Вплив леветирацетаму та нікотинаміду на інтерлейкін-1-продукуючу функцію мононуклеарних клітин крові у хворих на епілепсію

Abstract

На фоне лечения детей, у которых была диагностирована височная эпилепсия с применением в течение месяца леветирацетама (дважды в сутки по 250 мг у детей до 12 лет и 500 мг — старшего возраста), а также никотинамида (10,0 мг дважды в сутки, внутримышечно) в течение двух недель отмечено снижение показателя пролиферативной активности мононуклеарных клеток крови, индуцированной бактериальным липополисахаридом и фитогемагглютинином, показатель выраженности которой до лечения превышал таковой в группе практически здорових в 2,16 раза. При этом исследуемый показатель был меньше, чем в группе пациентов с традиционным лечением, на 33,5 % (р<0,05), а также на 28,2 % в сравнении с показателем в группе пациентов, которым применяли один леветирацетам (р<0,05).

Mechanisms of epileptiform signs precipitation and development are recognized as dependent upon cytokines level, including interleukin-1 (IL-1). Antiepleptic drugs are able to affect the level of cytokines both in blood and nervous tissue. Objective is to determine the functional capacity of those cells which are the sources of IL-1 and peculiaities of this ability under conditions of antiepileptic treatment. All measurements have been performed in children who suffered from temporal epilepsy in accordance to the next scheme: on the third day after abandoning the traditional pharmacotherapy (15 children), after a month long treatment with levetiracetam (LVR) (15 children); after a month long treatment with LVR combined with nicotinamide during the last two weeks of LVR treatment (22 children). LVR (UCB Pharma, Germany) was given twice per day starting with 250 (in children up to 12 years) and 500 (more than 12 years old) mg per one administration with the consequent increasing of dosage of LVR up to 1500–2000 mg. Nicotinamide (5.0% solution) was used in a dosage of 10.0 мг twice per day i. m. With the aim of determination of the functional state of mononuclear cells the index of lymphocytes proliferative activity (ILPA) was determined. It was recalculated as a ratio between relative amount of blast cells in those samples where bacterial lipopolysaccharide (LPS) and phytohemagglutinin (PhGA) activation was performed to the relative number of blast cells in those samples which contained not-activated monocytes and PhGA-activated lymphocytes. The relative number of blast — transformed lymphocytes has been determined as well.