Evaluation of serum ghrelin, nesfatin-1, irisin, and vasoactive intestinal peptide levels in temporal lobe epilepsy patients with and without drug resistance: a cross-sectional study

Abstract

OBJECTIVE: Epilepsy is a common disorder that affects the nervous systems of 1% of worldwide population. In epilepsy, one-third of patients are unresponsive to current drug therapies and develop drug-resistant epilepsy. Alterations in ghrelin, nesfatin-1, and irisin levels with epilepsy were reported in previous studies. Vasoactive intestinal peptide is among the most common neuropeptides in the hippocampus, which is the focus of the seizures in temporal lobe epilepsy. However, there is also lack of evidence of whether these four neuropeptide levels are altered with drug resistant temporal lobe epilepsy or not. The aim herein was the evaluation of the serum levels of nesfatin-1, ghrelin, irisin, and Vasoactive intestinal peptide in drug-resistant temporal lobe epilepsy patients and temporal lobe epilepsy (TLE) without drug resistance, and to compare them to healthy controls. METHODS:This cross-sectional study group included 58 temporal lobe epilepsy patients (24 with drug resistant temporal lobe epilepsy and 34 with temporal lobe epilepsy who were not drug-resistant) and 28 healthy subjects. Nesfatin-1, ghrelin, irisin, and Vasoactive intestinal peptide serum levels were determined using enzyme-linked immunosorbent assay. RESULTS:The serum ghrelin levels of patients with drug resistant temporal lobe epilepsy were seen to have significantly decreased when compared to those of the control group (p<0.05). Serum nesfatin-1, vasoactive intestinal peptide, and irisin levels were seen to have decreased in the drug resistant temporal lobe epilepsy group when compared to those of the control and temporal lobe epilepsy groups; however, the difference was non-significant (p>0.05). CONCLUSIONS:The results herein suggested that ghrelin might contribute to the pathophysiology of drug resistant temporal lobe epilepsy. However, further studies are needed to confirm this hypothesis.

Targeting the Ghrelin Receptor as a Novel Therapeutic Option for Epilepsy

“…The serum DAG levels did not differ after three months of ASD treatment, while the AG levels were decreased after three months [ 80 ]. Finally, ASD-responsive patients had increased ghrelin levels compared to nonresponders in two studies, but not in another study [ 82 , 86 , 89 ]. A significant positive correlation has been shown between both the AG and DAG levels and disease duration, which could be indicative of ghrelin resistance, but could also be related to ASD use [ 84 ].…”

“…Up to now, there has been no general consensus regarding the differences in interictal ghrelin levels between adult epilepsy patients and healthy subjects. Three studies showed lower ghrelin levels in seizure-controlled epilepsy patients compared to healthy controls [ 80 , 81 , 82 ], while two studies did not detect differences in plasma ghrelin levels between epilepsy patients and controls [ 83 , 84 ]. One study demonstrated that patients with seizure-controlled epilepsy had significantly higher serum ghrelin compared to healthy controls [ 85 ].…”

Effect of irisin on the epilepsy induced by penicillin G: An electrophysiological study

“…In seizures induced by pentylenetetrazole (PTZ), Erkeç et al demonstrated that serum and brain FNDC5 / irisin levels of rats were significantly higher compared to the control group (31). In the study conducted by Elhady et al, epileptic children without seizure control had higher serum irisin levels compared to control groups (24), however, in a study in which Erkeç et al investigated possible changes in irisin levels between adult epileptic patients and healthy subjects, no significant difference was found in serum irisin levels between the groups (51). These controversial results may be associated with various factors such as patients' age, duration of antiepileptic drug treatment or antiepileptic drug type.…”