Proinflammatory and anti-inflammatory cytokines in febrile seizures and epilepsy: systematic review and meta-analysis

Activation of proinflammatory and anti-inflammatory cytokines network seems to have a role in febrile seizures (FS). The present meta-analysis was aimed to pool the inconsistent data provided with case-control studies on the relationship of proinflammatory and anti-inflammatory cytokines and FS/epilepsy risk. The genotype interleukin (IL)-1 alpha-8891/1 (recessive model) was significantly correlated with increased risk of epilepsy (p=0.008) and FS/epilepsy (p=0.004). Patients with IL-1 beta-511 T/T homozygote were more susceptible to develop FS (p = 0.036) but not epilepsy. Furthermore, the T/T genotype was totally associated with increased risk of FS/epilepsy (p=0.043). Although the recessive model was also confirmed for the Asian subgroup (FS and FS/epilepsy), we found a protective effect of C/C genotype toward developing FS in the Caucasian race (p=0.020). The second meta-analysis on cytokine levels showed a statistically higher serum level of IL-6 in patients with epilepsy compared to control subjects without epilepsy. The present meta- analysis showed that two alleles of proinflammatory cytokines (IL-1 alpha- 889 and IL-1 beta-511) in addition to the serum concentration of IL-6 were significantly associated with FS and epilepsy or both in various subgroup analyses.