Turgut Ozal University, Faculty of Medicine, Department of Child Neurology, Ankara, Turkey.
Seizure. 2013 Sep;22(7):517-21. doi: 10.1016/j.seizure.2013.03.014. Epub 2013 Apr 25.
Antiepileptic drugs have been reported to reduce the levels of serum immunoglobulins and affect the production and levels of certain cytokines. We investigated the effects of valproic acid (VPA) and topiramate (TPM) on the blood levels of interleukin (IL)-1α, IL-1β, IL-6, IL-10, and TNF-α in children with idiopathic generalized and partial epilepsy.
Forty prepubertal children aged 6-12 (mean 8.3±1.7) years, 19/40 (47.5%) female and 21/40 (52.5%) male, with idiopathic generalized or partial epilepsy diagnosed in the child neurology outpatient clinic were included. The patients were divided into two treatment groups: 20 were treated with VPA and 20 with TPM. The plasma levels of IL-1α, IL-1β, IL-6, IL-10, TNF-α were measured using ELISA method before the initiation of treatment and at the 6th and 12th months of the treatment. The Chi-square test was used to compare qualitative data. To compare the periods, recurrence measurements were done using variance analysis and Freidman 2-sided variance analysis. p<0.05 was considered as statistically significant.
In the VPA group, the levels of IL-1α significantly increased at 12 months while the levels of IL-10 decreased at 6 months of treatment compared to values before treatment (p<0.05). There was no significant difference in levels of IL-1β, IL-6, TNF-α (p>0.05). In the TPM group, lower levels of IL-10 were observed at 6th and 12th months compared to the onset of treatment (p<0.05).
The results of this study demonstrated that VPA and TPM might lead to changes in the levels of cytokines in epileptic patients. The next step would be to investigate the relation of these findings to the outcome of epilepsy and response to treatment.
已报道抗癫痫药物会降低血清免疫球蛋白水平,并影响某些细胞因子的产生和水平。我们研究了丙戊酸(VPA)和托吡酯(TPM)对特发性全面性和部分性癫痫患儿血液中白细胞介素(IL)-1α、IL-1β、IL-6、IL-10 和 TNF-α水平的影响。
40 名 6-12 岁(平均 8.3±1.7 岁)的青春期前儿童,19/40(47.5%)为女性,21/40(52.5%)为男性,在儿童神经科门诊被诊断为特发性全面性或部分性癫痫。患者分为两组:20 例用 VPA 治疗,20 例用 TPM 治疗。在开始治疗前及治疗第 6 个月和第 12 个月时,采用 ELISA 法测定血浆 IL-1α、IL-1β、IL-6、IL-10、TNF-α水平。采用卡方检验比较定性数据。为了比较不同时期,采用方差分析和 Friedman 双侧方差分析进行复发测量。p<0.05 为有统计学意义。
在 VPA 组,与治疗前相比,治疗 12 个月时 IL-1α 水平显著升高,而治疗 6 个月时 IL-10 水平下降(p<0.05)。IL-1β、IL-6、TNF-α水平无显著差异(p>0.05)。在 TPM 组,与治疗开始时相比,第 6 个月和第 12 个月时 IL-10 水平较低(p<0.05)。
本研究结果表明,VPA 和 TPM 可能导致癫痫患者细胞因子水平发生变化。下一步将研究这些发现与癫痫结局和治疗反应的关系。