Prospective Evaluation of Ghrelin and Des-Acyl Ghrelin Plasma Levels in Children with Newly Diagnosed Epilepsy: Evidence for Reduced Ghrelin-to-Des-Acyl Ghrelin Ratio in Generalized Epilepsies

Abstract

Children with epilepsy and identified as responders to antiseizure medications (ASMs) were found to present markedly higher ghrelin plasma levels when compared to drug-resistant patients. However, it was undetermined if this phenotype could be influenced by the ASMs. Here, we prospectively investigated total ghrelin and des-acyl ghrelin (DAG) plasma levels by enzyme-linked immunosorbent assay before and after ASM administration. Inclusion criteria were: (i) subject with a suspicion of epilepsy; (ii) age ranging from 0 to 16 years; and (iii) informed consent signed by parents or caregivers. Exclusion criteria were acute or chronic metabolic disorders with occasional convulsions but without epilepsy. Fifty patients were followed over a period of one year in Italian neuropediatric centers. Apart from a few exceptions, the majority of children were responsive to ASMs. No differences were found in total ghrelin and DAG levels before and after the treatment, but total ghrelin levels were significantly lower in children with generalized epilepsy compared to those with combined focal and generalized epilepsy. Moreover, the ghrelin-to-DAG ratio was also markedly lower in generalized epilepsies compared to all the other types of epilepsy. Finally, ghrelin was unchanged by ASMs, including the first (e.g., carbamazepine), second (levetiracetam), and third (lacosamide) generation of anticonvulsants.

Diagnosis and prognosis of serum Fut8 for epilepsy and refractory epilepsy in children

“…However, the effect depends on the kind of drugs. Costa et al found that ghrelin was unchanged by ASMs, including the first (e.g., carbamazepine), second (levetiracetam), and third (lacosamide) generation of anticonvulsants [ 24 ]. But Gungor et al found that the weight gain in using valproic acid may be associated with the increase in ghrelin level in the early treatment period [ 25 ].…”

Antiseizure Effects of Cannabidiol Leading to Increased Peroxisome Proliferator-Activated Receptor Gamma Levels in the Hippocampal CA3 Subfield of Epileptic Rats

“…In general, the complete understanding of the signaling pathways involved in the beneficial effects of CBD could help in defining the efficacy and safety of CBD as an add-on anticonvulsant therapy in different populations of epileptic patients [ 41 ], so not only in those populations in which CBD was already shown to display beneficial effects (e.g., patients with treatment-resistant Lennox–Gastaut syndrome and Dravet syndrome) [ 5 , 6 ]. In our experiment, data suggested that the levels of immunoreactivity for PPARγ were significantly increased within brain regions in a dose-related manner, and the CA3 hippocampal subfield emerged as the most important target region for the modulation of PPARγ levels by the effective CBD dose.…”

The impact of early-life environment on absence epilepsy and neuropsychiatric comorbidities

“…Put into other words, the dysregulation of the HPA system might be proposed as a common pathophysiological mechanism of epilepsy and depression co-morbidity ( Mazarati et al, 2009 ). Recently it was found that the neuropeptide hormone ghrelin is altered in children with generalized epilepsies ( Costa et al, 2022 ) and is associated with stress response ( Meyer et al, 2014 , Stark et al, 2016 ). Ghrelin regulates the HPA axis and associated stress-related mood disorders, such as fear, anxiety, and depression ( Spencer et al, 2015 ).…”