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Altered plasma prostaglandin E2 levels in epilepsy and in response to antiepileptic drug monotherapy

  • Chitra Rawat
    Affiliations
    Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Mall Road, Delhi 110007, India

    Academy of Scientific and Innovative Research (AcSIR), Council of Scientific and Industrial Research (CSIR), Delhi 110007, India
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  • Shivangi
    Affiliations
    Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Mall Road, Delhi 110007, India

    Department of Biotechnology, Delhi Technological University, Shahbad Daulatpur, Main Bawana Road, Delhi 110042, India
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  • Suman Kushwaha
    Affiliations
    Institute of Human Behavior & Allied Sciences (IHBAS), Dilshad Garden, Delhi 110095, India
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  • Sangeeta Sharma
    Affiliations
    Institute of Human Behavior & Allied Sciences (IHBAS), Dilshad Garden, Delhi 110095, India
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  • Achal K Srivastava
    Affiliations
    Department of Neurology, All India Institute of Medical Sciences, Ansari Nagar, Delhi 110029, India
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  • Ritushree Kukreti
    Correspondence
    Corresponding author at Genomics and Molecular Medicine Unit, Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Mall Road, Delhi 110007, India.
    Affiliations
    Institute of Genomics and Integrative Biology (IGIB), Council of Scientific and Industrial Research (CSIR), Mall Road, Delhi 110007, India

    Academy of Scientific and Innovative Research (AcSIR), Council of Scientific and Industrial Research (CSIR), Delhi 110007, India
    Search for articles by this author
Published:January 22, 2020DOI:https://doi.org/10.1016/j.plefa.2020.102056

      Highlights

      • Inflammation is a contributing factor as well as consequence of seizure development in epilepsy
      • Prostaglandin E2 (PGE2), an inflammatory mediator, was elevated in the plasma of patients with epilepsy receiving no antiepileptic drug (AED) treatment (drug-free group)
      • Patients responding to valproate had lower plasma PGE2 levels compared to the non-responders as well as drug-free group
      • Alike the drug-free group, patients receiving phenytoin or carbamazepine had elevated plasma PGE2 levels
      • Altered PGE2 levels were independent of plasma arachidonic acid levels.

      Abstract

      Prostaglandin E2 (PGE2), a physiologically active lipid compound, is increased in several diseases characterized by chronic inflammation. To determine its significance in epilepsy-associated inflammation and response to antiepileptic drug (AED), we evaluated the plasma PGE2 (median, pg/ml) levels in drug-free patients with epilepsy (N = 34) and patients receiving AED monotherapy (N = 55) in addition to that in healthy controls (N = 34). When compared to controls, plasma PGE2 levels were significantly elevated in all drug-free patients independent of the type of epilepsy (137.2 versus 475.7 pg/ml, p < 0.0001). Among the patients receiving AED monotherapy, only valproate responders showed a significant decrease compared to both drug-free patients (232.1 versus 475.7 pg/ml, p < 0.01) as well as valproate non-responders (232.1 versus 611.9 pg/ml, p < 0.0001). Both responders and non-responders on phenytoin or carbamazepine monotherapy had elevated PGE2 levels similar to drug-free patients. In addition, no difference was observed in plasma profiles of PGE2 precursor, arachidonic acid among the groups. Our work presents the clinical evidence of the association between plasma PGE2 levels and valproate efficacy in patients with epilepsy.

      Keywords

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