title: Inflammatory mediators in human epilepsy: A systematic review and meta-analysis.
abstract: BACKGROUND
  Accumulating evidence suggests a role for inflammation in the pathophysiology of epilepsy.
  
  
  METHODS
  We performed a systematic review and meta-analysis of studies that investigated inflammatory mediators in human epilepsy. Studies reporting on inflammatory mediators in serum, cerebrospinal fluid or brain tissue of epilepsy patients were included. Studies comparing patients to controls were included in a meta-analysis.
  
  
  RESULTS
  66 articles reporting on 1934 patients were included. IL-1ra, IL-1β, IL-6, IL-10, IFN-γ and TNF-α were the most extensively investigated proteins. Elevated levels for IL-1ra, IL-1β, IL-6 and CXCL8/IL-8 were reported in several different epilepsy etiologies and media, while other proteins were specifically increased for one etiology. IL-1α, IL-7 and IL-13, as well as the chemokines CCL2-5, -19 and -22, were increased exclusively in brain tissue. In an aggregate meta-analysis, we found significantly different protein levels for serum IL-6, IL-17 and CSF IL-1β and IL-10.
  
  
  CONCLUSIONS
  Inflammatory pathways are involved in epilepsy. Future studies may further clarify their role, and prove potential of targeted anti-inflammatory treatment.
authors.affiliation: Brain Center Rudolf Magnus, Department of Pediatric Neurology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: eveliendevriez@gmail.com.
authors.forename: Evelien E
authors.initials: EE
authors.lastname: de Vries
authors.affiliation: Brain Center Rudolf Magnus, Department of Pediatric Neurology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: B.vandenMunckhof@umcutrecht.nl.
authors.forename: Bart
authors.initials: B
authors.lastname: van den Munckhof
authors.affiliation: Brain Center Rudolf Magnus, Department of Pediatric Neurology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: K.Braun@umcutrecht.nl.
authors.forename: Kees P J
authors.initials: KP
authors.lastname: Braun
authors.affiliation: Department of Pediatric Immunology, Laboratory of Translational Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands. Electronic address: A.vanRoyen@umcutrecht.nl.
authors.forename: Annet
authors.initials: A
authors.lastname: van Royen-Kerkhof
authors.affiliation: Department of Pediatric Immunology, Laboratory of Translational Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands. Electronic address: wjager@umcutrecht.nl.
authors.forename: Wilco
authors.initials: W
authors.lastname: de Jager
authors.affiliation: Brain Center Rudolf Magnus, Department of Pediatric Neurology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: F.E.Jansen@umcutrecht.nl.
authors.forename: Floor E
authors.initials: FE
authors.lastname: Jansen
mesh_terms: D001921:Brain / Q000378:metabolism*; D004827:Epilepsy / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications / Q000378:metabolism*; D018836:Inflammation Mediators / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism*
chemical_list: D018836:Inflammation Mediators
keywords: Cytokines; Epilepsy; Febrile seizures; Inflammation; Meta-analysis; Systematic review