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| ORIGINAL ARTICLE
|Year : 2015 | Volume
| Issue : 2 | Page : 190--196
Cytokines, MMP-2, and MMP-9 levels in patients with a solitary cysticercus granuloma
Rakesh Shyam Lalla1, Ravindra Kumar Garg1, Hardeep Singh Malhotra1, Amita Jain2, Rajesh Verma1, Chandra Mani Pandey3, Gyan Prakash Singh4, Praveen Kumar Sharma1
1 Department of Neurology, King George Medical University, Uttar Pradesh, Lucknow, India
2 Department of Microbiology, King George Medical University, Uttar Pradesh, Lucknow, India
3 Department of Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Uttar Pradesh, Lucknow, India
4 Department of Anaesthesia, King George Medical University, Uttar Pradesh, Lucknow, India
Objectives: In patients with neurocysticercosis, perilesional inflammatory activity is thought to be responsible for seizures. This study was designed to evaluate the serum and cerebrospinal fluid (CSF) concentrations of cytokines as well as matrix metalloproteinase (MMP)-2 and MMP-9 in patients with a solitary cysticercus granuloma.
Materials and Methods: The study included 47 patients suffering from seizures in whom a solitary cysticercus granuloma was detected on a computed tomography (CT) scan. The study also included 47 control subjects. Their serum and cerebrospinal fluid (CSF) was analysed for cytokines and MMP levels. A follow-up CT was performed after 6 months.
Results: The median levels of cytokines, interleukin (IL)-1β, IL-5, IL-6, IL-10 and tissue necrosis factor (TNF)-α, MMP-2 and MMP-9 were significantly elevated, both in the serum and CSF of patients having an intracerebral solitary cysticercus granuloma, in comparison to that of controls. The follow-up CT revealed that in 27 patients, the lesions were calcified and in 5 patients, there was complete resolution of the lesions. In 15 patients, the lesions remained unchanged. Higher baseline CSF MMP-2 and TNF-α level were seen in patients with persisting lesions. Higher serum baseline MMP-2, IL-6 and a low CSF IL-10 level were seen in patients with complete resolution of the granuloma. A high baseline IL-1β level was associated with a calcified lesion. Fourteen patients had recurrence of seizures. A high baseline serum TNF-α level was independently associated with seizure recurrence (P = 0.021, OR = 1.041, CI = 1.006 to 1.078).
Conclusion: In patients with a solitary cysticercus granuloma, cytokines and matrix metalloproteinases in the CSF and serum are elevated. Different patterns of immunological changes were observed in patients following resolution or calcification of the lesion.
Dr. Ravindra Kumar Garg
Department of Neurology, King George Medical University, Uttar Pradesh, Lucknow - 226 003
Source of Support: None, Conflict of Interest: None
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