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    Blood levels of cytokines in children with idiopathic partial and generalized epilepsy
    (W B Saunders Co Ltd, 2013) Sonmez, Fatma Mujgan; Serin, Hepsen Mine; Alver, Ahmet; Aliyazicioglu, Rezzan; Cansu, Ali; Cane, Gamze; Zaman, Dilek
    Purpose: Antiepileptic drugs have been reported to reduce the levels of serum immunoglobulins and affect the production and levels of certain cytokines. We investigated the effects of valproic acid (VPA) and topiramate (TPM) on the blood levels of interleukin (IL)-alpha, IL-1 beta, IL-6, IL-10, and TNF-alpha in children with idiopathic generalized and partial epilepsy. Methods: Forty prepubertal children aged 6-12 (mean 8.3 +/- 1.7) years, 19/40 (47.5%) female and 21/40 (52.5%) male, with idiopathic generalized or partial epilepsy diagnosed in the child neurology outpatient clinic were included. The patients were divided into two treatment groups: 20 were treated with VPA and 20 with TPM. The plasma levels of IL-1 alpha, IL-1 beta, IL-6, IL-10, TNF-alpha were measured using ELISA method before the initiation of treatment and at the 6th and 12th months of the treatment. The Chi-square test was used to compare qualitative data. To compare the periods, recurrence measurements were done using variance analysis and Freidman 2-sided variance analysis. p < 0.05 was considered as statistically significant. Results: In the VPA group, the levels of IL-1 alpha significantly increased at 12 months while the levels of IL-10 decreased at 6 months of treatment compared to values before treatment (p < 0.05). There was no significant difference in levels of IL-1 beta, IL-6, TNF-alpha (p > 0.05). In the TPM group, lower levels of IL-10 were observed at 6th and 12th months compared to the onset of treatment (p < 0.05). Conclusion: The results of this study demonstrated that VPA and TPM might lead to changes in the levels of cytokines in epileptic patients. The next step would be to investigate the relation of these findings to the outcome of epilepsy and response to treatment. (C) 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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    The effects of topiramate and valproate therapy on insulin, c-peptide, leptin, neuropeptide Y, adiponectin, visfatin, and resistin levels in children with epilepsy
    (W B Saunders Co Ltd, 2013) Sonmez, Fatma Mujgan; Zaman, Dilek; Aksoy, Ayse; Deger, Orhan; Aliyazicioglu, Rezzan; Karaguzel, Gulay; Fazlioglu, Kerim
    Purpose: Antiepileptic drugs may affect the endocrine system. We investigated the effects of valproic acid and topiramate on the levels of insulin, c-peptide and adipocytokines in pre-pubertal patients with idiopathic partial and generalized epilepsy. Methods: Forty-one children with epilepsy were included. The patients were divided into two groups (valproic acid; n = 21, topiramate; n = 20). The weight, height, body mass index and homeostasis model assessment of insulin resistance (HOMA-IR) were recorded and insulin, c-peptide, leptin, neuropeptide Y, adiponectin, visfatin and resistin levels were determined at 0, 6 and 12 months of therapy. Results: In the valproate group, weight and height increased significantly. Seven of 21 patients were overweight at the end of one year. Leptin was higher in the overweight subgroup. Although insulin and HOMA-IR increased (p < 0.05), none of the patients showed hyperinsulinism or IR. Resistin had decreased at the 6th and 12th months (p < 0.05). In the topiramate group, some statistically nonsignificant changes were demonstrated. Conclusion: The mechanisms behind valproate and topiramate-related weight control are still unclear, especially in children. Valproate and topiramate affect the weight, BMI, and insulin, leptin and adipocytokine levels in prepubertal children. We suggest that further studies including more patients with a long follow-up period are necessary to draw a firm conclusion regarding an association between the treatment with these drugs and the levels of leptin, insulin and adipocytokines. (C) 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.