Anticonvulsant-induced osteoporosis (AIO) and associated pain syndromes and patient disabilities are an important interdisciplinary medical problem generated by various molecular, genetic and pathophysiological mechanisms. AIO are the most important pathological processes associated with chronic pain in adults with epilepsy. Standard approaches to their prevention and treatment do not always solve the problem of the progression of the pathological process and chronicity of AIO. This is the reason for the search for new personalized strategies for the prevention and treatment of AIO. Vitamin D metabolism, expression and specificity of vitamin D receptors (VDRs) may play a key role in the development of AIO and chronic back pain in patients with epilepsy. The aim of the study was to review publications on changes in the vitamin D system in patients with AIO. We searched for articles published in e-Library, PubMed, Oxford Press, Clinical Case, Springer, Elsevier, and Google Scholar. The search was carried out by key-words and their combinations. The role of vitamin D and VDR in the development of AIO and the chronicity of back pain has been demonstrated mainly in animal models and humans. Associative genetic studies have shown that single nucleotide variants (SNVs) of the VDR gene encoding VDR may be associated with the development of osteoporosis of the spine (including those associated with the intake of an anticonvulsants). The prospects for the use of vitamin D preparations for modulating the effect of anticonvulsants used to treat epilepsy are discussed. Genetic association studies of VDR gene SNVs are important for understanding the genetic predictors of AIO and chronic back pain in patients with epilepsy, as well as for developing new personalized pharmacotherapy strategies.
Background. Epilepsy is a common disease in children and adults, requiring long-term or lifelong use of antiepileptic drugs (AEDs) in 60% of cases. Enzyme-inducing and enzyme-inhibiting AEDs may have a negative effect on vitamin D metabolism. However, at present, standard treatment protocols for patients with epilepsy include no nutrients and vitamin-mineral vitamin D containing complexes.Objective: to analyze studies on the prevalence of vitamin D deficiency induced by AEDs intake in patients with epilepsy.Material and methods. The search for full-text publications in Russian and English was carried out in еLibrary, PubMed/ MEDLINE, ClinicalKey, Google Scholar databases, covering the last five years. The analysis included 9 domestic and 54 foreign epidemiological studies assessing prevalence of AED-induced vitamin D deficiency and, consequently, altered bone mineralization and osteomalacia/osteoporosis.Results. Both in children and adults, the prevalence of AED-induced vitamin D deficiency reaches 40% and even higher. The region of residence of patients with epilepsy does not significantly affect this indicator. Impaired bone mineralization is associated with AED-induced vitamin D deficiency and requires the inclusion of vitamin D in the protocols of disease-modifying epilepsy therapy in children and adults.Conclusion. The results of the review showed high relevance of the discussed interdisciplinary problem and need to introduce laboratory screening of vitamin D deficiency among pediatric and adult patients with epilepsy.
Мастер-класс ПРОБЛЕМЫ ОБУЧЕНИЯ НАВЫКАМ ОКАЗАНИЯ ПЕРВОЙ ПОМОЩИ РАЗЛИЧНЫХ СОЦИАЛЬНЫХ ГРУПП Автономная некоммерческая организация дополнительного профессионального образования «Учебно-консультационный центр аварийно-спасательных формирований им. В.В. Никулина», Новомосковск, Тульская обл., Россия Руководитель -Исраилова Татьяна Анатольевна Исраилова Т.А. ПРОБЛЕМЫ ОБУЧЕНИЯ НАВЫКАМ ОКАЗАНИЯ ПЕРВОЙ ПОМОЩИ РАЗЛИЧНЫХ СОЦИАЛЬНЫХ ГРУПП Israilova Tatyana A. ISSUES OF TRAINING FIRST AID PROVISION SKILLS TO VARIOUS SOCIAL GROUPS 4-10 июня June 4-10 СЕКЦИИ КОНГРЕССА TOPICS OF CONGRESS 1. Стрессы и неврозы: механизмы, профилактика и коррекция Stress and neurosis: mechanisms, prophylactic and correction Агаева С.В., Фараджев А.Н.
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