Introduction: There are large numbers of inflammatory molecules and humoral mediators that can be involved in
the epileptogenesis such as cytokines, matrix metalloproteinases (MMP), and high mobility group box-1 (HMGB1).
We aimed to evaluate serum levels and the diagnostic value of MMP-2 and HMGB1 in Iraqi patients with epilepsy.
Methods: One hundred epileptic patients comprised 60 controlled epileptics and 40 refractory patients to treatment
with multi antiepileptic drugs (AEDs). Other 50 family-unrelated age- and sex-matched healthy subjects were selected
to represent the control group. Serum levels of MMP-2 and HMGB1 were estimated using ELISA. The receiver operating
characteristic (ROC) curve was used to evaluate the diagnostic value of these markers when required.
Results: MMP-2 level was significantly higher in controls than epileptic patients in general (controlled and refractory
patients). ROC curve, showed poor diagnostic value of MMP-2 in discriminating epileptics into responsive or refractory
to treatment from controls (AUC = 0.679 (95% CI = 0.536-0.823), and AUC = 0.77 (95% CI = 0.637-902), respectively).
Serum HMGB1 level in epileptic patients and controls was in close approximation to each other.
Conclusions: MMP-2 is significantly decreased in patients particularly those with refractory epilepsy (RE); however, it
has poor diagnostic value. No difference in the serum HMGB1 level between epileptic patients and controls.
Keywords: Refractory epilepsy, MMP-2, HMGB1
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