Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt.
Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, 83523, Egypt.
Biol Trace Elem Res. 2023 Feb;201(2):689-697. doi: 10.1007/s12011-022-03213-7. Epub 2022 Mar 29.
Epilepsy is one of the most common neurological disorders, and it places a significant economic strain on the healthcare system around the world. Although the exact mechanism of epilepsy has yet to be illustrated, various pathogenic cascades involving neurotransmitters and trace elements have been reported. We aimed to investigate the serum levels of growth-associated protein-43 (GAP-43) and neurotrophin-3 (NT-3) among cohort of Egyptian children with epilepsy and correlate these biomarkers with their zinc levels.
This case-control study included 50 pediatric patients with epilepsy who were comparable with 50 controls. Neurological assessment and electroencephalogram (EEG) were done to all included children. Biochemical measurements of serum GAP-43 and NT-3 using enzyme linked immunosorbent assays (ELISA), and total antioxidant capacity (TAC) and zinc using colorimetric assays, were performed to all participants.
There was significantly frequent positive parental consanguinity among cases with significantly frequent generalized onset seizures (94%) than simple partial seizure (6%). There were significantly lower serum GAP-43 and zinc levels with significantly higher TAC among cases vs. the controls, p˂0.05 for all. There was no significant difference in the serum levels of NT-3 among epileptic children vs. the controls, p = 0.269. Serum Zn was positively correlated with GAP-43 level among epileptic children (r = 0.381, p = 0.006). Serum GAP-43 in diagnosing childhood epilepsy at cut-off point ≤ 0.6 ng/mL showed 78% sensitivity, 62% specificity, positive predictive value (PPV) = 50.6%, negative predictive value (NPP) = 84.9% with AUC = 0.574.
GAP-43 can be considered a sensitive good negative biomarker in childhood epilepsy which correlated positively with the zinc status.
癫痫是最常见的神经障碍之一，它给全球医疗保健系统带来了巨大的经济负担。尽管癫痫的确切机制尚未阐明，但已有报道涉及神经递质和微量元素的各种致病级联。我们旨在研究埃及癫痫患儿队列中的生长相关蛋白-43（GAP-43）和神经营养因子-3（NT-3）的血清水平，并将这些生物标志物与他们的锌水平相关联。
这项病例对照研究包括 50 名癫痫患儿，与 50 名对照组相匹配。对所有纳入的儿童进行神经评估和脑电图（EEG）。使用酶联免疫吸附测定法（ELISA）对所有参与者进行血清 GAP-43 和 NT-3 的生化测量，以及使用比色法进行总抗氧化能力（TAC）和锌的测量。
病例组中存在显著频繁的阳性家族近亲结婚，且更常见全面性发作（94%）而非单纯部分性发作（6%）。与对照组相比，病例组的血清 GAP-43 和锌水平显著降低，TAC 水平显著升高，所有 p 值均＜0.05。癫痫患儿与对照组的血清 NT-3 水平无显著差异，p=0.269。癫痫患儿血清 Zn 与 GAP-43 水平呈正相关（r=0.381，p=0.006）。血清 GAP-43 在诊断儿童癫痫时，截断值≤0.6ng/mL 时具有 78%的灵敏度、62%的特异性、阳性预测值（PPV）=50.6%、阴性预测值（NPP）=84.9%，曲线下面积（AUC）=0.574。
GAP-43 可被视为儿童癫痫的敏感、良好的阴性生物标志物，与锌状态呈正相关。
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