The Level Of NETs In Cerebrospinal Fluid And Plasma Of Patients After Epileptic Seizure

Objective An increasing number of evidence suggests that inflammatory responses by leukocytes infiltration to the brain can play an important role in the occurrence and development of seizure.However,the mechanism of leukocytes causing neurons damage is still unclear.Neutrophil extracellular traps(NETs)is a web-like structure in the extracellular released by neutrophils,composed of DNA and antimicrobial proteins like histones and myeloperoxidase.It plays an important role in the infectious disease and neurons damage.The objective of this study was to evaluate the levels of NETs(dsDNA ? MPO)in cerebrosspinal fluid(CSF)and plasma in patients after generalized tonic-clonic(GTCS)seizure in the first 24 hours and to investigate the correlation between NETs(dsDNA?MPO)and Blood-brain barrier permeability.Methods This study was performed at the Department of Neurology in the First Affiliated Hospital of Xi'an Medical University.A total of 31 patients with GTCS seizure and 27 patients with tension headache were included in this study from November 2015 to December 2016.CSF and blood sampling were obtained from lumbar puncture and venipuncture within the first 24 hours of seizures.The concentrations of NETs(dsDNA?MPO)and S100 B protein were determined by picoGreen dsDNA Quantitation kits and enzyme-linked immunosorbent assay(ELISA),and then analyzed the correlation between them.Data are presented as mean ± SD for normally distributed,and M(LQ,UQ)for non-parametric data.Student's t-test and Mann-Whitney U-test were used for comparison of normally distributed and non-parametric data between two independent groups respectively.Wilcoxon signed rank test was used for comparison of non-parametric data,between two related groups.The qualitative data were examined using the chi-square test.Spearman's correlation coefficient was used to correlate variables in the groups studied.For all tests,(49)(27)0.05 was considered significant.Results We found that dsDNA concentrations in CSF and plasma of seizure patients were significantly higher than controls((49)(27)0.05;(49)(27)0.001),also,MPO concentrations in CSF and plasma of seizure patients were significantly higher than controls(both(49)(27)0.05).We measured an increased S100 B protein concentrations in plasma compared with controls((49)(27)0.05).While there was no correlation between NETs(dsDNA?MPO)concentrations in CSF/plasma and S100 B in plasma(both(49)> 0.05).Conclusions The levels of NETs(dsDNA?MPO)in CSF and plasma of GTCS seizure patients was increased,suggesting that NETs may plays an important role in the occurrence and development of epilepsy.The concentrations of S100 B in plasma of seizure patients were higher than controls,confirming a significant correlation between seizure and blood brain barrier(BBB)damage.While no correlation between NETs(dsDNA?MPO)in CSF/plasma and S100 B in plasma of seizure patients was found,suggesting that the forming of NETs and blood brain barrier(BBB)damage after seizure may have no significant correlation.