Time course of serum cytokine level changes within 72 h after onset in children with acute encephalopathy and febrile seizures

Abstract

Background Cytokine levels have been measured in acute encephalopathy (AE) to determine its pathology or as a diagnostic biomarker to distinguish it from febrile seizures (FS); however, the dynamics of cytokine level changes have not yet been fully captured in these two neurological manifestations. Thus, we aimed to explore the time course of serum cytokine level changes within 72 h after onset in AE and FS. Methods We retrospectively measured cytokine level in residual serum samples at multiple timepoints in seven children whose final diagnoses were AE or FS. Results The levels of 13 cytokines appeared to increase immediately after onset and peaked within 12–24 h after onset: interleukin (IL)-1β, IL-4 IL-5, IL-6, IL-8, IL-10, IL-17, eotaxin, fibroblast growth factor, granulocyte colony-stimulating factor, interferon gamma, interferon-inducible protein-10, and macrophage chemoattractant protein-1. There were no dynamic changes in the levels of three cytokines (IL-1 receptor agonist, macrophage inflammatory protein-1α, and platelet-derived growth factor-bb) 72 h after onset. Levels of some cytokines decreased to around control levels within 48 h after onset: IL-1β, IL-4, IL-5, IL-17, fibroblast growth factor, and interferon gamma. The levels of most cytokines appeared to be higher in AE, especially in hemorrhagic shock encephalopathy syndrome, than in FS. Conclusions Cytokine levels in both AE and FS change dynamically, such as the levels of several cytokines increased within a few hours after onset and decreased at 12–24 h after onset. Therefore, it will be desirable to make clinical decisions regarding the administration of anti-inflammatory therapy in 24 h after onset in AE.

Clinical Efficacy of Extracellular Vesicle Therapy in Periodontitis: Reduced Inflammation and Enhanced Regeneration

“…While some cytokines maintained their original distribution, many exhibited non-normal distributions following the therapy. This phenomenon can be attributed to a multitude of factors intricately woven into the nature of the research, the disease, the treatment modality, and the characteristics of the cytokines themselves [ 35 , 36 , 37 , 38 ]: Individuals may respond diversely to EV therapy due to genetic and epigenetic variations, environmental influences, degree of disease, and lifestyle factors. These differences can lead to varying extents of cytokine modulation post-treatment, contributing to the non-normal distribution observed in specific cytokines after therapy.…”

“…While some cytokines maintained their original distribution, many exhibited non-normal distributions following the therapy. This phenomenon can be attributed to a multitude of factors intricately woven into the nature of the research, the disease, the treatment modality, and the characteristics of the cytokines themselves [35][36][37][38]:…”

Timing of therapeutic interventions against infection-triggered encephalopathy syndrome: a scoping review of the pediatric literature

“…Therefore, although corticosteroid therapy is theoretically effective for AEs, the disease conditions, disease severity, and timing of treatment that result in clinical efficacy have not been sufficiently clarified. In our studies on the dynamics of inflammatory cytokines in patients with HSES (a cytokine storm-mediated AE) and ICU-treated patients with febrile status epilepticus, inflammatory cytokine levels peaked within 24 h after neurological symptom onset, followed by a gradual decline in cytokine levels (Yamaguchi et al, 2021;Tomioka et al, 2023). Probably, corticosteroids should be administered preferably within 12 h (T1) and…”