Serum biomarkers of cerebral cellular stress after self-limiting tonic clonic seizures: An exploratory study
Serum biomarkers of cerebral cellular stress after self-limiting tonic clonic seizures: An exploratory study
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DOI：
10.1016/j.seizure.2020.12.009
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发表时间：
2021-02-01
影响因子：
3
通讯作者：
Ziemssen, Tjalf
中科院分区：
文献类型：
--
作者：
Nass, Robert Daniel;Akguen, Katja;Ziemssen, Tjalf
目的：单次自限性癫痫发作是否会损害脑细胞已经争论了几十年。与此同时，非常灵敏的生物标志物测量已经变得可用，即tau，神经丝蛋白轻（NFL），胶质细胞酸性蛋白（GFAP）和泛素羧基终止水解酶L1（UCHL-1），我们在这项研究中探索。方法：癫痫监护室的成年患者在书面同意后进入研究。在基线、TCS后即刻以及2、6和24 h后采集血样。用单分子阵列（SIMOA）从冷冻样品中测量标记物。结果：20例患者和20次癫痫发作。所有标记物均显示轻微但显著的发作后增加，并在接下来的几小时内恢复正常（p <0.05）。在30%的患者中注意到tau、UCHL-1和GFAP从基线增加至少100%，而NFL水平从未增加超过100%。乳酸与tau蛋白增加轻微相关（r = 0.47，p = 0.037），白细胞与GFAP的发作后变化相关（r = 0.68，p = 0.001）。结论：我们的数据支持的假设，显着的脑应激发生在一些，但不是所有的自限性TCS。发作后的炎症反应似乎尤其起着重要作用。
Objective: It has been debated for decades whether single, self-limited seizures damage cerebral cells. Meanwhile, very sensitive measurements of biomarkers have become available, i.e. tau, neurofilament protein light (NFL), glial fibrillary acidic protein (GFAP) and ubiquitin carboxyterminate hydrolase L1 (UCHL-1), which we explored in this study. Methods: Adult patients of the epilepsy monitoring unit were admitted to the study after written consent. Blood samples were drawn at baseline, immediately after a TCS and after two, six and 24 h. The markers were measured from frozen samples with a single-molecule array (SIMOA). Results: 20 patients and 20 seizures were included. All markers showed subtle but significant postictal increases and returned to normal within the next few hours (p < 0.05). An increase of at least 100 % from baseline was noted in 30 % of patients for tau, 25 % for UCHL-1 and 15 % for GFAP, while NFL levels never increased above 100 %. Lactate was slightly correlated with the tau increase (r = 0.47, p = 0.037), leukocytes were correlated with postictal changes of GFAP (r = 0.68 p = 0.001). Conclusion: Our data supports the assumption that significant cerebral stress occurs in some but not all selflimited TCS. The postictal inflammatory response in particular seems to play an important role.