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July 03, 2018; 91 (1) Article

High plasma levels of ghrelin and des-acyl ghrelin in responders to antiepileptic drugs

Maddalena Marchiò, Laura Roli, Carmela Giordano, Elisa Caramaschi, Azzurra Guerra, Tommaso Trenti, Giuseppe Biagini
First published May 25, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005741
Maddalena Marchiò
From the Department of Biomedical, Metabolic and Neural Sciences (M.M., C.G., G.B.) and Center for Neuroscience and Neurotechnology (G.B.), University of Modena and Reggio Emilia; Pediatric Neurology (M.M., E.C., A.G.), Polyclinic Hospital; and Department of Laboratory Medicine and Pathological Anatomy (L.R., T.T.), AUSL Modena, Italy.
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Laura Roli
From the Department of Biomedical, Metabolic and Neural Sciences (M.M., C.G., G.B.) and Center for Neuroscience and Neurotechnology (G.B.), University of Modena and Reggio Emilia; Pediatric Neurology (M.M., E.C., A.G.), Polyclinic Hospital; and Department of Laboratory Medicine and Pathological Anatomy (L.R., T.T.), AUSL Modena, Italy.
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Carmela Giordano
From the Department of Biomedical, Metabolic and Neural Sciences (M.M., C.G., G.B.) and Center for Neuroscience and Neurotechnology (G.B.), University of Modena and Reggio Emilia; Pediatric Neurology (M.M., E.C., A.G.), Polyclinic Hospital; and Department of Laboratory Medicine and Pathological Anatomy (L.R., T.T.), AUSL Modena, Italy.
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Elisa Caramaschi
From the Department of Biomedical, Metabolic and Neural Sciences (M.M., C.G., G.B.) and Center for Neuroscience and Neurotechnology (G.B.), University of Modena and Reggio Emilia; Pediatric Neurology (M.M., E.C., A.G.), Polyclinic Hospital; and Department of Laboratory Medicine and Pathological Anatomy (L.R., T.T.), AUSL Modena, Italy.
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Azzurra Guerra
From the Department of Biomedical, Metabolic and Neural Sciences (M.M., C.G., G.B.) and Center for Neuroscience and Neurotechnology (G.B.), University of Modena and Reggio Emilia; Pediatric Neurology (M.M., E.C., A.G.), Polyclinic Hospital; and Department of Laboratory Medicine and Pathological Anatomy (L.R., T.T.), AUSL Modena, Italy.
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Tommaso Trenti
From the Department of Biomedical, Metabolic and Neural Sciences (M.M., C.G., G.B.) and Center for Neuroscience and Neurotechnology (G.B.), University of Modena and Reggio Emilia; Pediatric Neurology (M.M., E.C., A.G.), Polyclinic Hospital; and Department of Laboratory Medicine and Pathological Anatomy (L.R., T.T.), AUSL Modena, Italy.
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Giuseppe Biagini
From the Department of Biomedical, Metabolic and Neural Sciences (M.M., C.G., G.B.) and Center for Neuroscience and Neurotechnology (G.B.), University of Modena and Reggio Emilia; Pediatric Neurology (M.M., E.C., A.G.), Polyclinic Hospital; and Department of Laboratory Medicine and Pathological Anatomy (L.R., T.T.), AUSL Modena, Italy.
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High plasma levels of ghrelin and des-acyl ghrelin in responders to antiepileptic drugs
Maddalena Marchiò, Laura Roli, Carmela Giordano, Elisa Caramaschi, Azzurra Guerra, Tommaso Trenti, Giuseppe Biagini
Neurology Jul 2018, 91 (1) e62-e66; DOI: 10.1212/WNL.0000000000005741

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Abstract

Objective To reconsider ghrelin and des-acyl ghrelin plasma levels in children with epilepsy in order to establish a possible relation with response to antiepileptic drugs (AEDs).

Methods We designed an observational study in which 114 patients with epilepsy were classified as responders (77) or nonresponders (37) and compared to 59 controls. In these patients, we measured ghrelin and des-acyl ghrelin by immunoassays in blood samples obtained after overnight fast.

Results Ghrelin plasma levels were higher (+94%; p < 0.001, Dunn test) in responders compared to controls. Des-acyl ghrelin plasma levels were also higher in the same group (+55%; p < 0.001). In addition, both hormones were unmodified in nonresponders compared to controls. By comparing responders to nonresponders, ghrelin and des-acyl ghrelin, respectively, were +126% (p < 0.001) and +29% (p < 0.001) in patients with a positive response to AEDs.

Conclusions These results indicate that ghrelin and des-acyl ghrelin plasma levels are especially high in patients with epilepsy who positively respond to AEDs. In view of the anticonvulsant properties of ghrelin and des-acyl ghrelin, we propose that their higher levels could play a role in modulating the response to AEDs. Moreover, these peptides could be promising markers of response to AEDs.

Glossary

AED=
antiepileptic drug;
IQR=
interquartile range;
RT=
room temperature

Footnotes

  • ↵* These authors contributed equally to this work.

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • See page 29

  • Received November 23, 2017.
  • Accepted in final form March 30, 2018.
  • © 2018 American Academy of Neurology
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