Department of Clinical Laboratory, General Hospital of the Yangtze River Shipping, Wuhan, 430005, China.
Neurol Sci. 2023 Jul;44(7):2329-2337. doi: 10.1007/s10072-023-06720-0. Epub 2023 Mar 18.
Epilepsy pathogenesis and progression are strongly influenced by inflammation. High-mobility group box-1 (HMGB1) is a key proinflammatory factor. The purpose of this study was to quantify and assess the relationship between HMGB1 level and epilepsy.
We searched Embase, Web of Science, PubMed, and the Cochrane Library for studies examining the relationship between HMGB1 and epilepsy. Two independent researchers extracted data and assessed quality using the Cochrane Collaboration tool. Data extracted were analyzed using Stata 15 and Review Manager 5.3. The study protocol was registered prospectively at INPLASY, ID: INPLASY2021120029.
A total of 12 studies were eligible for inclusion. After exclusion of one study with reduced robustness, 11 studies were included, with a total of 443 patients and 333 matched controls. Two of the articles included cerebrospinal fluid and serum HMGB1 data, which were distinguished by "a" and "b," respectively. The meta-analysis indicated that in comparison with the control group, the HMGB1 level was higher in epilepsy patients (SMD = 0.56, 95% CI = 0.27-0.85, P = 0.0002). Subgroup analysis of specimen types indicated that both serum HMGB1 and cerebrospinal fluid HMGB1 were higher in epilepsy patients than in the control group, with the increase in cerebrospinal fluid HMGB1 being more obvious. Subgroup analysis of disease types demonstrated that the serum HMGB1 level of epileptic seizure patients (including febrile and nonfebrile seizures) was significantly higher than that of matched controls. However, serum HMGB1 levels did not differ significantly between mild epilepsy patients and severe epilepsy patients. Patient age subgroup analysis showed higher HMGB1 in adolescents with epilepsy. Begg's test did not indicate publication bias.
This is the first meta-analysis to summarize the association between HMGB1 level and epilepsy. The results of this meta-analysis indicate that epilepsy patients have elevated HMGB1. Large-scale studies with a high level of evidence are needed to reveal the exact relationship between HMGB1 level and epilepsy.
癫痫的发病机制和进展受炎症的强烈影响。高迁移率族蛋白 B1（HMGB1）是一种关键的促炎因子。本研究的目的是定量评估 HMGB1 水平与癫痫之间的关系。
我们在 Embase、Web of Science、PubMed 和 Cochrane 图书馆中检索了研究 HMGB1 与癫痫关系的文献。两名独立的研究者使用 Cochrane 协作工具提取数据并评估质量。使用 Stata 15 和 Review Manager 5.3 分析提取的数据。研究方案在 INPLASY 进行了前瞻性注册，编号为 INPLASY2021120029。
共有 12 项研究符合纳入标准。排除一项稳健性降低的研究后，共有 11 项研究纳入，共计 443 名患者和 333 名匹配对照。其中两篇文章分别包含脑脊液和血清 HMGB1 数据，分别用“a”和“b”区分。荟萃分析表明，与对照组相比，癫痫患者的 HMGB1 水平更高（SMD=0.56，95%CI=0.27-0.85，P=0.0002）。标本类型的亚组分析表明，血清和脑脊液 HMGB1 水平在癫痫患者中均高于对照组，且脑脊液 HMGB1 水平升高更为明显。疾病类型的亚组分析表明，癫痫发作患者（包括热性和非热性癫痫发作）的血清 HMGB1 水平明显高于匹配对照组。然而，轻度癫痫患者和重度癫痫患者之间的血清 HMGB1 水平没有显著差异。患者年龄亚组分析显示，青少年癫痫患者的 HMGB1 水平较高。Begg 检验未提示存在发表偏倚。
这是第一项总结 HMGB1 水平与癫痫之间关系的荟萃分析。该荟萃分析的结果表明，癫痫患者的 HMGB1 水平升高。需要开展大规模、高质量的研究来揭示 HMGB1 水平与癫痫的确切关系。
