Serum and urine ghrelin in adult epileptic patients

Abstract

Background: Several neuropeptides have concerned with epilepsy pathogenesis; ghrelin showed an anticonvulsant effect. There is a potential relation between its level and antiepileptic drug (AEDs) response.Objective: To evaluate ghrelin effect in adult epileptic patients and in response to AEDs. Materials and methods: This case control study included 40 adult epileptic patients and 40 healthy controls. Participants were subjected to history taking of seizure semiology, full general and neurological examination, electroencephalography, and cranial imaging. Fasting serum acylated ghrelin (AG), unacylated ghrelin (UAG), and urine AG levels were estimated to all participants by enzyme-linked immunosorbent assay (ELIZA).Results: Serum AG, UAG, and urine AG levels were statistically higher in epileptic patients than controls (p = 0.005, 0.003, and 0.018 respectively). A significant higher level of serum AG was found among generalized epileptic patients (p = 0.038). There was higher statistically significant levels of all measured parameters among poly therapy patients (p = 0.003, 0.013, and 0.001 respectively). Also, a higher statistical significant level of serum AG and UAG in AEDs-responsive patients was found (p < 0.001). Our results demonstrated significant positive correlation between all measured parameters (serum AG, UAG, and urine AG) and epilepsy duration (p = 0.001, 0.002, and 0.009 respectively). High serum AG and UAG levels were independently associated with longer epilepsy duration (p = 0.00 and 0.008) and better response to AEDs (p < 0.001). Conclusion: These results indicated that serum AG and UAG levels were significantly high in epileptic patients especially with prolonged epilepsy duration and good AEDs response.Trial registration: ClinicalTrials.gov NCT03926273 (22-04-2019) "retrospectively registered."

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

“…To our knowledge, this is the first time that the ghrelin-to-DAG ratio has been found to be specifically affected in children with generalized epilepsy. Indeed, similar results were reported only in adult patients with a history of generalized seizures [28][29][30] by some, but not all, investigators [31,32] and, especially, no data were available before the drug treatment [5].…”

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 ].…”

“…Three studies demonstrated that patients suffering from focal epilepsy had higher ghrelin plasma levels compared to patients suffering from generalized seizures [ 80 , 81 , 85 ]. Two studies were not able to replicate this finding [ 84 , 86 ] ( Table 1 ).…”

Liquid biopsies in epilepsy: biomarkers for etiology, diagnosis, prognosis, and therapeutics

“…These nucleic acids are often contained within exosomes released into the bloodstream from blood cells, the brain, and the spine [48]. Advances in sequencing technology have allowed higher level molecular profiling of blood, CSF, and more recently urine and saliva, to investigate nucleic acids within epilepsy outside of the exosome [49][50][51]. While evidence on the utility of circulating nucleic acids in epilepsy is underdeveloped in comparison to other diseases, we review the current landscape below.…”