Increased level of serum interleukin-1 receptor antagonist subsequent to resolution of clinical symptoms in patients with West syndrome

Abstract 

The aim of this study was to evaluate whether proconvulsive interleukin-1β (IL-1β) and anticonvulsive IL-1 receptor antagonist (IL-1Ra) are markers of the effectiveness of treatment in patients with West syndrome (WS). We analyzed serum and cerebrospinal fluid (CSF) levels of IL-1β and IL-1Ra in 13 patients with WS. The serum IL-1Ra levels postimprovement (average, 384.6pg/ml) in clinical and electroencephalographic (EEG) findings were significantly higher than the preimprovement values (average, 240.6pg/ml). No significant difference in the preimprovement serum IL-1Ra levels was noted between the anticonvulsant (AED)-response and adrenocorticotropic hormone (ACTH)-response groups (260.0pg/ml, n=7 vs. 218.0pg/m, n=6) and the cryptogenic and symptomatic groups (290.1pg/ml, n=4 vs. 218.3pg/m, n=9), respectively; as for the preimprovement CSF levels, the AED-response group (114.5pg/m; n=3) and ACTH-response groups (138.0pg/m; n=6) and the cryptogenic (59.3pg/m; n=3) and symptomatic groups (165.6pg/m; n=6), respectively. Serum and CSF IL-1β levels were detected only in 3 patients preimprovement. Serum IL-1Ra levels were elevated subsequent to resolution of clinical and EEG findings in WS patients. A larger study should be conducted to clarify whether an immunological processes are concerned with the pathophysiology of WS.

Keywords: Interleukin-1 receptor antagonist, Cytokine, Epilepsy, West syndrome, Infantile spasm, ACTH