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Histopathologically, FCD 2 is subdivided into FCD 2a and FCD 2b, the only discriminator being the presence of balloon cells (BCs) in FCD 2b. While pro\u2010epileptogenic immune system activation and inflammatory responses are commonly detected in both subtypes, it is unknown what contextual role BCs play.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The present study employed RNA sequencing of surgically resected brain tissue from FCD 2a (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a011) and FCD 2b (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a020) patients compared to autopsy control (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a09) focusing on three immune system processes: adaptive immunity, innate immunity and cytokine production. This analysis was followed by immunohistochemistry on a clinically well\u2010characterised FCD 2 cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Differential expression analysis revealed stronger expression of components of innate immunity, adaptive immunity and cytokine production in FCD 2b than in FCD 2a, particularly complement activation and antigen presentation. Immunohistochemical analysis confirmed these findings, with strong expression of leukocyte antigen I and II in FCD 2b as compared to FCD 2a. Moreover, T\u2010lymphocyte tissue infiltration was elevated in FCD 2b. Expression of markers of immune system activation in FCD 2b was concentrated in subcortical white matter. Lastly, antigen presentation was strongly correlated with BC load in FCD 2b lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We conclude that, next to mutation\u2010driven mTOR activation and seizure activity, BCs are crucial drivers of inflammation in FCD 2b. Our findings indicate that therapies targeting inflammation may be beneficial in FCD 2b.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nan.12736","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T09:03:04Z","timestamp":1621328584000},"page":"826-839","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Balloon cells promote immune system activation in focal cortical dysplasia type 2b"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6869-3697","authenticated-orcid":false,"given":"Till S.","family":"Zimmer","sequence":"first","affiliation":[{"name":"Department of (Neuro)Pathology Amsterdam UMC University of Amsterdam Amsterdam Neuroscience  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4842-0659","authenticated-orcid":false,"given":"Diede W. M.","family":"Broekaart","sequence":"additional","affiliation":[{"name":"Department of (Neuro)Pathology Amsterdam UMC University of Amsterdam Amsterdam Neuroscience  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Luinenburg","sequence":"additional","affiliation":[{"name":"Department of (Neuro)Pathology Amsterdam UMC University of Amsterdam Amsterdam Neuroscience  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Mijnsbergen","sequence":"additional","affiliation":[{"name":"Department of (Neuro)Pathology Amsterdam UMC University of Amsterdam Amsterdam Neuroscience  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper J.","family":"Anink","sequence":"additional","affiliation":[{"name":"Department of (Neuro)Pathology Amsterdam UMC University of Amsterdam Amsterdam Neuroscience  Amsterdam The 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