Department of Pharmacology, University College of Medical Sciences & GTB Hospital, University of Delhi, New Delhi, India.
Department of Pharmacology, University College of Medical Sciences & GTB Hospital, University of Delhi, New Delhi, India.
Epilepsy Behav. 2021 Dec;125:108358. doi: 10.1016/j.yebeh.2021.108358. Epub 2021 Oct 27.
Contemporary research indicates the role of neuroinflammation/inflammatory markers in epilepsy. In addition, comorbidities such as anxiety and poor health-related quality of life are vital concerns in clinical care of pediatric patients with epilepsy. This open-label, prospective, observational study evaluated the effect of valproate and add-on levetiracetam on serum levels of C-C motif ligand 2 (CCL2) and Interleukin-1 beta (IL-1β) in pediatric patients with epilepsy. We also studied effect of valproate and add-on levetiracetam on anxiety and health-related quality of life (HRQoL) in specified age subgroups.
Children aged 1 to 12 years, diagnosed with epilepsy (generalized or focal seizures), treated with valproate (n = 40) and valproate with add-on levetiracetam (n = 40) were included. All patients were followed up for 16 weeks and assessed for changes in serum CCL2 and IL-1β levels. Spence Children Anxiety Scale short version (SCAS-S) and QOLCE-16 scales were used to measure anxiety and HRQoL, respectively, in specific age groups.
The serum CCL2 level decreased significantly (p < .001) from 327.95 ± 59.07 pg/ml to 207.02 ± 41.50 pg/ml in the valproate group and from 420.65 ± 83.72 pg/ml to 250.06 ± 46.05 pg/ml in the add-on levetiracetam group. Serum IL-1β level did not change significantly in both groups. Spence Children Anxiety Scale short version scores were decreased and QOLCE-16 scores were increased significantly (p < .001) in both valproate and add-on levetiracetam groups.
The results of our study suggest that valproate and levetiracetam led to decrease serum CCL2 levels without any change in serum IL-1β levels in children with epilepsy. Anti-inflammatory property of valproate and levetiracetam might underlie their antiepileptic effect and CCL2 could be a potential marker of drug efficacy in epilepsy. Also, valproate and levetiracetam reduced anxiety and improved quality of life in children with epilepsy in the age groups evaluated.
当代研究表明神经炎症/炎症标志物在癫痫中的作用。此外，焦虑和健康相关生活质量等合并症是儿科癫痫患者临床护理的重要关注点。本开放性、前瞻性、观察性研究评估了丙戊酸钠和添加用左乙拉西坦对癫痫患儿血清 C-C 基序配体 2（CCL2）和白细胞介素-1β（IL-1β）水平的影响。我们还研究了丙戊酸钠和添加用左乙拉西坦对特定年龄亚组的焦虑和健康相关生活质量（HRQoL）的影响。
纳入年龄在 1 至 12 岁之间、诊断为癫痫（全面性或局灶性发作）、接受丙戊酸钠（n=40）和丙戊酸钠加左乙拉西坦（n=40）治疗的儿童。所有患者均随访 16 周，并评估血清 CCL2 和 IL-1β 水平的变化。使用斯宾塞儿童焦虑量表短版（SCAS-S）和 QOLCE-16 量表分别在特定年龄组测量焦虑和 HRQoL。
丙戊酸钠组血清 CCL2 水平从 327.95±59.07 pg/ml 显著降低至 207.02±41.50 pg/ml（p<0.001），添加用左乙拉西坦组从 420.65±83.72 pg/ml 降低至 250.06±46.05 pg/ml（p<0.001）。两组血清 IL-1β 水平均无显著变化。丙戊酸钠和添加用左乙拉西坦组的斯宾塞儿童焦虑量表短版评分降低，QOLCE-16 评分显著升高（p<0.001）。
我们的研究结果表明，丙戊酸钠和左乙拉西坦导致癫痫患儿血清 CCL2 水平降低，而血清 IL-1β 水平无变化。丙戊酸钠和左乙拉西坦的抗炎特性可能是其抗癫痫作用的基础，CCL2 可能是癫痫药物疗效的潜在标志物。此外，丙戊酸钠和左乙拉西坦降低了评估年龄组癫痫患儿的焦虑并改善了生活质量。
