Department of Pediatrics of Medicine, Akdeniz University Hospital, Antalya, Turkey.
Department of Medical Pharmacology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
Epilepsy Res. 2021 Jan;169:106516. doi: 10.1016/j.eplepsyres.2020.106516. Epub 2020 Nov 28.
Fever-induced inflammatory processes and pro-inflammatory cytokines have gained importance in recent years in the pathogenesis of febrile convulsion. Increased levels of HMGB1 (high mobility group box 1), one of the most important pro-inflammatory cytokines, are associated with prolongation of seizure duration, recurrence of seizures and the development of epilepsy. Changes in the sTLR4 level (soluble toll-like receptor 4) in the cerebrospinal fluid (CSF) are thought to be associated with memory and learning functions. In our study, we aimed to evaluate changes in HMGB1 and sTLR4 levels in patients who had febrile seizures between 6 months and 6 years.
Forty patients who were admitted to Akdeniz University Medical Faculty Hospital between April 2016 and April 2018 with a complaint of febrile seizure and 45 patients whose CSF samples were taken for complaints other than febrile convulsion (control group) were included in our study.
Comparison of the CSF HMGB1 levels of the febrile convulsion group and control group revealed a statistically significant increase in patients with febrile convulsions (p: 0.001). Comparison of the subgroups revealed that the mean value of CSF HMGB1 level was highest in the complex FS group with a mean value of 3363.9 ± 835,47 pg/mL. Comparison of the patient and control groups revealed that the changes in CSF sTLR4 levels were not statistically significant.
HMGB1 level, a key inflammatory molecule, was significantly higher in the CSF of children with febrile seizures. Our data suggest that the HMGB1 network may contribute to the generation of febrile seizures in children.
发热引起的炎症过程和促炎细胞因子近年来在热性惊厥的发病机制中变得尤为重要。高迁移率族蛋白 1（HMGB1）水平升高，作为最重要的促炎细胞因子之一，与癫痫持续时间延长、癫痫发作复发和癫痫的发生有关。脑脊液（CSF）中可溶性 TLR4 水平（sTLR4）的变化被认为与记忆和学习功能有关。在我们的研究中，我们旨在评估 6 个月至 6 岁热性惊厥患者 HMGB1 和 sTLR4 水平的变化。
本研究纳入了 2016 年 4 月至 2018 年 4 月因热性惊厥入住阿特丹大学医学院附属医院的 40 例患者和因发热以外的其他原因接受 CSF 取样的 45 例患者（对照组）。
比较热性惊厥组和对照组 CSF HMGB1 水平，发现热性惊厥患者的 HMGB1 水平显著升高（p：0.001）。亚组比较显示，复杂 FS 组 CSF HMGB1 水平均值最高，为 3363.9±835.47pg/mL。比较患者组和对照组发现 CSF sTLR4 水平的变化无统计学意义。
HMGB1 是关键的炎症分子，在热性惊厥患儿的 CSF 中显著升高。我们的数据表明，HMGB1 网络可能有助于儿童热性惊厥的发生。
