肿瘤坏死因子-α在局灶性皮质发育不良相关难治性癫痫的表达及临床意义

Expression and clinical implication of tumor necrosis factor-alpha in the intractable epilepsy with focal cortical dysplasias

目的探讨肿瘤坏死因子-α（TNF-α）及其受体p55、p75在局灶性皮质发育不良（FCD）相关难治性癫痫（IE）癫痫灶中的表达及临床意义。方法免疫组织化学链霉亲和素-生物素-过氧化物酶复合物（SABC）法检测29例FCD相关IE组癫痫灶与10例对照组脑组织TNF-α、p55、p75的表达。结果对照组TNF-α、p55、p75全部阴性表达；在FCDⅢ型中表达强度比Ⅱ型中高（P〈0．05），FCDⅢ型与Ⅰ型、Ⅱ型与Ⅰ型之间表达强度差异无统计学意义（P〉0．05）；其在Ⅰ型与Ⅱ型中有少数胶质细胞表达，Ⅲ型胶质细胞多数有表达；在髓质中，TNF-α、p55、p75在异位神经元、活化的星形胶质细胞阳性表达，而在形态异常神经元（DNs）、气球样细胞（BCs）中的表达强度较其他类型神经元弱，BCs的表达明显较DNs弱。结论TNF-α通过与其受体结合可能参与了各种类型FCD相关IE的发生、发展。

Objective To investigate the expression and clinical implication of tumor necrosis fac- tor-alpha （TNF-α） , and its receptors lO55 and lO75 in the intractable epilepsy with focal cortical dysplasias （FCD）. Methods The expression of TNF-α, p55 and p75 was detected by suing strept avidin-biotin complex （SABC） staining in epileptic foci of refractory epilepsy group （ including 29 cases of FCD） and 10 cases of normal brain tissue （control group）. Results The expression of TNF-α, p55 and p75 in the control group was negative, The expression intensity of TNF-α, p55 and p75 in the FCD type Ⅲ was stronger than the FCD type Ⅱ, but there was no significant difference between type Ⅲ and type I, and between type Ⅱ and type I. A small fraction of glial cells expressed TNF-α, p55 and p75 in the FCD type Ⅰ and type Ⅱ, but the majority of glial cells expressed them in the type Ⅲ. The expression of TNF-α, p55 and of p75 was detectable in both ectopic neurons and activated astrocytes of the medulla, and their expression in dysmor- phic neurons （DNs） and balloon cells （BCs） in the FCD type II was weaker than in other types of neu- rons. The expression intensity of TNF-α, p55 and p75 in BCs was significantly weaker that in DNs. Conclusion TNF-α through binding its receptors, p55 and p75, may be involved in the generation and development of epilepsy in the FCD.