Study On The Correlation Between3Serum Autoantibodies And Intractable Epilepsy

Objective: To investigate the pathogenetic correlation of glutamic aciddecarboxylase antibody、ganglioside antibody、anticardiolipin antibody andadult intractable epilepsy (IE），analyze the relationship between levels of thethree antibodies and different clinical types of adult intractable epilepsy,meanwhile to explore the immunologic pathogenetic correlation of IE anddiabetes (DM).Method: Thirty IE patients were chosen in sequence from IE diagnosticcenter of neurology department of the First Hospital affiliated Jilin Universityfrom January2011to December2011as IE group, meanwhile another30mildepilepsy patients were chosen in sequence as normal epilepsy group(NE), and30healthy persons were chosen randomly from physical examination centerduring the same period as normal control group(NC). All patients in both IEand NE group meet the diagnostic standard of classification which was built upby International League Against Epilepsy(ILAE) in1981, and meet thedefinition of epilepsy and epilepsy syndrome in1989as well as the newestassociatively definition on intractable epilepsy. General conditions, clinicalepisode types, laboratory results about the patients were recorded separately.Fasting blood were collected in all patients and healthy control group detect thelevels of lutamic acid decarboxylase antibody, ganglioside antibody, andanticardiolipin antibody by enzyme linked immunosorbent assay (ELISA)method. All data were analyzed by statistic package for social science17.0(SPSS17.0). Test of normality was performed among all the variables. Thequantitative data which meet normal distribution was tested by T-test, otherwiseby Mann-Whitney U Test. Rates of sample were compared by χ2test，and when n<40or T<1Fisher’s Exact Test was used. As for quantitative data which meetnormality distribution, correlation analysis between two groups，were analyzedby Pearson analysis method, otherwise by Spearman correlation test.(α=0.05)。Results: The levels of glutamic acid decarboxylase antibody, gangliosideantibody, and anticardiolipin antibody in IE group were higher than those in NEand NC groups significantly(p<0.05). In IE group, the positive rate of the threeantibodies was60%,80%, and76.67%respectively; at the same time, thepositive rate of the three antibodies were found apparently consistent with theclinical diagnosis of IE. There were no statistic significance in levels of thethree antibodies between NE and NC group. Besides the positive correlationwas found between the three antibodies levels and course of IE. Combinativedetection of GM1-A and ACA antibodies was performed preferentially in IEclinical diagnosis and treatment decision making.Conclusion Adult intractable epilepsy is related with autoimmunologicabnormality, and several autoantibodies can be detected in IE patients’peripheral blood serum; The three antibodies (glutamic acid decarboxylaseantibody、ganglioside antibody、anticardiolipin antibody) levels have positivecorrelation with IE course and episode frequency. Detection of three antibodiesplays an important guiding role in diagnosis、medical decision-making andprognosis judgment of IE. Combinative detection of GM1-A and ACA probablyis sensitive index to the clinical diagnosis of immune intractable epilepsy.Refractory epilepsy associated with autoimmune diabetes on pathogenesis ofimmunology. More with elevated blood glucose in GADA antibody-positive inthe IE group and NE group comparison.