Hu Yun, Zhou Ting, Li Qingye
Department of Emergency Medicine, People's Hospital of Dongxihu District, Wuhan, Hubei, 430040, China.
Department of Neurology, People's Hospital of Dongxihu District, 48 Jinbei 1st Road, Jinghe Street, Dongxihu District, Wuhan, Hubei, 430040, China.
Open Med (Wars). 2024 Jul 30;19(1):20241011. doi: 10.1515/med-2024-1011. eCollection 2024.
In this prospective observational study, we aimed to investigate the serum levels of sirtuin (SIRT)3 in epilepsy patients and its association with the severity of the disease.
This prospective observational study included 203 patients with symptomatic epilepsy and 100 healthy controls who visited our hospital from November 2019 to November 2022. The severity of the disease in epilepsy patients was assessed using the National Hospital Seizure Severity Scale (NHS3). We used enzyme-linked immunosorbent assay to measure the serum levels of SIRT3, interleukin (IL)-6, IL-1β, tumor necrosis factor-alpha, and C-reactive protein in all patients. In addition, the cognitive function of all study participants was evaluated using the Mini-Mental State Examination and the Montreal Cognitive Assessment (MOCA). All data were analyzed using SPSS 25.0 software.
The MOCA scores of the epilepsy patients were significantly lower compared to the healthy volunteers ( < 0.05). The serum SIRT3 levels were decreased significantly in patients with refractory epilepsy (183.16 ± 17.22 pg/mL) compared to non-refractory epilepsy patients (199.00 ± 18.68 pg/mL). In addition, serum SIRT3 levels were negatively correlated with the inflammatory factors IL-6 (Pearson's correlation -0.221, = 0.002) and NHS score (Pearson's correlation -0.272, < 0.001) of epilepsy patients, while positively correlated with MOCA scores (Pearson's correlation 0.166, = 0.018). Furthermore, the receiver operating characteristic curve demonstrated that serum SIRT3 could be used to diagnose epilepsy, as well as refractory epilepsy. Finally, logistic regression analysis showed that SIRT3 (OR = 1.028, 95%CI: 1.003-1.054, = 0.028), IL-6 (OR = 0.666, 95%CI: 0.554-0.800, < 0.001), IL-1β (OR = 0.750, 95%CI: 0.630-0.894, = 0.001), and NHS3 (OR = 0.555, 95%CI: 0.435-0.706, < 0.001) were risk factors for refractory epilepsy.
In conclusion, our findings demonstrated that serum SIRT3 levels were significantly decreased in epilepsy patients and further decreased in patients with refractory epilepsy. This study might provide new therapeutic targets and comprehensive treatment strategies for epilepsy patients.
在这项前瞻性观察性研究中，我们旨在调查癫痫患者血清中沉默调节蛋白（SIRT）3的水平及其与疾病严重程度的关联。
这项前瞻性观察性研究纳入了203例症状性癫痫患者和100名健康对照者，这些患者和对照者于2019年11月至2022年11月期间到我院就诊。使用国家医院癫痫发作严重程度量表（NHS3）评估癫痫患者的疾病严重程度。我们采用酶联免疫吸附测定法测量所有患者血清中SIRT3、白细胞介素（IL）-6、IL-1β、肿瘤坏死因子-α和C反应蛋白的水平。此外，使用简易精神状态检查表和蒙特利尔认知评估量表（MOCA）评估所有研究参与者的认知功能。所有数据均使用SPSS 25.0软件进行分析。
癫痫患者的MOCA评分显著低于健康志愿者（<0.05）。与非难治性癫痫患者（199.00±18.68 pg/mL）相比，难治性癫痫患者的血清SIRT3水平显著降低（183.16±17.22 pg/mL）。此外，癫痫患者血清SIRT3水平与炎症因子IL-6（Pearson相关系数-0.221，P=0.002）和NHS评分（Pearson相关系数-0.272，P<0.001）呈负相关，而与MOCA评分呈正相关（Pearson相关系数0.166，P=0.018）。此外，受试者工作特征曲线表明，血清SIRT3可用于诊断癫痫以及难治性癫痫。最后，逻辑回归分析显示，SIRT3（比值比[OR]=1.028，95%置信区间[CI]：1.003-1.054，P=0.028）、IL-6（OR=0.666，95%CI：0.554-0.800，P<0.001）、IL-1β（OR=0.750，95%CI：0.630-0.894，P=0.001）和NHS3（OR=0.555，95%CI：0.435-0.706，P<0.001）是难治性癫痫的危险因素。
总之，我们的研究结果表明，癫痫患者血清SIRT3水平显著降低，难治性癫痫患者血清SIRT3水平进一步降低。本研究可能为癫痫患者提供新的治疗靶点和综合治疗策略。
