1
|
Ildarabadi A, Mir Mohammad Ali SN, Rahmani F, Mosavari N, Pourbakhtyaran E, Rezaei N. Inflammation and oxidative stress in epileptic children: from molecular mechanisms to clinical application of ketogenic diet. Rev Neurosci 2024; 35:473-488. [PMID: 38347675 DOI: 10.1515/revneuro-2023-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 12/18/2023] [Indexed: 06/02/2024]
Abstract
Childhood epilepsy affects up to 1 % of children. It has been shown that 30 % of patients are resistant to drug treatments, making further investigation of other potential treatment strategies necessary. One such approach is the ketogenic diet (KD) showing promising results and potential benefits beyond the use of current antiepileptic drugs. This study aims to investigate the effects of KD on inflammation and oxidative stress, as one of the main suggested mechanisms of neuroprotection, in children with epilepsy. This narrative review was conducted using the Medline and Google Scholar databases, and by searching epilepsy, drug-resistant epilepsy, child, children, ketogenic, ketogenic diet, diet, ketogenic, keto, ketone bodies (BHB), PUFA, gut microbiota, inflammation, inflammation mediators, neurogenic inflammation, neuroinflammation, inflammatory marker, adenosine modulation, mitochondrial function, MTOR pathway, Nrf2 pathway, mitochondrial dysfunction, PPARɣ, oxidative stress, ROS/RNS, and stress oxidative as keywords. Compelling evidence underscores inflammation and oxidative stress as pivotal factors in epilepsy, even in cases with genetic origins. The ketogenic diet effectively addresses these factors by reducing ROS and RNS, enhancing antioxidant defenses, improving mitochondrial function, and regulating inflammatory genes. Additionally, KD curbs pro-inflammatory cytokine and chemokine production by dampening NF-κB activation, inhibiting the NLRP3 inflammasome, increasing brain adenosine levels, mTOR pathway inhibition, upregulating PPARɣ expression, and promoting a healthy gut microbiota while emphasizing the consumption of healthy fats. KD could be considered a promising therapeutic intervention in patients with epilepsy particularly in drug-resistant epilepsy cases, due to its targeted approach addressing oxidative stress and inflammatory mechanisms.
Collapse
Affiliation(s)
- Azam Ildarabadi
- Department of Nutrition Science, Science and Research Branch, Faculty of Medical Science and Technology, Islamic Azad University, Shodada Hesarak Blvd, Tehran 1477893855, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Dr. Qarib St, Tehran 1419733151, Iran
| | - Seyedeh Nooshan Mir Mohammad Ali
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Dr. Qarib St, Tehran 1419733151, Iran
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS 66502, USA
| | - Fatemeh Rahmani
- Department of Nutrition Science, Science and Research Branch, Faculty of Medical Science and Technology, Islamic Azad University, Shodada Hesarak Blvd, Tehran 1477893855, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Dr. Qarib St, Tehran 1419733151, Iran
| | - Narjes Mosavari
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Dr. Qarib St, Tehran 1419733151, Iran
| | - Elham Pourbakhtyaran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Dr. Qarib St, Tehran 1419733151, Iran
- Department of Pediatric Neurology, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Qarib St, Tehran 1419733151, Iran
| | - Nima Rezaei
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Dr. Qarib St, Tehran 1419733151, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Dr. Qarib St, Tehran 1419733151, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Science, Pour Sina St, Tehran 1461884513, Iran
- Research Center for Immunodeficiencies, Children's Medical Center Hospital, Dr. Qarib St, Keshavarz Blvd, Tehran 14194, Iran
| |
Collapse
|
2
|
Reza-López SA, González-Gurrola S, Morales-Morales OO, Moreno-González JG, Rivas-Gómez AM, González-Rodríguez E, Moreno-Brito V, Licón-Trillo A, Leal-Berumen I. Metabolic Biomarkers in Adults with Type 2 Diabetes: The Role of PPAR-γ2 and PPAR-β/δ Polymorphisms. Biomolecules 2023; 13:1791. [PMID: 38136661 PMCID: PMC10741495 DOI: 10.3390/biom13121791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/27/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
Glucose and lipid metabolism regulation by the peroxisome proliferator-activated receptors (PPARs) has been extensively reported. However, the role of their polymorphisms remains unclear. OBJECTIVE To determine the relation between PPAR-γ2 rs1801282 (Pro12Ala) and PPAR-β/δ rs2016520 (+294T/C) polymorphisms and metabolic biomarkers in adults with type 2 diabetes (T2D). MATERIALS AND METHODS We included 314 patients with T2D. Information on anthropometric, fasting plasma glucose (FPG), HbA1c and lipid profile measurements was taken from clinical records. Genomic DNA was obtained from peripheral blood. End-point PCR was used for PPAR-γ2 rs1801282, while for PPAR-β/δ rs2016520 the PCR product was digested with Bsl-I enzyme. Data were compared with parametric or non-parametric tests. Multivariate models were used to adjust for covariates and interaction effects. RESULTS minor allele frequency was 12.42% for PPAR-γ2 rs1801282-G and 13.85% for PPAR-β/δ rs2016520-C. Both polymorphisms were related to waist circumference; they showed independent effects on HbA1c, while they interacted for FPG; carriers of both PPAR minor alleles had the highest values. Interactions between FPG and polymorphisms were identified in their relation to triglyceride level. CONCLUSIONS PPAR-γ2 rs1801282 and PPAR-β/δ rs2016520 polymorphisms are associated with anthropometric, glucose, and lipid metabolism biomarkers in T2D patients. Further research is required on the molecular mechanisms involved.
Collapse
Affiliation(s)
- Sandra A. Reza-López
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Campus II. Circuito Universitario S/N, Chihuahua 31109, CP, Mexico; (S.A.R.-L.); (O.O.M.-M.); (J.G.M.-G.); (E.G.-R.); (V.M.-B.); (A.L.-T.)
| | - Susana González-Gurrola
- Instituto Mexicano del Seguro Social UMF 33, Avenida Melchor Ocampo y Arroyo de los Perros S/N, Col. El Palomar, Chihuahua 31204, CP, Mexico; (S.G.-G.); or (A.M.R.-G.)
| | - Oscar O. Morales-Morales
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Campus II. Circuito Universitario S/N, Chihuahua 31109, CP, Mexico; (S.A.R.-L.); (O.O.M.-M.); (J.G.M.-G.); (E.G.-R.); (V.M.-B.); (A.L.-T.)
| | - Janette G. Moreno-González
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Campus II. Circuito Universitario S/N, Chihuahua 31109, CP, Mexico; (S.A.R.-L.); (O.O.M.-M.); (J.G.M.-G.); (E.G.-R.); (V.M.-B.); (A.L.-T.)
| | - Ana M. Rivas-Gómez
- Instituto Mexicano del Seguro Social UMF 33, Avenida Melchor Ocampo y Arroyo de los Perros S/N, Col. El Palomar, Chihuahua 31204, CP, Mexico; (S.G.-G.); or (A.M.R.-G.)
| | - Everardo González-Rodríguez
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Campus II. Circuito Universitario S/N, Chihuahua 31109, CP, Mexico; (S.A.R.-L.); (O.O.M.-M.); (J.G.M.-G.); (E.G.-R.); (V.M.-B.); (A.L.-T.)
| | - Verónica Moreno-Brito
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Campus II. Circuito Universitario S/N, Chihuahua 31109, CP, Mexico; (S.A.R.-L.); (O.O.M.-M.); (J.G.M.-G.); (E.G.-R.); (V.M.-B.); (A.L.-T.)
| | - Angel Licón-Trillo
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Campus II. Circuito Universitario S/N, Chihuahua 31109, CP, Mexico; (S.A.R.-L.); (O.O.M.-M.); (J.G.M.-G.); (E.G.-R.); (V.M.-B.); (A.L.-T.)
| | - Irene Leal-Berumen
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Campus II. Circuito Universitario S/N, Chihuahua 31109, CP, Mexico; (S.A.R.-L.); (O.O.M.-M.); (J.G.M.-G.); (E.G.-R.); (V.M.-B.); (A.L.-T.)
| |
Collapse
|
3
|
Slanina AM, Coman AE, Anton-Păduraru DT, Popa E, Barbacariu CL, Novac O, Petroaie AD, Bacușcă AI, Manole M, Cosmescu A. PEX6 Mutation in a Child with Infantile Refsum Disease—A Case Report and Literature Review. CHILDREN 2023; 10:children10030530. [PMID: 36980088 PMCID: PMC10047879 DOI: 10.3390/children10030530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023]
Abstract
The aim of this paper is to describe the temporal progression and clinical picture of a 2-year-old child with infantile Refsum disease, as well as the diagnostic procedures performed; this case presented multiple hematologic, metabolic, and developmental complications and progressive disabilities. Genetic testing revealed a mutation of the PEX6 (Peroxisomal Biogenesis Factor 6) gene, and the metabolic profile was consistent with the diagnosis. Particularly, the child also presented altered coagulation factors and developed a spontaneous brain hemorrhage. The clinical picture includes several neurological, ophthalmological, digestive, cutaneous, and endocrine disorders as a result of the very long chain fatty acid accumulation as well as secondary oxidative anomalies. The study of metabolic disorders occurring because of genetic mutations is a subject of core importance in the pathology of children today. The PEX mutations, difficult to identify antepartum, are linked to an array of cell anomalies with severe consequences on the patient’s status, afflicting multiple organs and systems. This is the reason for which our case history may be relevant, including a vast number of symptoms, as well as modified biological parameters.
Collapse
Affiliation(s)
- Ana-Maria Slanina
- Department of Family Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
| | - Adorata-Elena Coman
- Department of Family Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
| | - Dana-Teodora Anton-Păduraru
- Department of Mother and Child Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
- Correspondence:
| | - Elena Popa
- Department of Family Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
| | - Carmen-Liliana Barbacariu
- Department of Family Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
| | - Otilia Novac
- Department of Family Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
| | - Antoneta Dacia Petroaie
- Department of Family Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
| | - Agnes-Iacinta Bacușcă
- Department of Family Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
| | - Mihaela Manole
- Department of Family Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
| | - Adriana Cosmescu
- Department of Family Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași 700115, Romania
| |
Collapse
|