Interictal interleukin-6 and tumor necrosis factor α levels are associated with seizure recurrence in adults with epilepsy

• Published in: Epilepsy & behavior 2024-06, Vol.155, p.109786-109786, Article 109786
• Main Authors: Fang, Wenqiang, Chen, Shihao, Xia, Xuefen, Huang, Wenting, Du, Yanru, Liu, Zhipeng, Chen, Lekai, Wang, Xinshi, Xu, Huiqin
• Format: Article
• Language: English
• Subjects: Adult; Biomarkers - blood; Epilepsy; Epilepsy - blood; Female; Follow-Up Studies; Humans; Inflammatory mediators; Interleukin-6 - blood; Male; Middle Aged; Prospective Studies; Recurrence; Seizure recurrence; Seizures - blood; Tumor Necrosis Factor-alpha - blood; Young Adult
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2024.109786

•Elevated pro-inflammatory cytokines such as IL-6 and TNF-α may be risk factors for seizure recurrence.•Interleukin-6 level was negatively correlated with time to seizure recurrence.•In addition to validated variables, IL-6 may be included in subsequent construction of seizure recurrence prediction models. 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. 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. 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). 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.