Increased level of serum interleukin-1 receptor antagonist subsequent to resolution of clinical symptoms in patients with West syndrome

The aim of this study was to evaluate whether proconvulsive interleukin-1 beta (IL-1 beta) and anticonvulsive IL-1 receptor antagonist (IL-1Ra) are markers of the effectiveness of treatment in patients with West syndrome (WS). We analyzed serum and cerebrospinal fluid (CSF) levels of IL-1 beta and IL-1Ra in 13 patients with WS. The serum IL-1Ra levels postimprovement (average, 384.6 pg/ml) in clinical and electroencephalographic (EEG) findings were significantly higher than the preimprovement values (average, 240.6 pg/ml). No significant difference in the preimprovement serum IL-1Ra levels was noted between the anticonvulsant (AED)-response and adrenocorticotropic hormone (ACTH)-response groups (260.0 pg/ml, n = 7 vs. 218.0 pg/m, n = 6) and the cryptogenic and symptomatic groups (290.1 pg/ml, n = 4 vs. 218.3 pg/m, n = 9), respectively; as for the preimprovement CSF levels, the AED-response group (114.5 pg/m; n = 3) and ACTH-response groups (138.0 pg/m; n = 6) and the cryptogenic (59.3 pg/m; n = 3) and symptomatic groups (165.6 pg/m; n = 6), respectively. Serum and CSF IL-1 beta levels were detected only in 3 patients preimprovement. Serum IL-1Ra levels were elevated subsequent to resolution of clinical and EEG findings in WS patients. A larger study should be conducted to clarify whether an immunological processes are concerned with the pathophysiology of WS. (C) 2010 Elsevier B.V. All rights reserved.