Walker Lauren Elizabeth, Sills Graeme John, Jorgensen Andrea, Alapirtti Tiina, Peltola Jukka, Brodie Martin J, Marson Anthony Guy, Vezzani Annamaria, Pirmohamed Munir
Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK.
Department of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Finland.
Epilepsia. 2022 Jan;63(1):e1-e6. doi: 10.1111/epi.17116. Epub 2021 Nov 8.
Currently no sensitive and specific biomarkers exist to predict drug-resistant epilepsy. We determined whether blood levels of high-mobility group box 1 (HMGB1), a mediator of neuroinflammation implicated in drug-resistant epilepsies, identifies patients with drug-resistant seizures. Patients with drug-resistant epilepsy express significantly higher levels of blood HMGB1 than those with drug-responsive, well-controlled seizures and healthy controls. No correlation existed between blood HMGB1 levels and total pretreatment seizure count or days since last seizure at new epilepsy diagnosis, indicating that blood HMGB1 does not solely reflect ongoing seizures. HMGB1 distinguishes with high specificity and selectivity drug-resistant versus drug-responsive patients. This protein therefore has potential clinical utility to act as a biomarker for predicting response to therapy, which should be addressed in prospective clinical studies.
目前尚无敏感且特异的生物标志物可用于预测耐药性癫痫。我们研究了高迁移率族蛋白B1（HMGB1）的血液水平，其作为一种与耐药性癫痫相关的神经炎症介质，能否用于识别耐药性癫痫发作的患者。耐药性癫痫患者血液中HMGB1的表达水平显著高于药物反应性良好、发作得到有效控制的患者以及健康对照者。血液中HMGB1水平与新诊断癫痫患者的治疗前癫痫发作总数或自上次发作以来的天数之间无相关性，这表明血液中的HMGB1并不能单纯反映癫痫的持续发作情况。HMGB1能够以高特异性和选择性区分耐药性患者与药物反应性患者。因此，这种蛋白质具有作为预测治疗反应生物标志物的潜在临床应用价值，这一点应在前瞻性临床研究中加以探讨。
