Abstract：
BACKGROUND: Although there are models predicting epilepsy recurrence under different clinical conditions, few studies have examined blood biomarkers. Inflammation plays a crucial role in the occurrence and development of epilepsy. We analyzed inflammatory mediators in a regional hospital-based epilepsy cohort and investigated their relationship with subsequent epilepsy recurrence.
METHODS: Interictal inflammatory mediators were measured in 128 patients diagnosed with epilepsy participating in a prospective study. Inflammatory mediators were compared during the follow-up period between patients who experienced epilepsy recurrence and those who did not. We also assessed the correlation between inflammatory mediators and the time interval until the next recurrence.
RESULTS: Over a median 4-month follow-up period, 41 patients experienced seizure recurrence. Differences in interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) levels were observed between seizure recurrence and non-recurrence groups. After adjusting for covariates through multivariate Cox regression analysis, the patients in the third IL-6 tertile (>2.31 pg/mL; HR: 2.49; 95 % CI: 1.00-6.16; P = 0.049) and in the third TNF-α tertile (>0.74 pg/mL; HR: 2.80; 95 % CI: 1.13-6.92; P = 0.026) had higher risk of seizure recurrence. The time until the next recurrence was negatively correlated with IL-6 level (ρ = - 0.392, P = 0.011).
CONCLUSIONS: High levels of IL-6 and TNF-α are associated with a higher possibility of seizure recurrence. Future predictive models should also include inflammatory mediators in addition to clinical variables.
METHODS: Interictal inflammatory mediators were measured in 128 patients diagnosed with epilepsy participating in a prospective study. Inflammatory mediators were compared during the follow-up period between patients who experienced epilepsy recurrence and those who did not. We also assessed the correlation between inflammatory mediators and the time interval until the next recurrence.
RESULTS: Over a median 4-month follow-up period, 41 patients experienced seizure recurrence. Differences in interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) levels were observed between seizure recurrence and non-recurrence groups. After adjusting for covariates through multivariate Cox regression analysis, the patients in the third IL-6 tertile (>2.31 pg/mL; HR: 2.49; 95 % CI: 1.00-6.16; P = 0.049) and in the third TNF-α tertile (>0.74 pg/mL; HR: 2.80; 95 % CI: 1.13-6.92; P = 0.026) had higher risk of seizure recurrence. The time until the next recurrence was negatively correlated with IL-6 level (ρ = - 0.392, P = 0.011).
CONCLUSIONS: High levels of IL-6 and TNF-α are associated with a higher possibility of seizure recurrence. Future predictive models should also include inflammatory mediators in addition to clinical variables.
摘要：
背景：尽管存在预测不同临床条件下癫痫复发的模型，很少有研究检查血液生物标志物。炎症在癫痫的发生发展中起着至关重要的作用。我们分析了基于区域医院的癫痫队列中的炎症介质，并研究了它们与随后的癫痫复发的关系。
方法：在参与一项前瞻性研究的128例诊断为癫痫患者中测量了发作间期炎症介质。在随访期间，比较了有癫痫复发的患者和没有癫痫复发的患者的炎症介质。我们还评估了炎症介质与下一次复发之前的时间间隔之间的相关性。
结果：在中位4个月的随访期内，41例患者出现癫痫发作复发。在癫痫发作复发和未复发组之间观察到白细胞介素6（IL-6）和肿瘤坏死因子α（TNF-α）水平的差异。在通过多变量Cox回归分析调整协变量后，第3组IL-6患者(>2.31pg/mL;HR:2.49;95%CI:1.00~6.16;P=0.049)和第3组TNF-α患者(>0.74pg/mL;HR:2.80;95%CI:1.13~6.92;P=0.026)癫痫发作复发风险较高.直到下一次复发的时间与IL-6水平呈负相关（ρ=-0.392，P=0.011）。
结论：高水平的IL-6和TNF-α与癫痫发作复发的可能性更高相关。除临床变量外，未来的预测模型还应包括炎症介质。
方法：在参与一项前瞻性研究的128例诊断为癫痫患者中测量了发作间期炎症介质。在随访期间，比较了有癫痫复发的患者和没有癫痫复发的患者的炎症介质。我们还评估了炎症介质与下一次复发之前的时间间隔之间的相关性。
结果：在中位4个月的随访期内，41例患者出现癫痫发作复发。在癫痫发作复发和未复发组之间观察到白细胞介素6（IL-6）和肿瘤坏死因子α（TNF-α）水平的差异。在通过多变量Cox回归分析调整协变量后，第3组IL-6患者(>2.31pg/mL;HR:2.49;95%CI:1.00~6.16;P=0.049)和第3组TNF-α患者(>0.74pg/mL;HR:2.80;95%CI:1.13~6.92;P=0.026)癫痫发作复发风险较高.直到下一次复发的时间与IL-6水平呈负相关（ρ=-0.392，P=0.011）。
结论：高水平的IL-6和TNF-α与癫痫发作复发的可能性更高相关。除临床变量外，未来的预测模型还应包括炎症介质。
