MicroRNAs as potential biomarkers of response to modified Atkins diet in treatment of adults with drug-resistant epilepsy: A proof-of-concept study.

Autor: Samões R; Neurology Department, Centro Hospitalar Universitário de Santo António, ULS Santo António, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal. Electronic address: raquelsamoes.neurologia@chporto.min-saude.pt., Cavalheiro A; Nutrition Service, Centro Hospitalar Universitário do Porto, ULS Santo António, Porto, Portugal., Santos C; Immunogenetics Laboratory, Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal., Lopes J; Neurology Department, Centro Hospitalar Universitário de Santo António, ULS Santo António, Porto, Portugal., Teixeira C; Neurology Department, Centro Hospitalar Universitário de Santo António, ULS Santo António, Porto, Portugal., Tavares MM; Nutrition Service, Centro Hospitalar Universitário do Porto, ULS Santo António, Porto, Portugal., Carvalho C; Immunogenetics Laboratory, Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal., Lemos C; ICBAS, School of Medicine and Biomedical Sciences - University of Porto, Porto, Portugal; UnIGENe, IBMC - Instituto de Biologia Celular Molecular, Portugal; i3S‑Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal., E Costa PP; Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Immunogenetics Laboratory, Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal; Genetics Department, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal., Cavaco S; Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Neuropsychology Service, Centro Hospitalar Universitário de Santo António, ULS Santo António, Porto, Portugal., Chaves J; Neurology Department, Centro Hospitalar Universitário de Santo António, ULS Santo António, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal., Leal B; Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; Immunogenetics Laboratory, Abel Salazar Biomedical Sciences Institute - University of Porto, Porto, Portugal.
Jazyk: angličtina
Zdroj: Epilepsy research [Epilepsy Res] 2024 Dec; Vol. 208, pp. 107478. Date of Electronic Publication: 2024 Nov 08.
DOI: 10.1016/j.eplepsyres.2024.107478
Abstrakt: Background: Accurate predictors of response to modified Atkins diet (MAD) are needed. MicroRNAs are potential biomarkers in epilepsy. This study aimed to explore the value of circulating miR-146a, miR-155, miR-22, miR-21 and miR-134 levels in predicting response to MAD.
Methods: Patients who completed 3 months of MAD were selected from a prospective cohort of adults with DRE followed in a specialized MAD outpatient clinic. Patients were classified as responders if any reduction in seizure frequency at follow-up, calculated through seizure-calendars). The >50 % seizure reduction cut-off was also explored. Qualitative benefits in seizures and cognition were analysed. Blood samples were collected prior to initiate MAD and microRNAs were quantified by qRT-PCR.
Results: Thirty-nine patients were included (56 %males, mean age=33.1±8.5yo, 62 %focal epilepsies, 59 %structural aetiology): 20(51 %) were responders [mean reduction in seizure frequency=54 %(17-100 %); 10 had ≥50 % reduction]; 25(64 %) reported qualitative benefit in seizures and 21(54 %) reported cognitive benefits. At pre-treatment baseline, a panel combining serum levels of all studied microRNAs predicted seizure reduction (AUC=0.839, p<0.0001), qualitative benefit in seizures (AUC=0.683, p=0.048) and in cognition (AUC=0.751, p<0.01) at 3months. miR-146a was the only significant microRNA when evaluated in isolation. There was no statistical correlation in the biomarkers when a ≥50 % seizure reduction was compared to <50 %.
Conclusions: A panel combining pre-treatment serum levels of miR-146a, miR-155, miR-134, miR-21 and miR-22 predicted any reduction in seizures with MAD in adults with DRE at 3months. This panel may be a promising biomarker and a useful tool in the selection of patients.
Competing Interests: Declaratin of Competing Interest Raquel Samões has served as a paid consultant for Nutricia®; Raquel Samões, Ana Cavalheiro and Maria Manuel Tavares have received support from Nutricia® for participating in educational courses about ketogenic diet; Ana Cavalheiro and Maria Manuel Tavares have received support from Glutamine® for participating in educational courses about ketogenic diet. The remaining authors have no conflicts of interest
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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