Interleukin-1 beta, interleukin-1 receptor antagonist levels in patients with subacute sclerosing panencephalitis and the effects of different treatment protocols

Subacute sclerosing panencephalitis is a rare progressive inflammatory dise ase of the central nervous system caused by a persistent aberrant measles v irus infection. Cytokines are polypeptides that regulate immune responses a nd inflammatory reactions. Interleukin-1 beta has been implicated as a cent ral mediator of tissue damage and destruction in a number of central nervou s system diseases. Interleukin-1 receptor antagonist could function as an i mportant anti-inflammatory cytokine. We studied interleukin-1 beta and inte rleukin-1 receptor antagonist levels in the cerebrospinal fluids of patient s with subacute sclerosing panencephalitis and evaluated the effects of dif ferent treatment protocols on these cytokines. Interleukin-1 beta and inter leukin-1 receptor antagonist levels were measured in 15 patients who had a recent diagnosis of subacute sclerosing panencephalitis (group 1), 6 patien ts who had been treated with isoprinosine (group 2), 5 patients with intrav entricular interferon-alpha (group 3), and 6 patients with interferon-beta (group 4). The results were compared within the groups and also with the re sults of 10 patients with other neurologic disease (group 5). The interleuk in-1 beta concentrations in cerebrospinal fluid and sera were all below the detection limits (3.9 pg/mL). Interleukin-1 receptor antagonist levels wer e not statistically different, except for the group treated with intraventr icular interferon-a. Interleukin-1 receptor antagonist levels were 170 +/- 52, 175 +/- 58, 1605 +/- 518, 77.5 +/- 24, and 108 +/- 18 pg/mL in groups 1 to 5, respectively. Interleukin-1 receptor antagonist levels and cerebrosp inal fluid serum ratios were significantly increased during interferon-alph a treatment. In conclusion, interleukin-1 and interleukin-1 receptor antago nist levels were not elevated in the patients with subacute sclerosing pane ncephalitis. The only treatment protocol that affects interleukin-1 recepto r antagonist levels in cerebrospinal fluid was intraventricular interferon- alpha. Further studies on higher numbers of patients may better document th e immunologic status of patients with subacute sclerosing panencephalitis a nd the effects of different treatment modes.