2020 Fiscal Year Final Research Report
Elucidation of the pathophysiology of refractory status epilepticus by comprehensive inflammation analysis and development of new diagnosis and treatment methods
| Project/Area Number |
18K08918
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 55060:Emergency medicine-related
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| Research Institution | Kobe University |
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Principal Investigator |
Nagase Hiroaki 神戸大学, 医学研究科, 特命教授 (80571968)
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| Co-Investigator(Kenkyū-buntansha) |
森岡 一朗 日本大学, 医学部, 教授 (80437467)
篠原 正和 神戸大学, 医学研究科, 准教授 (80437483)
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| Project Period (FY) |
2018-04-01 – 2021-03-31
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| Keywords | 熱性けいれん / てんかん重積状態 / 急性脳症 / 炎症 / サイトカイン / GDF-15 |
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| Outline of Final Research Achievements |
Febrile status epilepticus (FSE) and refractory FSE (fRSE) are common in pediatric emergency, and are often diagnosed as acute encephalopathy with serious outcomes such as death and sequelae. In this study, we found that in pediatric patients with fRSE, inflammatory cytokines peaked within 24 hours of onset and then decreased, regardless of the final diagnosis or outcome. We also revealed that the inflammation-related protein GDF15 reported as an excellent pathological and prognostic markers such as sepsis was also significantly elevated in FSE, peaked out within 12 hours of onset. Furthermore, the peak value of GDF-15 within 6 hours of onset was shown to be associated with the neurological sequelae in children with FSE.
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| Free Research Field |
小児神経学、小児神経救急集中治療学
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| Academic Significance and Societal Importance of the Research Achievements |
FSE, fRSEと炎症性サイトカインが関連することはこれまでにも報告されており，抗炎症治療が行われているが，発症24時間以内にはすでにピークアウトしていることが本研究で初めて明らかになった．さらに炎症関連蛋白であるGDF-15は発症12時間以内にピークアウトしていること，発症6時間以内の値が転帰と関連することも今回初めて明らかとなった．炎症のピークとなる時間が6－12時間であることが明らかになったことで，今後fRSEに対する抗炎症治療の有効性、ゴールデンタイムの解明につながる成果であると考えた。
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