Plasma homocysteine and aminothiol levels in idiopathic epilepsy patients receiving antiepileptic drugs

Ramazan, Dilber Coban; Anadol, Ulker; Yalçın, Ayşe Destînâ; Yalçın, A. Süha

doi:10.1515/tjb-2018-0218

Cited by 3 publications

(9 citation statements)

References 24 publications

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“…In contrary to the present results, glutathione levels were observed to be higher, although not significantly, in adult patients with epilepsy than in controls [ 8 ]. Similarly, in a Turkish study based on a cohort with idiopathic epilepsy also including adolescents, glutathione was significantly increased in the epileptic cases compared to the controls [ 23 ].…”

Section: Discussionmentioning

confidence: 96%

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Serum Levels of Lipids and Selected Aminothiols in Epileptic Children—A Pilot Case-Control Study

2022

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Background: Standard treatment of epileptic seizures involves the use of antiepileptic drugs (AEDs). Both AEDs themselves and treatment duration may influence the levels of biochemical parameters, e.g., lipids or homocysteine (HCys), that may increase the risk of cardiovascular diseases. The aim of the present study was to compare the levels of lipid parameters, as well as the concentrations of selected aminothiols (i.e., HCys, cysteine, and glutathione) between epileptic children treated with multiple AEDs and children without epilepsy. Methods: In the study, 21 children with epilepsy treated with two or more AEDs for at least 6 months (8 girls and 13 boys, mean age 7.03 ± 4.51) and 23 children without epilepsy (7 girls and 16 boys, mean age 7.54 ± 3.90) were prospectively analyzed. Lipid parameters, i.e., total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL), and levels of selected aminothiols were determined in the blood serum. Results: No differences in the mean levels of lipid parameters and in the mean values of lipid ratios (TC/HDL, TG/HDL, LDL/HDL) were observed between the total groups as well as in the sex subgroups. HCys and cysteine levels did not differ between the patients and controls. We observed significantly lower levels of glutathione in children with epilepsy than in children without epilepsy (1.49 ± 0.35 µmol/L vs. 2.39 ± 1.17 µmol/L, respectively) (p < 0.001). Glutathione level was also lower in boys with epilepsy than in boys without epilepsy (p = 0.007). Similarly, epileptic girls had statistically decreased levels of glutathione when compared to girls without epilepsy (p = 0.006). Conclusions: A lower level of glutathione is observed in pediatric patients with epilepsy treated with two or more AEDs for at least 6 months. This indicates the oxidative stress of the patients treated with AEDs, which in turn may affect their well-being, and in the case of chronic occurrence resulting from long-term treatment, also on the function of the liver and the condition of the cardiovascular system.

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Section: Discussionmentioning

confidence: 96%

“…The higher the levels of TG and VLDL the greater the level of cysteine on average. In a study by Ramazan et al [ 23 ], cysteine was significantly higher in controls than in epileptic patients and especially low levels of cysteine was observed in a group of patients taking LTG.…”

Section: Discussionmentioning

confidence: 99%

Serum Levels of Lipids and Selected Aminothiols in Epileptic Children—A Pilot Case-Control Study

2022

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“…From the 11 studies included, fve compared LTG with a control group [11,12,14,15,17]; seven compared LEV with a control group [11,14,[16][17][18][19]; fve compared OXC with a control group [10,11,13,18]; and two compared TPM with a control group [11,14].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Six of the studies recruited patients from Iran, Turkey, and Egypt [10,13,14,16,17,19]; four studies recruited patients from China [11,12,15,18]; and one study recruited patients from Europe [11].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Compared with older AEDs, these new AEDs are less likely to infuence hepatic enzymes [9] and are supposed to be less likely to disrupt Hcy metabolism [10]. In recent years, some case-control studies have been conducted to explore the correlation between Hcy and new AEDs [11][12][13][14][15][16][17][18][19][20]. In a case study, Sun et al argued that the new AEDS do not cause elevated blood ammonia and Hcy levels, so they have high drug safety.…”

Section: Introductionmentioning

confidence: 99%

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Effects of New Antiepileptic Drugs on Homocysteine in Epileptic Patients: A Systematic Review and Meta-Analysis

Zheng

Bao

et al. 2023

Journal of Clinical Pharmacy and Therapeutics

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Background. Previous studies have reported inconsistent findings regarding the association between elevated plasma homocysteine (Hcy) levels and new antiepileptic drugs (AEDs). In this meta-analysis, we aimed to assess the effects of new AEDs on Hcy. Methods. PubMed, Embase, Cochrane, and Web of Science databases were searched from inception to June 2022 for articles that focused on the effects of new AEDs on Hcy. A meta-analysis was performed using Stata 16.0 software. The results were presented as the mean difference (MD) and corresponding to 95% confidence intervals (CIs) comparing epileptic patients with new AEDs to the control subjects. Results. A total of 11 studies were included in the meta-analysis. Hcy was markedly increased in the new AEDs group compared with the control group (MD = 2.220, 95% CI: 0.596–3.844, P = 0.007 ), with a high degree of heterogeneity (I2 = 99.5%). In the drugs subgroup, the oxcarbazepine (OXC) (MD = 2.30, 95% CI: −1.11–5.72, P = 0.187 ) and lamotrigine (LTG) (MD = 1.14, 95% CI: −0.209–2.482, P < 0.001 ) groups had no significant differences when compared with the control group. The levetiracetam (LEV) (MD = 1.81, 95% CI: 1.03–2.18, P < 0.001 ) and topiramate (TPM) (MD = 6.922, 95% CI: 0.788–13.055, P = 0.027 ) groups were significantly higher than the control group. Conclusions. The new AEDs, especially TPM and LEV, may increase the plasma of Hcy. The role of Hcy in patients with epilepsy who are given TPM and LEV should not be ignored in clinical situations. Patients with epilepsy who also have a high-risk vascular profile are recommended to use OXC and LTG.

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Reversed Phase HPLC Determination of Total Homocysteine, Cysteine, Cysteinyl Glycine, Glutathione in Plasma of Epileptic Patients

Abid¹,

Alajeeli²,

Al-Karawi³

et al. 2023

tajmspr

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The fast and accurate reversed-phase HPLC method was predicated on qualitative and quantitative estimation of the total concentrations of the essential thiols in the plasma of adults volunteers compared with epileptic patients, which is l-cysteine (Cys) total homocysteine (tHys), cysteinyl glycine (Cys-Gly), glutathione (GSH) and cysteamine (Cstm), respectively. The plasma samples of (50) epileptic patients were classified into three groups; the non-anti-epileptic drug consisted of 20 patients (12 male, eight female) who were mainly diagnosed with idiopathic generalized epilepsy. The mean age was 34 ± 13 (range 19–48) years. The second group consisted of 30 patients receiving two types of anti-epileptic drugs, 18 patients (12 male and six female) receiving Carbamazepine, and 12 patients (7 males and five female) receiving phenytoin. The mean age of the patients was 32 ± 11 Compared with 31 healthy volunteers (20 male and 11 female). The mean age of the controls was 31 ± 9 (range 26–49 years). The mean duration of treatment of patients receiving the anti-epileptic drug was six months). All measurement was done using pre-column derivatization with bromobimane, and the derivative of each standard mixture were baseline separated on C18-DB (50 x 4.6 mm ID) column, 3μm particle size. The regression coefficients for the separated and standard deviation SD within-run ranged from 0.09 to 8.40 μmol/L, and between-run ranged from 0.15to 9.16 μmol/L; the analytical procedure gave good linearity in the range between 1.25 to 20 µmole/ l, the detection limit was 0.1 µmole /L for all the thiol groups. Analytical recovery was 96.9–107.4 %; the mean concentration of plasma cysteine and total homocysteine was slightly higher in males than females; it was 221± 75 for adult males and 190± 44 μmol/L for adult females, while t-homocysteine was (10.55 ±2.45 vs. 9.79 ± 1.88 μmol/L, the results observed that the value of cysteine and homocysteine were significantly higher in epileptic patients using Carbamazepine and phenytoin than in healthy volunteers. Mean values for glutathione were lower, while cysteinyl glycine showed no significant difference in healthy and epileptic patients and no sex- and age-dependent.

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Plasma homocysteine and aminothiol levels in idiopathic epilepsy patients receiving antiepileptic drugs

Cited by 3 publications

References 24 publications

Serum Levels of Lipids and Selected Aminothiols in Epileptic Children—A Pilot Case-Control Study

Serum Levels of Lipids and Selected Aminothiols in Epileptic Children—A Pilot Case-Control Study

Effects of New Antiepileptic Drugs on Homocysteine in Epileptic Patients: A Systematic Review and Meta-Analysis

Reversed Phase HPLC Determination of Total Homocysteine, Cysteine, Cysteinyl Glycine, Glutathione in Plasma of Epileptic Patients

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