Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India.
J Neurol. 2018 Nov;265(11):2594-2601. doi: 10.1007/s00415-018-9026-1. Epub 2018 Sep 1.
S100B, a cytokine produced by astrocytes, has been studied as a biomarker of glial and neuronal damage in epilepsy. The present study investigated the reliability of serum S100B as a biomarker and the effect of carbamazepine and oxcarbazepine on serum S100B in patients with focal seizure.
The present randomized, open-label, active-controlled, parallel design clinical trial (NCT02705768) conducted on 60 patients with focal seizure. After recruitment, clinical evaluations were performed including Chalfont-National Hospital seizure severity scale (NHS3), Quality of Life in Epilepsy Inventory (QOLIE-31) and serum S100B was estimated. Thirty healthy individuals were recruited for evaluation of serum S100B at baseline only. After randomization, the study groups received either tablet oxcarbazepine or tablet carbamazepine. At follow-up after 2 weeks, clinical status was checked and at 4 weeks, NHS3 and QOLIE-31 were scored along with serum S100B level estimation.
Serum S100B level in patients with focal seizure increased significantly in comparison to healthy volunteers. The decrease in serum S100B was significantly higher with carbamazepine group (0.004; 95% CI 0.001-0.006; p = 0.01) over oxcarbazepine group. In logistic regression analysis, there was an increase in the log odds of 0.17 for focal seizure positivity against healthy controls if S100B level increases by 1 pg and area under curve obtained by ROC analysis was 0.96 (p < 0.001).
Serum S100B increases in the patients with focal seizure and therapy with carbamazepine can decrease serum S100B level significantly over oxcarbazepine. Serum S100B can be used as a prognostic biomarker in a focal seizure.
S100B 是一种星形胶质细胞产生的细胞因子，已被研究作为癫痫中神经胶质和神经元损伤的生物标志物。本研究调查了血清 S100B 作为生物标志物的可靠性，以及卡马西平和奥卡西平对局灶性癫痫患者血清 S100B 的影响。
本随机、开放标签、活性对照、平行设计临床试验（NCT02705768）纳入 60 例局灶性癫痫患者。招募后进行临床评估，包括 Chalfont-National 医院癫痫严重程度量表（NHS3）、癫痫生活质量量表（QOLIE-31）和血清 S100B 估计。仅招募 30 名健康个体进行基线血清 S100B 评估。随机分组后，研究组分别接受奥卡西平片或卡马西平片治疗。治疗 2 周后随访时检查临床状态，4 周时评估 NHS3 和 QOLIE-31，并测定血清 S100B 水平。
与健康志愿者相比，局灶性癫痫患者的血清 S100B 水平显著升高。卡马西平组血清 S100B 下降（0.004；95%置信区间 0.001-0.006；p=0.01）显著高于奥卡西平组。Logistic 回归分析显示，S100B 水平增加 1pg，局灶性癫痫阳性的对数优势比增加 0.17，ROC 分析获得的曲线下面积为 0.96（p<0.001）。
局灶性癫痫患者的血清 S100B 增加，卡马西平治疗可显著降低奥卡西平组的血清 S100B 水平。血清 S100B 可作为局灶性癫痫的预后生物标志物。
