抗癫痫药对成年癫痫患者体内细胞铁死亡的影响

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[中图分类号] R742.1 [文献标志码] A

Effect of antiepileptic drugs on ferroptosis of cells in adult patients with epilepsyWANG Feiyu， ZHONG Rujie，YANG Hailin，LI Xiaoyu，LIU Xue，GAO Jing（Departmentof Neurology，The Afited Hospitalof Qing dao University，Qingdao 266035，China）

[ABSTRACT]ObjectiveToinvestigatetheefectofmonotherapy withvalproicacid（VPA），lamotrigine（LTG）orlevetiracetam（LEV）onferroptosisofcelsinadult patients withepilepsy.MethodsAtotal of95 patients withepilepsy who were treated inDepartmentofNeurologyTheAfiliated HospitalofQingdaoUniversity，fromDecember222 toSeptember024were enroledas epilepsygroup，andaccording tothetypeof thedrug used，they were divided into VPAgroup，LTG group，and LEV group;93individuals，matchedforageandsex，whounderwent physicalexaminationin thesamehospitalduringthesame period of time were enroled as control group.Fasting peripheral venous blood samples were colectedfrom all subjects atbaselineand fromthepatients withepilepsyafter6monthsofmedication.Colorimetrywasused tomeasuretheserumlevelsofferousion （204 （Fe2+） ，glutathione （GSH），and malondialdehyde（MDA），and RT-qPCR and Western blot（WB）were used to measure the expresion levelsof glutathioneperoxidase4（GPX4）and solutecarierfamily7 member11（SLC7A11）in peripheralblood.The aboveindicators werecomparedbetween groups.ResultsAtbaseline，compared withthecontrol group，theepilepsygrouphad significantly higher serum levels of Fe2+ and MDA and significantly lower levels of GSH，GPX4，and SLC7A11 （ t=15.62-18.17 ， Z=-6.97-3.16，P<0.05） . After treatment，VPA，LTG，and LEV all significantly reduced the serum levels of Fe2+ and MDA in the epilepsy group （t=5.14-14.75，P<0.05） ，and LTG and VPA induced significantly greater reductions than LEV （ F=5.94 ， （204号 7.05，t=-3.56--2.38，P<0.05） . VPA，LTG，and LEV all inhibited the downregulation of GSH，GPX4，and SLC7A1l in peripheral blood （t=3.06-11.15，P<0.05） ，with no significant difference in the degree of such inhibition between the three drugs （ P>0.05） .ConclusionThe threeantiepileptic drugs VPA，LTG，and LEVcan inhibit feroptosis of cels in adult patients with epilepsy，whileLTGandVPAhaveabeterefectthanLEVinimproving ironoverloadandlipidperoxidationduringferroptosis.

[KEY WORDs]Epilepsy；Ferroptosis；Anticonvulsants； Valproic acid； Lamotrigine； Levetiracetam;Treatment outcome;Adult

癫痫是一种具有致残性的慢性神经系统疾病，目前全球癫痫患者已超过7000万人[1]。（剩余11050字）