Towards a Treatment for Neuroinflammation in Epilepsy: Interleukin-1 Receptor Antagonist, Anakinra, as a Potential Treatment in Intractable Epilepsy

被引:38
作者
Yamanaka, Gaku [1 ]
Ishida, Yu [1 ]
Kanou, Kanako [1 ]
Suzuki, Shinji [1 ]
Watanabe, Yusuke [1 ]
Takamatsu, Tomoko [1 ]
Morichi, Shinichiro [1 ]
Go, Soken [1 ]
Oana, Shingo [1 ]
Yamazaki, Takashi [1 ]
Kawashima, Hisashi [1 ]
机构
[1] Tokyo Med Univ, Dept Pediat & Adolescent Med, Tokyo 1600023, Japan
关键词
anakinra; cytokine; febrile infection-related epilepsy syndrome; IL-1; beta; IL-1 receptor antagonist; JUVENILE IDIOPATHIC ARTHRITIS; REFRACTORY STATUS EPILEPTICUS; SUDDEN UNEXPECTED DEATH; INCREASED PLASMA-LEVELS; FEBRILE SEIZURES; SYNDROME FIRES; CYTOKINES; IL-1-BETA; ENCEPHALOPATHY; INFLAMMATION;
D O I
10.3390/ijms22126282
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Febrile Infection-Related Epilepsy Syndrome (FIRES) is a unique catastrophic epilepsy syndrome, and the development of drug-resistant epilepsy (DRE) is inevitable. Recently, anakinra, an interleukin-1 receptor antagonist (IL-1RA), has been increasingly used to treat DRE due to its potent anticonvulsant activity. We here summarized its effects in 38 patients (32 patients with FIRES and six with DRE). Of the 22 patients with FIRES, 16 (73%) had at least short-term seizure control 1 week after starting anakinra, while the remaining six suspected anakinra-refractory cases were male and had poor prognoses. Due to the small sample size, an explanation for anakinra refractoriness was not evident. In all DRE patients, seizures disappeared or improved, and cognitive function improved in five of the six patients following treatment. Patients showed no serious side effects, although drug reactions with eosinophilia and systemic symptoms, cytopenia, and infections were observed. Thus, anakinra has led to a marked improvement in some cases, and functional deficiency of IL-1RA was indicated, supporting a direct mechanism for its therapeutic effect. This review first discusses the effectiveness of anakinra for intractable epileptic syndromes. Anakinra could become a new tool for intractable epilepsy treatment. However, it does not currently have a solid evidence base.
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页数:12
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