Serum and CSF cytokine profile in patients with facial palsy (Bell’s palsy): a pilot study

Abstract

Abstract Background and purpose Facial nerve palsy is the most common cranial nerve disorder, and over 60% are idiopathic (Bell’s palsy, BP). An inflammatory process is discussed as a causative factor. The aim of this study was to search for changes in various cytokine concentrations in serum and cerebrospinal fluid (CSF) in patients with facial nerve palsy. Methods In this prospective study, 47 patients with peripheral facial nerve palsy were included. Of these, 40 patients were diagnosed as BP and seven patients as non-idiopathic peripheral facial palsy (nipFP). Seventeen cytokines, including IL-1A, IL-5, IL-9, granulocyte colony-stimulating factor (G-CSF), CXCL-13, granulocyte–macrophage-colony-stimulating factor (GM-CSF), tumor necrosis factor-SF13 (TNFSF13), IL-8, IL-1ß, CXCL-10, fractalkine (Fract), monocyte chemotactic protein (MCP-1), IFN-y, IL-4, IL-17A, tumor necrosis factor (TNF), and Granzyme, were measured in the serum and CSF. For comparison, sera from 10 healthy individuals were used. Results In serum, the levels of cytokines G-CSF, CXCL13, TNFSF13, and Granzyme were statistically significantly higher in patients with BP and nipFP compared to healthy individuals ( p < 0.05). Cytokine IL-1ß was significantly higher in nipFP patients compared to healthy individuals and patients with BP ( p < 0.05). Cytokine IL-8 was significantly lower in both patient groups than in healthy individuals ( p < 0.05). In CSF, G-CSF, CXCL13, TNFSF13, IL-8, IL-1ß, and IL-17A were statistically significantly higher in patients with nipFP compared to patients with BP ( p < 0.05). In addition, patients with BP also showed a clustering of cytokine elevation. For differentiating nipFP from BP, serum G-CSF and IL1ß indicated a certain discrimination (AUC 0.643; 0.614). Patients with severe facial palsy revealed higher CSF TNFSF13 ( p = 0.02), and clinical outcome after 3 months was less favorable at higher CSF Fractalkine ( p = 0.025). Elevated CSF cell count was associated with elevated CXCL13, IL-8, IL-1ß, IP-10, IFNa and granzyme in the CSF ( r = 0.32–0.57; p < 0.05). Conclusion Compared to healthy individuals, our study revealed an altered cytokine profile in patients with BP that resembles patients with nipFP. In CSF, a subset of cytokines was identified in patients with BP, but higher levels were found in patients with nipFP, suggesting a graduated inflammatory process. Study registration The study "Serum and CSF cytokine profile in patients with facial palsy (Bell´s palsy)" has been officially registered at the German Clinical Trials Register (DRKS00037815).

Affiliated Institutions

• Universitätsklinikum Erlangen DE
• University of Applied Sciences Landshut DE
• Asklepios DE
• Justus-Liebig-Universität Gießen DE
• Friedrich-Alexander-Universität Erlangen-Nürnberg DE

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