Inflammation and endothelium response in epileptic patients: A case-control study

Abstract

BACKGROUND: Blood brain barrier (BBB) permeability plays an important role in the brain impairments. The barrier is composed of endothelium cells, due to the presence of tight junctions that connect endothelium cells. The failure of BBB function has triggering chronic or acute seizures through brain inflammation and BBB permeability. Seizure induces vasodilation, BBB leakage and up-regulation of vascular cell adhesion molecules which able to bind integrins blood leukocytes. MATERIALS AND METHODS: In this case-control study we included 40 epileptic patients who were sampled during a seizure as a case group and 20 healthy subjects as a healthy control group. Plasma levels of the inflammation and endothelium markers including intercellular adhesion molecule (ICAM), vascular adhesion molecule (VCAM), interleukin 1 beta (IL-1beta) and C-reactive protein (CRP) were measured by enzyme-linked immunosorbent assays (ELISAs). RESULTS: The ICAM and VCAM concentration in the epileptic patients (135.8 +/- 5.35) (52.04 +/- 4.24) were significantly higher than healthy control group (110.32 +/- 5.04) (23.38 +/- 3.01) (P < 0.005). IL-1 beta concentration was not significantly different between groups (P = 0.594). However, CRP level was significantly up-regulated in epileptic patients (P < 0.005). CONCLUSION: Epileptic patients have BBB leakage and dysfunction as the up-regulation of the endothelium cytokines showed. The BBB leakage may be the result of the inflammatory impairment.