The Regulation of Plasma Interleukin-6 Levels Is Modified by Hippocampal Sclerosis and Its Lateralization in Drug-Resistant Temporal Lobe Epilepsy

Abstract

Background. Several studies have reported the association of the proinflammatory cytokine IL-6 with temporal lobe epilepsy (TLE), but the regulation of IL-6 in hippocampal sclerosis (HS) is less studied. Objectives. To analyse IL-6 levels and the IL-6/IL-10 ratio in a larger, well-characterized group of patients with drug-resistant focal epilepsy (DRE), focusing especially on TLE and TLE-associated HS. Methods. IL-6 levels were measured by ELISA in plasma in a cross-sectional cohort of 265 patients comprising TLE with HS ( n = 34 ), TLE without HS ( n = 103 ), extratemporal lobe epilepsy ( n = 92 ), and idiopathic generalized epilepsy ( n = 36 ). Results. The IL-6/IL-10 ratio was higher in TLE with HS than in TLE without HS (3.1 vs. 1.6, p = 0.042 ), whereas the median levels of IL-6 did not differ among epilepsy types. TLE without HS patients had a higher proportion of increased IL-6 levels than TLE with HS patients ( p = 0.021 ). Additionally, IL-6 levels were higher in patients with right-sided HS than in those with left lateralization (1.71 vs. 0.80 pg/mL, p = 0.04 ). In TLE with HS patients, IL-6 levels showed a negative correlation with seizure frequency during the last month ( r = − 0.342 ; p = 0.047 ), whereas in TLE without HS patients, the correlation was positive but did not reach significance ( r = 0.136 ; p = 0.169 ). Conclusion. IL-6 levels and the IL-6/IL-10 ratio are differentially regulated among patients with TLE depending on the presence of HS and its lateralization, suggesting that TLE with HS is a distinct category regarding cytokine activation.

Hippocampal sclerosis is associated with celiac disease type immunity in patients with drug-resistant temporal lobe epilepsy

“…In the present study, 75% of the patients with CD-type immunity had left-sided HS compared to 25% of patients without CD-type immunity, suggesting a possibility for lateralized cerebral influence of immune processes of gluten-associated immunity. Interestingly, in our recent study with the same patient group, IL-6 levels and the IL-6/IL-10 ratio were differentially regulated among patients with TLE depending on the presence of HS and its lateralization [ 25 ].…”