Cytokines and Onchocerciasis-Associated Epilepsy, a Pilot Study and Review of the Literature.

Melissa Krizia Vieri,Robert Colebunders,Deby Mukendi,Gasim Abd-Elfarag,Jane Y Carter,Stephen Raimon,Samir Kumar-Singh,An Hotterbeekx

doi:10.3390/pathogens10030310

Abstract

Neuro-inflammation may be associated with onchocerciasis-associated epilepsy (OAE) but thus far very few immunological studies have been performed in children with this form of epilepsy. In a pilot study we measured the cytokine levels in cerebrospinal fluid (CSF) of persons with OAE from Maridi, South Sudan, and from Mosango, Democratic Republic of the Congo (DRC) and compared these results with cytokine levels in CSF of Africans with non-OAE neurological disorders, and Europeans with epilepsy or other neurological conditions. The following cytokines were studied: IL-6, TNF-α, IL1-β, IL-5, IL-4, IL-13, CCL3 (Mip-1α), VEGF-C, VCAM-1. No cytokine was significantly associated with OAE, although a lower IL-13 level was observed in CSF of persons with OAE compared to African controls. Observed cytokine profiles and neuro-inflammation may be the consequence of long-standing epilepsy, concomitant infections and malnutrition. Ideally cytokine levels should be determined in a prospective study in serum and CSF collected at the time of onset of the first seizures.

Highlights

Recent studies suggest that nodding syndrome is one of the clinical presentations of an epileptic disorder called onchocerciasis associated epilepsy (OAE) [1]
The authors of this study reported a 85−99% reduction of cytokines IL-1β, IL-2, IL-6, IL-8, TNFα and IFNγ in children with nodding syndrome compared to healthy subjects [13]
We present the data of our pilot study and compare them with the results of the studies conducted in the Democratic Republic of the Congo (DRC) and Uganda

Summary

Introduction

Recent studies suggest that nodding syndrome is one of the clinical presentations of an epileptic disorder called onchocerciasis associated epilepsy (OAE) [1]. Only three studies have measured cytokine levels in persons with OAE, including nodding syndrome. In a second case control study from South Sudan, 20 children with nodding syndrome and 10 healthy controls were enrolled [13]. The authors of this study reported a 85−99% reduction of cytokines IL-1β, IL-2, IL-6, IL-8, TNFα and IFNγ in children with nodding syndrome compared to healthy subjects [13]. A recent case control study conducted in Uganda compared 154 persons with longstanding nodding syndrome and 154 community controls by measuring plasma levels of cytokines, chemokines and complement activation (C5a) markers using ELISA or a custom MagPix Luminex assay. Ovo.lvvoullvuusliunsfeincfteiocntiomnamy aaylsoalisnofliuneflnuceenccyetcoyktionkeilneevelelsv.eHlse. lHmeinlmthininthfeicntfioecntsioinn-s dinudceuctehethperpodroudcuticotnioonfotfytpyep2e 2cyctyotkoiknienseswwhihcihchlelaedadtotobbooththeexxppuulslsioionnoofftthheeppaarraassiitteeaanndd adradreneinipfpffifoienoenrrfrrfltelteeaneandmdmtt ftmftmoooorariaminmtntoodsdsrruyuoyoccfrfereeeeeespespppppiiloiloielelnenpeppspssseetyty.i.iccM[[M22ss5oe5eo]ir]ir.z.zeeuFuoFoorvorvereeressrere,b,xbxeyeayallmemeaavvccppatatliilttevveee,a,dadctctiyciycnnytytgogottokokttkihkhinnieienenecsecesyyslsltetueuoovvcckkehehiillnnssaaeehshscacaIIaLavLvss-e-ecc11aaaaββdldlssaeaeoonn[[bdb22de6e6IeIe]]LL.n.n--8o8obhbhssaaeevvrrevevebebddeeeeiinnnn

Materials and Methods

Statistical Analysis

Findings

Conclusions