Am J Clin Exp Immunol 2013;2(3):234-244

Original Article
Increased levels of interleukins 2 and 17 in the cerebrospinal fluid of
patients with idiopathic intracranial hypertension

Laura J Edwards, Basil Sharrack, Azza Ismail, Christopher R Tench, Bruno Gran, Samish Dhungana, Johannes
Brettschneider, Hayrettin Tumani, Cris S Constantinescu

Clinical Neurology Research Group, Division of Clinical Neuroscience, University of Nottingham School of Medicine,
Queen’s Medical Centre, Nottingham, NG7 2UH, UK; Sheffield Institute of Translational Neuroscience (SITraN), The
University of Sheffield, 385a Glossop Road, Sheffield S10 2HQ, UK; Klinik und Poliklinik für Neurologie der Universität
Ulm, Oberer Eselsberg 45, D-89081 Ulm, Germany

Received October 1, 2013; Accepted October 12, 2013; Epub October 16, 2013; Published October 30, 2013

Abstract: IIH is a condition of raised intracranial pressure of unknown pathogenesis, which is most commonly seen in
young overweight women. This study was designed to confirm and extend previous reports by our and other groups
showing increased inflammatory cytokine expression in patients with IIH. We analyzed the concentrations of 14 cytokines
(IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-17, IL-22, IL-23, IFNγ, TNFα, TGFβ, and osteopontin) in the serum and
cerebrospinal fluid (CSF) of 17 patients with IIH and 53 patients with other neurological conditions. Patients with IIH had
highly elevated IL-2, IL-4, IL-10, IL-17 and IFNγ in the CSF compared to patients with multiple sclerosis or non-
organic/non-inflammatory neurological conditions. No significant differences were seen between serum cytokine levels
in four patient groups (IIH - multiple sclerosis - inflammatory neurological conditions - non-organic/non-inflammatory
neurological conditions) and there were no correlations between serum and CSF cytokine levels. In IIH, levels of IL-2, IL-
8 and IL-17 were significantly higher in CSF than serum; levels of IL-1β, IL-4, IL-22, IFNγ and TNFα were significantly
higher in serum than CSF. For most cytokines, the CSF/serum cytokine ratio was significantly higher than the CSF/serum
albumin ratio, indicating intrathecal synthesis of these cytokines in IIH. We conclude that IIH is associated with elevated
levels of IL-17 and IL-2 in the CSF, suggesting the involvement of these cytokines in disease pathogenesis.

Keywords: Cerebrospinal fluid, cytokines, idiopathic intracranial hypertension, serum

Address correspondence to: Dr. Laura J Edwards, Clinical Neurology Research Group, Division of Clinical
Neuroscience, University of Nottingham School of Medicine, C Floor, South Block, Queen’s Medical Centre, Nottingham,
NG7 2UH, UK. Tel: 0115 8754597; Fax: 0115 9709738; E-mail:
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