently regulated in vivo and in vitro among therapy resistant epilepsy patients. Epilepsy Res 59:199–205CrossRefPubMed Hulkkonen J, Koskikallio E, Rainesalo S, Keränen T, Peltola J (2004) The balance of inhibitory and excitatory cytokines is differently regulated in vivo and in vitro among therapy resistant epilepsy patients. Epilepsy Res 59:199–205CrossRefPubMed
13.
go back to reference Sheng JG, Boop FA, Mrak RE, Griffin WS (1994) Increased neuronal beta-amyloid precursor protein expression in human temporal lobe epilepsy: association with interleukin-1 alpha immunoreactivity. J Neurochem 63:1872–1879PubMedCrossRef Sheng JG, Boop FA, Mrak RE, Griffin WS (1994) Increased neuronal beta-amyloid precursor protein expression in human temporal lobe epilepsy: association with interleukin-1 alpha immunoreactivity. J Neurochem 63:1872–1879PubMedCrossRef
14.
go back to reference Crespel A, Coubes P, Rousset MC, Brana C, Rougier A, Rondouin G, Bockaert J, Baldy-Moulinier M, Lerner-Natoli M (2002) Inflammatory reactions in human medial temporal lobe epilepsy with hippocampal sclerosis. Brain Res 18:159–169CrossRef Crespel A, Coubes P, Rousset MC, Brana C, Rougier A, Rondouin G, Bockaert J, Baldy-Moulinier M, Lerner-Natoli M (2002) Inflammatory reactions in human medial temporal lobe epilepsy with hippocampal sclerosis. Brain Res 18:159–169CrossRef
15.
go back to reference Ravizza T, Gagliardi B, Noé F, Boer K, Aronica E, Vezzani A (2008) Innate and adaptive immunity during epileptogenesis and spontaneous seizures: evidence from experimental models and human temporal lobe epilepsy. Neurobiol Dis 29:142–160CrossRefPubMed Ravizza T, Gagliardi B, Noé F, Boer K, Aronica E, Vezzani A (2008) Innate and adaptive immunity during epileptogenesis and spontaneous seizures: evidence from experimental models and human temporal lobe epilepsy. Neurobiol Dis 29:142–160CrossRefPubMed
16.
go back to reference Ravizza T, Boer K, Redeker S, Spliet WG, van Rijen PC, Troost D, Vezzani A, Aronica E (2006) The IL-1beta system in epilepsy-associated malformations of cortical development. Neurobiol Dis 24:128–143CrossRefPubMed Ravizza T, Boer K, Redeker S, Spliet WG, van Rijen PC, Troost D, Vezzani A, Aronica E (2006) The IL-1beta system in epilepsy-associated malformations of cortical development. Neurobiol Dis 24:128–143CrossRefPubMed
17.
go back to reference Peltola J, Kulmala P, Isojärvi J, Saiz A, Latvala K, Palmio J, Savola K, Knip M, Keränen T, Graus F (2000) Autoantibodies to glutamic acid decarboxylase in patients with therapy-resistant epilepsy. Neurology 12:46–50 Peltola J, Kulmala P, Isojärvi J, Saiz A, Latvala K, Palmio J, Savola K, Knip M, Keränen T, Graus F (2000) Autoantibodies to glutamic acid decarboxylase in patients with therapy-resistant epilepsy. Neurology 12:46–50
18.
go back to reference Peltola JT, Haapala A, Isojärvi JI, Auvinen A, Palmio J, Latvala K, Kulmala P, Laine S, Vaarala O, Keränen T (2000) Antiphosholipid and antinuclear antibodies in epileptic syndromes and newly onset seizure disorders. Am J Med 109:712–717CrossRefPubMed Peltola JT, Haapala A, Isojärvi JI, Auvinen A, Palmio J, Latvala K, Kulmala P, Laine S, Vaarala O, Keränen T (2000) Antiphosholipid and antinuclear antibodies in epileptic syndromes and newly onset seizure disorders. Am J Med 109:712–717CrossRefPubMed
19.
go back to reference Vincent A, Buckley C, Schott JM, Baker I, Dewar BK, Detert N, Clover L, Parkinson A, Bien CG, Omer S, Lang B, Rossor MN, Palace J (2004) Potassium channel antibody-associated encephalopathy: a potentially immunotherapy-responsive form of limbic encephalitis. Brain 127:701–712CrossRefPubMed Vincent A, Buckley C, Schott JM, Baker I, Dewar BK, Detert N, Clover L, Parkinson A, Bien CG, Omer S, Lang B, Rossor MN, Palace J (2004) Potassium channel antibody-associated encephalopathy: a potentially immunotherapy-responsive form of limbic encephalitis. Brain 127:701–712CrossRefPubMed
20.
go back to reference Lehtimäki K, Keränen T, Huhtala H, Hurme M, Ollikainen J, Honkaniemi J, Palmio J, Peltola J (2004) Regulation of IL-6 system in cerebrospinal fluid and serum compartments by seizures: the effect of seizure type and duration. J Neuroimmunol 152:121–125CrossRefPubMed Lehtimäki K, Keränen T, Huhtala H, Hurme M, Ollikainen J, Honkaniemi J, Palmio J, Peltola J (2004) Regulation of IL-6 system in cerebrospinal fluid and serum compartments by seizures: the effect of seizure type and duration. J Neuroimmunol 152:121–125CrossRefPubMed
21.
go back to reference Lehtimäki KA, Keränen T, Palmio J, Mäkinen R, Hurme M, Honkaniemi J, Peltola J (2007) Increased plasma levels of cytokines after seizures in localization-related epilepsy. Acta Neurol Scand 116:226–230CrossRefPubMed Lehtimäki KA, Keränen T, Palmio J, Mäkinen R, Hurme M, Honkaniemi J, Peltola J (2007) Increased plasma levels of cytokines after seizures in localization-related epilepsy. Acta Neurol Scand 116:226–230CrossRefPubMed
22.
go back to reference Kwan P, Brodie MJ (2002) Refractory epilepsy: a progressive, intractable but preventable condition? Seizure 11:77–84CrossRefPubMed Kwan P, Brodie MJ (2002) Refractory epilepsy: a progressive, intractable but preventable condition? Seizure 11:77–84CrossRefPubMed
23.
go back to reference Mohanraj R, Brodie MJ (2006) Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur J Neur 13:277–282CrossRef Mohanraj R, Brodie MJ (2006) Diagnosing refractory epilepsy: response to sequential treatment schedules. Eur J Neur 13:277–282CrossRef
24.
go back to reference Commission on Classification, Terminology of the International League Against Epilepsy (1989) Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 30:389–399CrossRef Commission on Classification, Terminology of the International League Against Epilepsy (1989) Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 30:389–399CrossRef
25.
go back to reference Commission on Neuroimaging of the International League Against Epilepsy (1997) Recommendations for neuroimaging of patients with epilepsy. Epilepsia 38:1255–1256CrossRef Commission on Neuroimaging of the International League Against Epilepsy (1997) Recommendations for neuroimaging of patients with epilepsy. Epilepsia 38:1255–1256CrossRef
26.
go back to reference Kanemoto K, Kawasaki J, Miyamoto T, Obayashi H, Nishimura M (2000) Interleukin (IL)1beta, IL-1alpha, and IL-1 receptor antagonist gene polymorphisms in patients with temporal lobe epilepsy. Ann Neurol 47:571–574CrossRefPubMed Kanemoto K, Kawasaki J, Miyamoto T, Obayashi H, Nishimura M (2000) Interleukin (IL)1beta, IL-1alpha, and IL-1 receptor antagonist gene polymorphisms in patients with temporal lobe epilepsy. Ann Neurol 47:571–574CrossRefPubMed
27.
go back to reference Peltola J, Keränen T, Rainesalo S, Hurme M (2001) Polymorphism of the interleukin-1 gene complex in localization-related epilepsy. Ann Neurol 50:275–276CrossRefPubMed Peltola J, Keränen T, Rainesalo S, Hurme M (2001) Polymorphism of the interleukin-1 gene complex in localization-related epilepsy. Ann Neurol 50:275–276CrossRefPubMed
28.
go back to reference Buono RJ, Ferraro TN, O′Connor MJ, Sperling MR, Ryan SG, Scattergood T, Mulholland N, Gilmore J, Lohoff FW, Berrettini WH (2001) Lack of association between an interleukin 1 beta (IL-1beta) gene variation and refractory temporal lobe epilepsy. Epilepsia 42:782–784CrossRefPubMed Buono RJ, Ferraro TN, O′Connor MJ, Sperling MR, Ryan SG, Scattergood T, Mulholland N, Gilmore J, Lohoff FW, Berrettini WH (2001) Lack of association between an interleukin 1 beta (IL-1beta) gene variation and refractory temporal lobe epilepsy. Epilepsia 42:782–784CrossRefPubMed
29.
go back to reference Lim C, Alexander MP, LaFleche G, Schnyer DM, Verfaellie M (2004) The neurological and cognitive sequelae of cardiac arrest. Neurology 23:1774–1778 Lim C, Alexander MP, LaFleche G, Schnyer DM, Verfaellie M (2004) The neurological and cognitive sequelae of cardiac arrest. Neurology 23:1774–1778
30.
go back to reference Freund TF, Ylinen A, Miettinen R, Pitkänen A, Lahtinen H, Baimbridge KG, Riekkinen PJ (1992) Pattern of neuronal death in the rat hippocampus after status epilepticus. Relationship to calcium binding protein content and ischemic vulnerability. Brain Res Bull 28:27–38CrossRefPubMed Freund TF, Ylinen A, Miettinen R, Pitkänen A, Lahtinen H, Baimbridge KG, Riekkinen PJ (1992) Pattern of neuronal death in the rat hippocampus after status epilepticus. Relationship to calcium binding protein content and ischemic vulnerability. Brain Res Bull 28:27–38CrossRefPubMed
31.
go back to reference Getts DR, Balcar VJ, Matsumoto I, Müller M, King NJ (2008) Viruses and the immune system: their roles in seizure cascade development. J Neurochem 104:1167–1176CrossRefPubMed Getts DR, Balcar VJ, Matsumoto I, Müller M, King NJ (2008) Viruses and the immune system: their roles in seizure cascade development. J Neurochem 104:1167–1176CrossRefPubMed
32.
go back to reference Bien CG, Urbach H, Schramm J, Soeder BM, Becker AJ, Voltz R, Vincent A, Elger CE (2007) Limbic encephalitis as a precipitating event in adult-onset temporal lobe epilepsy. Neurology 18:1236–1244CrossRef Bien CG, Urbach H, Schramm J, Soeder BM, Becker AJ, Voltz R, Vincent A, Elger CE (2007) Limbic encephalitis as a precipitating event in adult-onset temporal lobe epilepsy. Neurology 18:1236–1244CrossRef
33.
go back to reference Pitkänen A, Sutula TP (2002) Is epilepsy a progressive disorder? prospects for new therapeutic approaches in temporal-lobe epilepsy. Lancet Neurol 1:173–181CrossRefPubMed Pitkänen A, Sutula TP (2002) Is epilepsy a progressive disorder? prospects for new therapeutic approaches in temporal-lobe epilepsy. Lancet Neurol 1:173–181CrossRefPubMed
34.
go back to reference Majak K, Pitkänen A (2003) Projections from the periamygdaloid cortex to the amygdaloid complex, the hippocampal formation, and the parahippocampal region: a PHA-L study in the rat. Hippocampus 13:922–942CrossRefPubMed Majak K, Pitkänen A (2003) Projections from the periamygdaloid cortex to the amygdaloid complex, the hippocampal formation, and the parahippocampal region: a PHA-L study in the rat. Hippocampus 13:922–942CrossRefPubMed
35.
go back to reference Jefferson AL, Massaro JM, Wolf PA, Seshadri S, Au R, Vasan RS, Larson MG, Meigs JB, Keaney JF Jr, Lipinska I, Kathiresan S, Benjamin EJ, DeCarli C (2007) Inflammatory biomarkers are associated with total brain volume: the Framingham heart study. Neurology 27:1032–1038CrossRef Jefferson AL, Massaro JM, Wolf PA, Seshadri S, Au R, Vasan RS, Larson MG, Meigs JB, Keaney JF Jr, Lipinska I, Kathiresan S, Benjamin EJ, DeCarli C (2007) Inflammatory biomarkers are associated with total brain volume: the Framingham heart study. Neurology 27:1032–1038CrossRef
36.
go back to reference Engelhart MJ, Geerlings MI, Meijer J, Kiliaan A, Ruitenberg A, van Swieten JC, Stijnen T, Hofman A, Witteman JC, Breteler MM (2004) Inflammatory proteins in plasma and the risk of dementia: the Rotterdam study. Arch Neurol 61:668–672CrossRefPubMed Engelhart MJ, Geerlings MI, Meijer J, Kiliaan A, Ruitenberg A, van Swieten JC, Stijnen T, Hofman A, Witteman JC, Breteler MM (2004) Inflammatory proteins in plasma and the risk of dementia: the Rotterdam study. Arch Neurol 61:668–672CrossRefPubMed
37.
go back to reference McGeer PL, Rogers J, McGeer EG (2006) Inflammation, anti-inflammatory agents and Alzheimer disease: the last 12 years. J Alzheimer′s Dis 9:271–276 McGeer PL, Rogers J, McGeer EG (2006) Inflammation, anti-inflammatory agents and Alzheimer disease: the last 12 years. J Alzheimer′s Dis 9:271–276
38.
go back to reference Campbell IL, Abraham CR, Masliah E, Kemper P, Inglis JD, Oldstone MB, Mucke L (1993) Neurologic disease induced in transgenic mice by cerebral overexpression of interleukin 6. Proc Natl Acad Sci USA 90:10061–10065CrossRefPubMed Campbell IL, Abraham CR, Masliah E, Kemper P, Inglis JD, Oldstone MB, Mucke L (1993) Neurologic disease induced in transgenic mice by cerebral overexpression of interleukin 6. Proc Natl Acad Sci USA 90:10061–10065CrossRefPubMed
39.
go back to reference Panegyres PK, Hughes J (1998) The neuroprotective effects of the recombinant interleukin-1 receptor antagonist rhIL-1ra after excitotoxic stimulation with kainic acid and its relationship to the amyloid precursor protein gene. J Neurol Sci 5:123–132CrossRef Panegyres PK, Hughes J (1998) The neuroprotective effects of the recombinant interleukin-1 receptor antagonist rhIL-1ra after excitotoxic stimulation with kainic acid and its relationship to the amyloid precursor protein gene. J Neurol Sci 5:123–132CrossRef
40.
go back to reference Xiao E, Xia L, Ferin M, Wardlaw SL (1999) Intracerebroventricular injection of interleukin-1 stimulates the release of high levels of interleukin-6 and interleukin-1 receptor antagonist into peripheral blood in the primate. J Neuroimmunol 97:70–76CrossRefPubMed Xiao E, Xia L, Ferin M, Wardlaw SL (1999) Intracerebroventricular injection of interleukin-1 stimulates the release of high levels of interleukin-6 and interleukin-1 receptor antagonist into peripheral blood in the primate. J Neuroimmunol 97:70–76CrossRefPubMed
41.
go back to reference Meierkord H, Shorvon S, Lightman S, Trimble M (1992) Comparison of the effects of frontal and temporal lobe partial seizures on prolactin levels. Arch Neurol 49:225–230PubMed Meierkord H, Shorvon S, Lightman S, Trimble M (1992) Comparison of the effects of frontal and temporal lobe partial seizures on prolactin levels. Arch Neurol 49:225–230PubMed
42.
go back to reference Miyawaki T, Sogawa N, Maeda S, Kohjitani A, Shimada M (2001) Effect of midazolam on interleukin-6 mRNA expression in human peripheral blood mononuclear cells in the absence of lipopolysaccharide. Cytokine 15:320–327CrossRefPubMed Miyawaki T, Sogawa N, Maeda S, Kohjitani A, Shimada M (2001) Effect of midazolam on interleukin-6 mRNA expression in human peripheral blood mononuclear cells in the absence of lipopolysaccharide. Cytokine 15:320–327CrossRefPubMed
Metadata
Title
Interleukin-6 levels are increased in temporal lobe epilepsy but not in extra-temporal lobe epilepsy
Authors
Suvi Liimatainen
Mahdi Fallah
Elham Kharazmi
Maria Peltola
Jukka Peltola
Publication date
01-05-2009
Publisher
D. Steinkopff-Verlag
Published in
Journal of Neurology / Issue 5/2009
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-009-5021-x

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