Korkmazer Nadir, Vurucu Sebahattin, Demirkaya Erkan, Unay Bulent, Kul Mustafa, Akin Ridvan, Gokcay Erdal
Department of Pediatrics, Gulhane Military Medical Academy, School of Medicine, Turkey.
Brain Dev. 2006 Sep;28(8):515-20. doi: 10.1016/j.braindev.2006.03.003. Epub 2006 May 6.
Valproic acid (VPA) is an antiepileptic drug widely used and well-tolerated by most of patients. Its non-dose-dependent side effects seen mostly are the temporary gastrointestinal disturbances including anorexia and nausea, and hepatoxicity. As to its dose-dependent side effects are the weight loss, tremor, skin eruption and the alopecia. In this study we aimed to put forward the biotinidase deficiency considered as a possible cause of alopecia in the rats administered with valproic acid, and the correlation between liver and serum biotinidase enzyme activities (BEA) and transaminases, albumin and serum valproic acid levels. In our study, 4 groups of which one of them was a control group, each consisting of 15 male Wistar rats was organized. 200, 400, and 600 mg/kg/day of VPA, and distilled water, two divided doses per day, were administered per orally to VPA-1, VPA-2, VPA-3, and control group, respectively, in 60 days. Their serum and liver biotinidase enzyme activities, serum AST, ALT, albumin, and valproic acid levels were measured. Alopecia was seen in the subjects of 6.6% of VPA-1, 13.3% of VPA-2, and 26.6% of VPA-3. Significant difference in the liver tissues BEA was noted only between VPA-3 and the control group. Reductions were observed both in the liver tissues BEA and the serum BEA levels, which are inversely proportional to the VPA doses. A positive correlation between the liver biotinidase enzyme activities and the serum valproic acid levels, and the negative correlation between the liver tissues biotinidase activities and the serum valproic acid levels were noted, respectively. As a conclusion, the partial alopecia which is an initial symptom of reduced biotinidase activity may also be created depending on the reduction of biotinidase activity during valproic acid therapy. The alopecia which may further be observed in the patients receiving valproic acid therapy may be prevented by means of administration of biotin in a dose of 10 mg/day.
丙戊酸(VPA)是一种广泛使用且大多数患者耐受性良好的抗癫痫药物。其最常见的非剂量依赖性副作用是包括厌食和恶心在内的暂时性胃肠道紊乱以及肝毒性。其剂量依赖性副作用则是体重减轻、震颤、皮疹和脱发。在本研究中,我们旨在提出生物素酶缺乏被视为服用丙戊酸大鼠脱发的可能原因,以及肝脏和血清生物素酶活性(BEA)与转氨酶、白蛋白和血清丙戊酸水平之间的相关性。在我们的研究中,组织了4组,其中1组为对照组,每组由15只雄性Wistar大鼠组成。VPA - 1、VPA - 2、VPA - 3组和对照组分别每天分两次口服给予200、400和600mg/kg/天的VPA以及蒸馏水,持续60天。测量了它们的血清和肝脏生物素酶活性、血清AST、ALT、白蛋白和丙戊酸水平。在VPA - 1组6.6%的受试对象、VPA - 2组13.3%的受试对象和VPA - 3组26.6%的受试对象中观察到脱发。仅在VPA - 3组和对照组之间观察到肝脏组织BEA有显著差异。观察到肝脏组织BEA和血清BEA水平均降低,且与VPA剂量呈反比。分别观察到肝脏生物素酶活性与血清丙戊酸水平呈正相关,以及肝脏组织生物素酶活性与血清丙戊酸水平呈负相关。结论是,生物素酶活性降低的初始症状——部分脱发也可能是由于丙戊酸治疗期间生物素酶活性降低所致。接受丙戊酸治疗的患者中可能进一步观察到的脱发可通过每天服用10mg生物素加以预防。