Zhao Huawei, Li Shan, Xie Meijuan, Chen Rongrong, Lu Haimei, Wen Chengping, Filiano Anthony J, Xu Zhenghao
Department of Pharmacy, Zhejiang University School of Medicine Children's Hospital, Hangzhou, Zhejiang, China.
Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Ther Adv Chronic Dis. 2020 Feb 7;11:2040622319899300. doi: 10.1177/2040622319899300. eCollection 2020.
An increasing number of studies support an association between rheumatoid arthritis (RA) and brain disorders. This study aims to determine the association between RA and epilepsy.
A comprehensive search of databases in both English and Chinese was performed. Data from the selected studies were extracted and analyzed independently by two authors. Genes associated with epilepsy and RA were also collected and analyzed.
We included six nationwide population based studies ( = 7,094,113 cases in total) for the meta-analysis. The risk of epilepsy was increased in RA patients [risk ratio (RR) = 1.601; 95% confidence interval (CI): 1.089-2.354; = 0.017; = 3,803,535 cases] and children born to mothers with RA (RR = 1.475; 95% CI: 1.333-1.633; < 0.001, = 3,290,578 cases). Subgroup analysis and meta-regression showed the RR of epilepsy in RA was negatively correlated with age. Furthermore, we found that 433 identified genes in a coexpression network from the hippocampi of 129 epileptic patients were enriched in the RA and related Kyoto Encyclopedia of Genes and Genomes pathways, while 13 genes (mainly related to inflammatory cytokines and chemokines) were identified as potential key genes bridging the RA and epilepsy.
Our study, utilizing meta-analysis and bioinformatical data, highlights a close association between epilepsy and RA. Further studies are still warranted to expand these findings, especially for a population that is exposed to RA during fetal and childhood periods.
越来越多的研究支持类风湿关节炎（RA）与脑部疾病之间存在关联。本研究旨在确定RA与癫痫之间的关联。
对中英文数据库进行全面检索。两位作者独立提取并分析所选研究的数据。还收集并分析了与癫痫和RA相关的基因。
我们纳入了六项基于全国人群的研究（共7,094,113例）进行荟萃分析。RA患者患癫痫的风险增加[风险比（RR）=1.601；95%置信区间（CI）：1.089 - 2.354；P = 0.017；n = 3,803,535例]，以及母亲患有RA的儿童（RR = 1.475；95% CI：1.333 - 1.633；P < 0.001，n = 3,290,578例）。亚组分析和荟萃回归显示，RA患者癫痫的RR与年龄呈负相关。此外，我们发现，在129例癫痫患者海马体共表达网络中鉴定出的433个基因在RA及相关京都基因与基因组百科全书通路中富集，而13个基因（主要与炎性细胞因子和趋化因子相关）被鉴定为连接RA和癫痫的潜在关键基因。
我们的研究利用荟萃分析和生物信息学数据，突出了癫痫与RA之间的密切关联。仍有必要进一步开展研究以扩展这些发现，特别是针对在胎儿期和儿童期接触过RA的人群。
