Cytokines and Chemokines in Idiopathic Intracranial Hypertension

The pathogenesis of idiopathic intracranial hypertension (IIH) remains unclear and as such it remains a diagnosis of exclusion. To identify cerebrospinal fluid (CSF) and serum cytokine and chemokine profiles associated with IIH. Semiquantitative assessment with cytokine antibody arrays was used to detect the relative expression of 42 different cytokines and chemokines in the CSF and serum of 8 IIH patients and 8 controls. Subsequently, quantitative assay with enzyme linked immunosorbent assay was performed for chemokine CCL2, interleukin-1 alpha (IL-1 alpha), and leptin. Cytokine antibody array showed elevated levels of CCL2 in the CSF and CCL7, CCL8, IL-1 alpha, and leptin levels in serum in IIH patients compared with controls. Subsequent quantitative assessment with enzyme linked immunosorbent assay showed significantly elevated CSF CCL2 in IIH patients compared with controls (P < .01) but there was no significant difference in leptin and IL-1 alpha levels between the groups. This is the first report demonstrating differences in cytokine expression in the serum and CSF in IIH patients compared with controls. Since the pathogenesis of IIH is unclear, the heterogeneity of the cytokine expression reported here may help understand the pathogenesis of this condition.