Lipidomics and Nutrition Research Centre, School of Human Sciences, London Metropolitan University, 166-220 Holloway Road, London N7 8DB, UK.
Faculty of Medicine, University of Khartoum, Al-Gamaa Avenue, Al Khartum 11111, Khartoum, Sudan.
Prostaglandins Leukot Essent Fatty Acids. 2021 Apr;167:102271. doi: 10.1016/j.plefa.2021.102271. Epub 2021 Mar 24.
Intervention studies have demonstrated that the n-3 fatty acids, docosahexaenoic and eicosapentaenoic acids, ameliorate seizure frequency in patients with drug-resistant epilepsy (DRE). There is a scarcity of fatty acid status of patients with epilepsy. We have investigated blood fatty acids of patients with DRE and assessed the indices of elongase and desaturase activities. DRE patients (n = 83) and healthy controls (n = 31) were recruited form Soba University Hospital Neurology Referral Clinic and Ibn-Auf paediatric Teaching Hospital Neurology Referral Clinic, Khartoum, Sudan. Fatty acid composition of plasma total lipids, phosphatidylcholine and neutral lipids were analysed. The patients compared with their healthy counterparts had higher levels of C14:0, C16:0, C18:0, C20:0, C22:0 (p<0.05) and C24:0, and total saturates (p<0.05). Similarly, the proportions of C16:1n-7, 18:1n-7, C18:1n-9, C20:1n-9, C24:1n-9 and total monounsaturated fatty acids; p<0.005) were higher in the drug-resistant patients. Conversely, the patients had lower levels of n-6 (C18:2n-6, C18:3n-6, C20:4n-6, n-6 metabolites and total n-6; p<0.005 and C20:2n-6 and C20:3n-6; p<0.05) and n-3 (C20:5n-3, C22:5n-3, C22:6n-3, ∑EPA and DHA, n-3 metabolites and total n-3; p<0.05) fatty acids. Indices of elongase and desaturase activities - The plasma total lipid ratios of C16:0/C14:0 (p = 0.001), C18:0/C16:0 (p = 0.001), C16:1n-7/C16:0 (p = 0.027), C18:1n-9/C18:0 (p = 0.022) and C22:4n-6/C20:4n-6 (p = 0.008) were higher and C18:3n-6/C18:2n-6 (p = 0.05), C20:4n-6/C20:3n-6 (p = 0.032) and C20:4n-6/C18:2n-6 (p>0.05) lower in the patients with drug-resistant epilepsy than in the healthy control subjects. DRE is associated with blood fatty acid perturbation and abnormal activities of long-chain fatty acid elongase (ELOVL-6), stearoyl-coenzyme A desaturase-1 (SCD-1), delta 6-fatty acid desaturase (D6D) and delta 5 fatty acid desaturase (D5D). N-3 fatty acids are known to ameliorate seizures frequency and dampen neuronal hyperexcitability. Therefore, patients with DRE should be regularly monitored and, if necessary, supplemented with n-3 fatty acids.
干预研究表明，n-3 脂肪酸，二十二碳六烯酸和二十碳五烯酸，可改善耐药性癫痫（DRE）患者的癫痫发作频率。癫痫患者的脂肪酸状况研究很少。我们研究了 DRE 患者的血液脂肪酸，并评估了延长酶和去饱和酶活性的指数。从苏巴大学医院神经病学转诊诊所和喀土穆 Ibn-Auf 儿科教学医院神经病学转诊诊所招募了 DRE 患者（n=83）和健康对照组（n=31）。分析了血浆总脂质、磷脂酰胆碱和中性脂质的脂肪酸组成。与健康对照组相比，患者的 C14:0、C16:0、C18:0、C20:0、C22:0（p<0.05）和 C24:0 以及总饱和脂肪酸水平更高（p<0.05）。同样，DRE 患者的 C16:1n-7、18:1n-7、C18:1n-9、C20:1n-9、C24:1n-9 和总单不饱和脂肪酸的比例也更高（p<0.005）。相反，患者的 n-6（C18:2n-6、C18:3n-6、C20:4n-6、n-6 代谢物和总 n-6；p<0.005 和 C20:2n-6 和 C20:3n-6；p<0.05）和 n-3（C20:5n-3、C22:5n-3、C22:6n-3、∑EPA 和 DHA、n-3 代谢物和总 n-3；p<0.05）脂肪酸水平较低。延长酶和去饱和酶活性的指数-血浆总脂质中 C16:0/C14:0（p=0.001）、C18:0/C16:0（p=0.001）、C16:1n-7/C16:0（p=0.027）、C18:1n-9/C18:0（p=0.022）和 C22:4n-6/C20:4n-6（p=0.008）的比值更高，而 C18:3n-6/C18:2n-6（p=0.05）、C20:4n-6/C20:3n-6（p=0.032）和 C20:4n-6/C18:2n-6（p>0.05）的比值更低在耐药性癫痫患者中低于健康对照组。DRE 与血液脂肪酸紊乱以及长链脂肪酸延长酶（ELOVL-6）、硬脂酰辅酶 A 去饱和酶-1（SCD-1）、δ6-脂肪酸去饱和酶（D6D）和 δ5-脂肪酸去饱和酶（D5D）的异常活性有关。已知 n-3 脂肪酸可改善癫痫发作频率并抑制神经元过度兴奋。因此，DRE 患者应定期监测，如果需要，应补充 n-3 脂肪酸。
