Serum HMGB1 in febrile seizures.

The role of high-mobility group box 1 (HMGB1) in the pathogenesis of febrile seizures (FSs) is unclear. In our controlled follow-up study, we compared serum levels of HMGB1 (s-HMGB1) in the same individuals after the first FS, during febrile episodes without a FS, after recurrent FS, during healthy periods after FS, and between patients and controls. In all, 122 patients with FSs were included in the final analysis, including 18 with recurrent FSs with a complete follow-up protocol. We recruited 30 febrile children and 18 matched febrile children without seizures as controls. S-HMGB1 was lower in patients with recurrent FSs after the first FS than that in matched febrile control children (median 1.12 μg/L (0.14–2.95) vs 1.79 μg/L (0.33–47.90), P<0.04). We did not find any other differences in s-HMGB1 between the groups. S-HMGB1 did not differ in different types of FSs. We updated a meta-analysis of s-HMGB1 in patients with FSs and found that the differences were significant only in the studies conducted in East Asian populations. We conclude that S-HMGB1 does not seem to be a key factor in the pathogenesis of FSs but differences in HMGB1 concentrations could explain some of the ethnicity related susceptibility to FSs. • In patients with recurrent FSs, s-HMGB1 was lower after first FS than in controls. • There were no differences in s-HMGB1 between different visits of patients with FSs. • In the meta-analysis, differences in s-HMGB1 were significant only in the East Asian studies. • S-HMGB1 does not seem to be a key factor in the pathomechanism of FSs. • S-HMGB1 could explain some of the ethnicity-related susceptibility to FSs. [ABSTRACT FROM AUTHOR]