Mean daily plasma concentrations of beta-endorphin, leu-enkephalin, ACTH, cortisol, and DHEAS in epileptic patients with complex partial seizures evolving to generalized tonic-clonic seizures.
Mean daily plasma concentrations of beta-endorphin, leu-enkephalin, ACTH, cortisol, and DHEAS in epileptic patients with complex partial seizures evolving to generalized tonic-clonic seizures.
复制标题
复杂部分性癫痫发作发展为全身强直阵挛性癫痫发作的癫痫患者的 β-内啡肽、亮氨酸脑啡肽、ACTH、皮质醇和 DHEAS 的每日平均血浆浓度。
作者：
B. Marek;D. Kajdaniuk;B. Kos;J. Kapustecki;E. Świętochowska;Z. Ostrowska;L. Siemińska;M. Nowak;J. Głogowska;H. Borgiel;N. Ciesielska;W. Foltyn;K. Pierzchala;R. Krysiak;R. Bienek
引言
癫痫的病理生理学涉及多种机制。
客观化
目的：评估复杂部分性发作演变为强直-阵挛的癫痫患者血浆ACTH、皮质醇、DHEAS、亮氨酸脑啡肽和β-内啡肽的日均浓度与癫痫发作频率(每周发作数次和每年发作数次)和病程(小于或大于10年)的关系。我们决定分析β-内啡肽和亮氨酸脑啡肽的日均浓度，因为这两种物质在白天血液中的浓度存在显著差异。
材料和方法
17例患者(男性14例，女性3例；平均年龄31.8岁)接受卡马西平(300-1800 mg/d)治疗。对照组由6名年龄匹配的健康志愿者组成。分别在上午8点、下午2点、晚上8点和凌晨2点采集血液。组间分析采用单因素方差Kruskal-Wallis检验。
结果
与健康志愿者相比，癫痫患者血液中ACTH和皮质醇的日均浓度高于健康志愿者，与癫痫发作频率和病程无关。与健康受试者相比，临床病程越重(癫痫发作更频繁，病程更长)的癫痫患者血液中β-内啡肽的平均日浓度更高。癫痫患者病程短的患者血中亮氨酸脑啡肽的日平均浓度高于病程长的患者。
结论
1.临床活动期癫痫患者存在垂体-肾上腺轴过度活动，与癫痫发作频率和病程无关。2.内源性阿片系统活性的变化与癫痫的临床活动性有关--β-内啡肽浓度与癫痫发作次数和病程有关，亮氨酸脑啡肽浓度与病程有关。3.内源性阿片肽可能参与人类癫痫的神经化学机制。(Pol J Endocrinol 2010；61(1)：103-110)。
INTRODUCTION
A multitude of mechanisms have been implicated in the pathophysiology of epilepsy.
OBJECTIVE
To assess mean daily plasma concentrations of ACTH, cortisol, DHEAS, leu-enkephalin, and beta-endorphin in epileptic patients with complex partial seizures evolving to tonic-clonic in relation to frequency of seizure occurrence (groups with seizure occurrences - several per week and several per year) and duration of the disease (groups less than and more than 10 years). We decided to analyse mean daily values of beta-endorphin and leu-enkephalin because of significant differences in concentrations of these substances in blood during the day.
MATERIAL AND METHODS
The study was performed on 17 patients (14 males + 3 females; mean age 31.8 yrs) treated with carbamazepine (300-1800 mg/day). The control group consisted of six age-matched healthy volunteers. Blood was collected at 8 a.m., 2 p.m., 8 p.m., and 2 a.m. Intergroup analysis was performed with the use of ANOVA Kruskal-Wallis test.
RESULTS
Mean daily concentrations of ACTH and cortisol in the blood of the patients with epilepsy were higher in comparison with those of the healthy volunteers, independently of the frequency of seizures and duration of the disease. Mean daily concentrations of beta-endorphin in the blood of the patients with epilepsy were higher in the groups of patients with more severe clinical course of disease (with more frequently occurring epilepsy seizures and longer duration of the disease) in comparison with healthy subjects. Mean daily concentrations of leu-enkephalin in the blood of the patients with epilepsy were higher in the group of patients with short duration of the disease in comparison with the group with long duration of the disease.
CONCLUSIONS
1. Pituitary-adrenal axis hyperactivity is observed in patients with clinically active epilepsy, independently of the frequency of seizures and duration of the disease. 2. Changes in endogenous opioid system activity are related to the clinical activity of epilepsy - beta-endorphin concentrations are connected with frequency of seizures and duration of the disease and leu-enkephalin concentrations with duration of the disease. 3. Endogenous opioid peptides might take part in the neurochemical mechanism of human epilepsy. (Pol J Endocrinol 2010; 61 (1): 103-110).