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.

中文翻译：

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基质金属蛋白酶2和高迁移率族框1在难治性癫痫患者中的诊断价值

介绍 有大量炎症分子和体液介质可参与癫痫发生，例如细胞因子、基质金属蛋白酶 (MMP) 和高迁移率族框 1 (HMGB1)。我们旨在评估伊拉克癫痫患者的血清水平和 MMP-2 和 HMGB1 的诊断价值。方法 100名癫痫患者包括60名控制癫痫患者和40名使用多种抗癫痫药物（AEDs）治疗的难治性患者。选择其他 50 名与家庭无关的年龄和性别匹配的健康受试者代表对照组。使用ELISA估计MMP-2和HMGB1的血清水平。需要时使用受试者工作特征 (ROC) 曲线来评估这些标志物的诊断价值。结果对照组MMP-2水平显着高于一般癫痫患者（对照组和难治性患者）。ROC 曲线显示 MMP-2 在将癫痫患者区分为对治疗有反应或难治的癫痫患者方面的诊断价值较差（AUC = 0.679（95% CI = 0.536-0.823）和 AUC = 0.77（95% CI = 0.637-902），分别）。癫痫患者和对照的血清 HMGB1 水平彼此非常接近。结论 MMP-2在患者尤其是难治性癫痫（RE）患者中显着降低；然而，它的诊断价值很差。癫痫患者和对照组之间的血清 HMGB1 水平没有差异。显示 MMP-2 在区分癫痫患者对治疗有反应或难治方面的诊断价值较差（分别为 AUC = 0.679（95% CI = 0.536-0.823）和 AUC = 0.77（95% CI = 0.637-902））。癫痫患者和对照的血清 HMGB1 水平彼此非常接近。结论 MMP-2在患者尤其是难治性癫痫（RE）患者中显着降低；然而，它的诊断价值很差。癫痫患者和对照组之间的血清 HMGB1 水平没有差异。显示 MMP-2 在区分癫痫患者对治疗有反应或难治方面的诊断价值较差（分别为 AUC = 0.679（95% CI = 0.536-0.823）和 AUC = 0.77（95% CI = 0.637-902））。癫痫患者和对照的血清 HMGB1 水平彼此非常接近。结论 MMP-2在患者尤其是难治性癫痫（RE）患者中显着降低；然而，它的诊断价值很差。癫痫患者和对照组之间的血清 HMGB1 水平没有差异。它的诊断价值很差。癫痫患者和对照组之间的血清 HMGB1 水平没有差异。它的诊断价值很差。癫痫患者和对照组之间的血清 HMGB1 水平没有差异。