Cerebrospinal fluid levels of cytokines in non-herpetic acute limbic encephalitis: Comparison with herpes simplex encephalitis

Non-Herpetic Acute Limbic Encephalitis: A New Subgroup of Limbic Encephalitis?

“…In the CSF cytokines of NHALE patients, the IFN-γ value is not elevated with an increase of IL-6 Ichiyama et al, 2008a;Fig.3). CSF IFN-γ levels were elevated in the central nervous system (CNS) disorders due to direct viral invasion, such as viral meningitis and HSE (Matsubara et al, 2000;Ichiyama et al, 2005;Ichiyama et al, 2008a), but not in immune-mediated CNS disorders, such as acute disseminated encephalomyelitis, influenzaassociated encephalopathy, and acute encephalopathy following prolonged febrile seizures, and hemolytic uremic syndrome with encephalopathy (Ichiyama et al, 2002;Ichiyama et al, 2004;Ichiyama et al, 2008b;Shiraishi et al, 2008).…”

“…Cerebrospinal fluid (CSF) shows a mild pleocytosis with increase of pressure, mild increase of protein, and sometimes, a lack of the pleocytosis. The CSF level of interferon-γ (IFN-γ) is unchanged with an increase of interleukin (IL)-6 Ichiyama et al, 2008a). Among them, NHALE patient group with the onset symptoms of abnormal behavior and incoherence, and the detection of anti-glutamate receptor (GluRε2 NR2B) antibodies is gaining attention (Nemoto et al, 2005;Hayashi et al 2005;Takahashi et al, 2007).…”

Herpes Simplex Type 1 Encephalitis

“…Serial changes observed in intrathecal cytokine and chemokine levels in patients with HSE were investigated in 4 separate clinical trials in detail. As a result of these studies; HSE identified in the acute stages of IFN-ү and IL-6 levels increased and these values, confirming the diagnosis has been reported to be helpful (Asaoka et al, 2004;Aurelius et al, 1994;Ichiyama et al, 2008;Rösler et al, 1998). Another preferred method of early diagnosis of HSE is EEG.…”

Biomarkers of Encephalitis

“…In HSE there is evidence of a vigorous intrathecal immune response during the acute phase, as shown by increased levels of 2-microglobulin and neopterin in CSF, followed by a chronic phase of low-grade intrathecal inflammation (Aurelius et al 1993). In addition the levels of a variety of CSF cytokines and their receptors are elevated like IL-6, IFN, soluble IL-2 receptor (sIL-2R) and soluble CD8 (Asaoka et al 2004;Aurelius et al 1994;Ichiyama et al 2008;Linde et al 1992;Rosler et al 1998). IFN and IL-6 levels increased during the first week of HSE while TNF, IL-2, and soluble CD8 became elevated at 2-6 weeks (Aurelius et al 1994).…”

“…Autopsy cases showed neuronal loss and severe gliosis with inflammatory cell infiltrations in the hippocampus and amygdala. Examination of the CSF revealed occasional mild pleocytosis, and increased IL-6 levels (Ichiyama et al 2008;Shoji 2010). Recent reports associate the disease with the presence of anti-glutamate receptor epsilon 2 antibodies (Shoji 2010).…”