Immunohistochemical evaluation of the autoantibodies in surgically treated MTLE-HS patientsAysegul Firat1, Fadime Irsel Tezer Filik2, Isik Unal3, Burcak Bilginer5, Figen Kaymaz3, Figen Soylemezoglu4, Serap Saygi2
2Department of Neurology, Hacettepe University, Ankara, Turkey
3Department of Histology and Embryology, Hacettepe University, Ankara, Turkey
4Department of Pathology, Hacettepe University, Ankara, Turkey
5Department of Neurosurgery, Hacettepe University, Ankara, Turkey
Introduction & Objectives
Epilepsy is one of the most common neurologic disease affecting many people worldwide. In many patients etiology is still unknown. In the recent years clinically detected autoantibodies in certain types of epilepsies attracted researches about the possible relation between the autoimmune parameters and epilepsies. In this study our aim was to evaluate the inflammatory parameters of surgically excised fresh frozen human brain samples in mesial temporal lobe epilepsy with hippocampal sclerosis patients.
Materials & Methods
Our study was composed of pathologically and radiologically proven 22 cases of MTLE-HS patients treated and followed in our neurology clinic. The patients were pharmacoresistant to the theraphy and were treated surgically by temporal lobectomy. Their pathological examinations confirmed the diagnosis. Post-surgically, frozen tissues were prepared to be stained with anti-NMDA receptor antibody, anti-Kv4.3 antibody, anti-GAD antibody, anti-NeuN antibody, anti-GFAP antibody and anti-CD3 and anti CD8 antibodies in order to evaluate the immunological parameters semiquantitatively.
In our patient group there were 13 patients with typical sclerosis (HS-1), 2 patients with gliosis and 7 patients with atypical sclerosis (HS-2, HS-3 and HS-3 dysplasia) according to the ILEA classification. We have seen that there was a statistically confirmed difference betwwen CD3 and CD8 levels of patients with typical vs. atypical hippocampal sclerosis. In atypical HS patients there was not any immunoreactivity for the Kv4.3 receptors in both temporal lobe and hippocampus regions and also no immunoreactivity was observed for NMDA receptors in only hippocampus samples.
Immunotherapies of patients with neurological diseases have been changing very rapidly. Such descriptive studies with immunohistochemistry of frozen human tissue samples will help to evaluate the clinical outcome and improve the treatment of the patients. For such reasons we have to expand the patient number and make comparisons with CSF and serum values of the antibodies against neuronal tissues.