High-mobility group box 1 as a predictive biomarker for drug-resistant epilepsy: A proof-of-concept study

Lauren Elizabeth Walker, Graeme John Sills, Andrea Jorgensen, Tiina Alapirtti, Jukka Peltola, Martin J. Brodie, Anthony Guy Marson, Annamaria Vezzani, Munir Pirmohamed

Research output: Contribution to journalArticleScientificpeer-review


Currently no sensitive and specific biomarkers exist to predict drug-resistant epilepsy. We determined whether blood levels of high-mobility group box 1 (HMGB1), a mediator of neuroinflammation implicated in drug-resistant epilepsies, identifies patients with drug-resistant seizures. Patients with drug-resistant epilepsy express significantly higher levels of blood HMGB1 than those with drug-responsive, well-controlled seizures and healthy controls. No correlation existed between blood HMGB1 levels and total pretreatment seizure count or days since last seizure at new epilepsy diagnosis, indicating that blood HMGB1 does not solely reflect ongoing seizures. HMGB1 distinguishes with high specificity and selectivity drug-resistant versus drug-responsive patients. This protein therefore has potential clinical utility to act as a biomarker for predicting response to therapy, which should be addressed in prospective clinical studies.

Original languageEnglish
Pages (from-to)e1-e6
Issue number1
Early online dateNov 2021
Publication statusPublished - Jan 2022
Publication typeA1 Journal article-refereed


  • biomarker
  • drug-resistant
  • epilepsy
  • HMGB1
  • neuroinflammation

Publication forum classification

  • Publication forum level 2

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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