Peripherally derived T regulatory and γδ T cells have opposing roles in the pathogenesis of intractable pediatric epilepsy

D Xu, AP Robinson, T Ishii, DAS Duncan… - Journal of Experimental …, 2018 - rupress.org
D Xu, AP Robinson, T Ishii, DAS Duncan, TD Alden, GE Goings, I Ifergan, JR Podojil
Journal of Experimental Medicine, 2018rupress.org
The pathophysiology of drug-resistant pediatric epilepsy is unknown. Flow cytometric
analysis of inflammatory leukocytes in resected brain tissues from 29 pediatric patients with
genetic (focal cortical dysplasia) or acquired (encephalomalacia) epilepsy demonstrated
significant brain infiltration of blood-borne inflammatory myeloid cells and memory CD4+
and CD8+ T cells. Significantly, proinflammatory (IL-17–and GM-CSF–producing) γδ T cells
were concentrated in epileptogenic lesions, and their numbers positively correlated with …
The pathophysiology of drug-resistant pediatric epilepsy is unknown. Flow cytometric analysis of inflammatory leukocytes in resected brain tissues from 29 pediatric patients with genetic (focal cortical dysplasia) or acquired (encephalomalacia) epilepsy demonstrated significant brain infiltration of blood-borne inflammatory myeloid cells and memory CD4+ and CD8+ T cells. Significantly, proinflammatory (IL-17– and GM-CSF–producing) γδ T cells were concentrated in epileptogenic lesions, and their numbers positively correlated with disease severity. Conversely, numbers of regulatory T (T reg) cells inversely correlated with disease severity. Correspondingly, using the kainic acid model of status epilepticus, we show ameliorated seizure activity in both γδ T cell– and IL-17RA–deficient mice and in recipients of T reg cells, whereas T reg cell depletion heightened seizure severity. Moreover, both IL-17 and GM-CSF induced neuronal hyperexcitability in brain slice cultures. These studies support a major pathological role for peripherally derived innate and adaptive proinflammatory immune responses in the pathogenesis of intractable epilepsy and suggest testing of immunomodulatory therapies.
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