Efficacy of levetiracetam combined with sodium valproate on pediatric epilepsy and its effect on serum miR-106b in children

Zhao,Jiaqiang; Sang,Yan; Zhang,Yuan; Zhang,Dongli; Chen,Jiao; Liu,Xiaoming

doi:10.3892/etm.2019.8098

Efficacy of levetiracetam combined with sodium valproate on pediatric epilepsy and its effect on serum miR-106b in children

Authors:
- Jiaqiang Zhao
- Yan Sang
- Yuan Zhang
- Dongli Zhang
- Jiao Chen
- Xiaoming Liu
View Affiliations

Affiliations: Department of Neurology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221006, P.R. China
Published online on: October 14, 2019 https://doi.org/10.3892/etm.2019.8098
Pages: 4436-4442
Copyright: © Zhao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Efficacy of levetiracetam (LEV) combined with sodium valproate (SV) on pediatric epilepsy and its effect on serum miR-106b in children were investigated. One hundred and twenty children with epilepsy in Xuzhou Children's Hospital from July 2015 to July 2017 were enrolled, and divided into control group (n=60) and observation group (n=60) according to random sampling. Additionally, 100 children undergoing normal physical examination were collected as normal group. Patients in the control group were treated with SV, and patients in the observation group were treated with SV and LEV. RT-qPCR was used for detecting the relative expression of serum miR-106b in children. The clinical efficacy was evaluated. After treatment, the relative expression of serum miR-106b in the control group was significantly higher than that in the observation group (P<0.05). The difference in the control group was smaller than that in the observation group (P<0.05). According to the ROC curve analysis, when the cut-off value was 1.442, the sensitivity, specificity and area under curve (AUC) of miR-106b in the diagnosis of pediatric epilepsy were 94.00, 64.17 and 0.833 respectively. The clinical efficacy in the observation group was significantly better than that in the control group (P<0.05). Spearman's test showed that the expression of miR-106b gradually decreased with the continuous improvement of the clinical efficacy (P<0.05). The AUC of miR-106b was 0.833, 95% CI: 0.779 to 0.887, the cut-off was 1.442. LEV combined with SV is effective in the treatment of children with epilepsy, and does not increase the clinical ADR. The expression of serum miR-106b in children can be used as a clinical prognostic indicator and a potential diagnostic indicator.

View Figures

View References

1	Berg AT and Scheffer IE: New concepts in classification of the epilepsies: Entering the 21st century. Epilepsia. 52:1058–1062. 2011. View Article : Google Scholar : PubMed/NCBI
2	Russ SA, Larson K and Halfon N: A national profile of childhood epilepsy and seizure disorder. Pediatrics. 129:256–264. 2012. View Article : Google Scholar : PubMed/NCBI
3	Theodore WH, Spencer SS, Wiebe S, Langfitt JT, Ali A, Shafer PO, Berg AT and Vickrey BG: Epilepsy in North America: A report prepared under the auspices of the global campaign against epilepsy, the International Bureau for Epilepsy, the International League Against Epilepsy, and the World Health Organization. Epilepsia. 47:1700–1722. 2006. View Article : Google Scholar : PubMed/NCBI
4	Mac TL, Tran DS, Quet F, Odermatt P, Preux PM and Tan CT: Epidemiology, aetiology, and clinical management of epilepsy in Asia: A systematic review. Lancet Neurol. 6:533–543. 2007. View Article : Google Scholar : PubMed/NCBI
5	Glennon JM, Weiss-Croft L, Harrison S, Cross JH, Boyd SG and Baldeweg T: Interictal epileptiform discharges have an independent association with cognitive impairment in children with lesional epilepsy. Epilepsia. 57:1436–1442. 2016. View Article : Google Scholar : PubMed/NCBI
6	Belcastro V, Costa C, Galletti F, Autuori A, Pierguidi L, Pisani F, Calabresi P and Parnetti L: Levetiracetam in newly diagnosed late-onset post-stroke seizures: A prospective observational study. Epilepsy Res. 82:223–226. 2008. View Article : Google Scholar : PubMed/NCBI
7	Chen L, Feng P, Wang J, Liu L and Zhou D: Intravenous sodium valproate in mainland China for the treatment of diazepam refractory convulsive status epilepticus. J Clin Neurosci. 16:524–526. 2009. View Article : Google Scholar : PubMed/NCBI
8	Ha M and Kim VN: Regulation of microRNA biogenesis. Nat Rev Mol Cell Biol. 15:509–524. 2014. View Article : Google Scholar : PubMed/NCBI
9	Condorelli G, Latronico MV and Cavarretta E: microRNAs in cardiovascular diseases: Current knowledge and the road ahead. J Am Coll Cardiol. 63:2177–2187. 2014. View Article : Google Scholar : PubMed/NCBI
10	Lin S and Gregory RI: MicroRNA biogenesis pathways in cancer. Nat Rev Cancer. 15:321–333. 2015. View Article : Google Scholar : PubMed/NCBI
11	Sun Y, Luo ZM, Guo XM, Su DF and Liu X: An updated role of microRNA-124 in central nervous system disorders: A review. Front Cell Neurosci. 9:1932015. View Article : Google Scholar : PubMed/NCBI
12	Sun J, Cheng W, Liu L, Tao S, Xia Z, Qi L and Huang M: Identification of serum miRNAs differentially expressed in human epilepsy at seizure onset and post-seizure. Mol Med Rep. 14:5318–5324. 2016. View Article : Google Scholar : PubMed/NCBI
13	Healy F and Panitch HB: Pulmonary complications of pediatric neurological diseases. Pediatr Ann. 39:216–224. 2010. View Article : Google Scholar : PubMed/NCBI
14	Livak KJ and Schmittgen TD: Analysis of relative geneexpression data using real-time quantitative PCR and the 2(-Delta Delta C(T)) method. Methods. 25:402–408. 2001. View Article : Google Scholar : PubMed/NCBI
15	Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J Jr, Forsgren L, French JA, Glynn M, et al: ILAE official report: A practical clinical definition of epilepsy. Epilepsia. 55:475–482. 2014. View Article : Google Scholar : PubMed/NCBI
16	Singh A and Trevick S: The epidemiology of global epilepsy. Neurol Clin. 34:837–847. 2016. View Article : Google Scholar : PubMed/NCBI
17	Ollenberger GP, Byrne AJ, Berlangieri SU, Rowe CC, Pathmaraj K, Reutens DC, Berkovic SF, Scheffer IE and Scott AM: Assessment of the role of FDG PET in the diagnosis and management of children with refractory epilepsy. Eur J Nucl Med Mol Imaging. 32:1311–1316. 2005. View Article : Google Scholar : PubMed/NCBI
18	Lagunju IA, Oyinlade AO and Babatunde OD: Seizure-related injuries in children and adolescents with epilepsy. Epilepsy Behav. 54:131–134. 2016. View Article : Google Scholar : PubMed/NCBI
19	Stephen LJ, Kwan P, Shapiro D, Dominiczak M and Brodie MJ: Hormone profiles in young adults with epilepsy treated with sodium valproate or lamotrigine monotherapy. Epilepsia. 42:1002–1006. 2001. View Article : Google Scholar : PubMed/NCBI
20	Fisher K, Vuppalanchi R and Saxena R: Drug-induced liver injury. Arch Pathol Lab Med. 139:876–887. 2015. View Article : Google Scholar : PubMed/NCBI
21	Guo CY, Ronen GM and Atkinson SA: Long-term valproate and lamotrigine treatment may be a marker for reduced growth and bone mass in children with epilepsy. Epilepsia. 42:1141–1147. 2001. View Article : Google Scholar : PubMed/NCBI
22	Weijenberg A, Brouwer OF and Callenbach PM: Levetiracetam monotherapy in children with epilepsy: A systematic review. CNS Drugs. 29:371–382. 2015. View Article : Google Scholar : PubMed/NCBI
23	Attilakos A, Dinopoulos A, Paschalidou M, Tsirouda M, Prasouli A, Siafakas N and Garoufi A: Effect of levetiracetam monotherapy on liver enzymes and creatine kinase concentrations in children with epilepsy: A prospective study. J Clin Neurol. 14:594–595. 2018. View Article : Google Scholar : PubMed/NCBI
24	Tan MJ and Appleton RE: Efficacy and tolerability of levetiracetam in children aged 10 years and younger: A clinical experience. Seizure. 13:142–145. 2004. View Article : Google Scholar : PubMed/NCBI
25	Moshiri F, Salvi A, Gramantieri L, Sangiovanni A, Guerriero P, De Petro G, Bassi C, Lupini L, Sattari A, Cheung D, et al: Circulating miR-106b-3p, miR-101-3p and miR-1246 as diagnostic biomarkers of hepatocellular carcinoma. Oncotarget. 9:15350–15364. 2018. View Article : Google Scholar : PubMed/NCBI
26	Wronska A, Kurkowska-Jastrzebska I and Santulli G: Application of microRNAs in diagnosis and treatment of cardiovascular disease. Acta Physiol (Oxf). 213:60–83. 2015. View Article : Google Scholar : PubMed/NCBI
27	Cava C, Manna I, Gambardella A, Bertoli G and Castiglioni I: Potential role of miRNAs as theranostic biomarkers of epilepsy. Mol Ther Nucleic Acids. 13:275–290. 2018. View Article : Google Scholar : PubMed/NCBI
28	Pitkänen A, Löscher W, Vezzani A, Becker AJ, Simonato M, Lukasiuk K, Gröhn O, Bankstahl JP, Friedman A, Aronica E, et al: Advances in the development of biomarkers for epilepsy. Lancet Neurol. 15:843–856. 2016. View Article : Google Scholar : PubMed/NCBI
29	An N, Zhao W, Liu Y, Yang X and Chen P: Elevated serum miR-106b and miR-146a in patients with focal and generalized epilepsy. Epilepsy Res. 127:311–316. 2016. View Article : Google Scholar : PubMed/NCBI
30	Wang J, Yu JT, Tan L, Tian Y, Ma J, Tan CC, Wang HF, Liu Y, Tan MS, Jiang T, et al: Genome-wide circulating microRNA expression profiling indicates biomarkers for epilepsy. Sci Rep. 5:95222015. View Article : Google Scholar : PubMed/NCBI