Serum zinc and copper levels in a sample of Egyptian epileptic children

Evaluating the serum levels of zinc, copper, magnesium, and 25-hydroxy vitamin D in children with idiopathic drug-resistant epilepsy; a cross-sectional study

BACKGROUND

Drug-resistant epilepsy is defined as failure of seizure control in spite of using 2 or 3 proper antiepileptic drugs in appropriate time. Mineral elements play important roles in neuronal function; it is believed that mineral deficiency may lead to complications through seizure management. In the present study, serum levels of zinc (Zn), copper (Cu), magnesium (Mg), calcium (Ca), and 25-hydroxy vitamin D (Vit D) in drug-resistant-epilepsy (DRE) patients were evaluated and compared with the controlled patients.

METHODS

In this cross-sectional study, epileptic patients were included and categorized into two groups of DRE and well-controlled patients. Patients' serum samples were analysed to evaluate Zn, Cu, Mg, Ca, and Vit D levels. The primary objective was comparison of serum levels of different trace elements between the groups.

RESULTS

Sixty-four epileptic children including 33 DRE and 31 well-controlled children entered the study. The DRE children showed a significantly earlier onset of disease compared to the other group (p = 0.014). Comparing the frequency of developmental delay between the groups, the results showed this complication was significantly more frequent in the DRE group (p < 0.001). Concerning serum elements, the results showed a significantly higher concentration of Zn in the well-controlled group than the DRE group (p = 0.007). On the other hand, no significant differences were observed between the groups regarding the means of Vit D, Ca, Cu, and Mg levels (p > 0.05).

CONCLUSION

The results of the present study delineated that drug-resistant epilepsy patients had earlier onset of disease and were at higher risk of neurodevelopmental delay compared with well-controlled-epilepsy patients. A significant lower serum levels of Zn were also observed in drug-resistant-epilepsy patients. This finding may suggest the role of zinc supplementation in help to better control of drug-resistant seizures, as well as, the importance of serum zinc monitoring in epileptic patients.

Serum Levels of Growth-Associated Protein-43 and Neurotrophin-3 in Childhood Epilepsy and Their Relation to Zinc Levels

BACKGROUND

Epilepsy is one of the most common neurological disorders, and it places a significant economic strain on the healthcare system around the world. Although the exact mechanism of epilepsy has yet to be illustrated, various pathogenic cascades involving neurotransmitters and trace elements have been reported. We aimed to investigate the serum levels of growth-associated protein-43 (GAP-43) and neurotrophin-3 (NT-3) among cohort of Egyptian children with epilepsy and correlate these biomarkers with their zinc levels.

METHODS

This case-control study included 50 pediatric patients with epilepsy who were comparable with 50 controls. Neurological assessment and electroencephalogram (EEG) were done to all included children. Biochemical measurements of serum GAP-43 and NT-3 using enzyme linked immunosorbent assays (ELISA), and total antioxidant capacity (TAC) and zinc using colorimetric assays, were performed to all participants.

RESULTS

There was significantly frequent positive parental consanguinity among cases with significantly frequent generalized onset seizures (94%) than simple partial seizure (6%). There were significantly lower serum GAP-43 and zinc levels with significantly higher TAC among cases vs. the controls, p˂0.05 for all. There was no significant difference in the serum levels of NT-3 among epileptic children vs. the controls, p = 0.269. Serum Zn was positively correlated with GAP-43 level among epileptic children (r = 0.381, p = 0.006). Serum GAP-43 in diagnosing childhood epilepsy at cut-off point ≤ 0.6 ng/mL showed 78% sensitivity, 62% specificity, positive predictive value (PPV) = 50.6%, negative predictive value (NPP) = 84.9% with AUC = 0.574.

CONCLUSION

GAP-43 can be considered a sensitive good negative biomarker in childhood epilepsy which correlated positively with the zinc status.

Cellular and molecular mechanisms underlying autism spectrum disorders and associated comorbidities: A pathophysiological review

Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders that develop in early life due to interaction between several genetic and environmental factors and lead to alterations in brain function and structure. During the last decades, several mechanisms have been placed to explain the pathogenesis of autism. Unfortunately, these are reported in several studies and reviews which make it difficult to follow by the reader. In addition, some recent molecular mechanisms related to ASD have been unrevealed. This paper revises and highlights the major common molecular mechanisms responsible for the clinical symptoms seen in people with ASD, including the roles of common genetic factors and disorders, neuroinflammation, GABAergic signaling, and alterations in Ca⁺² signaling. Besides, it covers the major molecular mechanisms and signaling pathways involved in initiating the epileptic seizure, including the alterations in the GABAergic and glutamate signaling, vitamin and mineral deficiency, disorders of metabolism, and autoimmunity. Finally, this review also discusses sleep disorder patterns and the molecular mechanisms underlying them.

Effect of Zinc Supplementation in Children Less Than 5 Years on Diarrhea Attacks: A Randomized Controlled Trial

Recurrent infections and weak immunity were found to be linked with zinc deficiency especially in children. The goal of this study is to measure the level of blood zinc in children aged 6 months to less than 5 years old, and to assess the effect of 4 months of daily zinc supplements on the incidence and the severity of diarrheal morbidity. A randomized controlled trial study was conducted in Pediatric Outpatient Clinic in Ain Shams University Hospital on 140 children less than 5 years old who are apparently healthy. Random assignment of the sampled children to group receiving zinc (70 children) or group receiving placebo (70 children) was done. A questionnaire containing questions about occurrence of diarrhea was used during follow up. Serum zinc at baseline was measured. The mean age was 25.26 ± 15.7 months. Mean of serum zinc was 51.08 μg/dL, with 70% had low baseline serum zinc level. Cumulative incidence of diarrhea, number of diarrhea episodes per child and frequency of stools/day decreased significantly in zinc group (P < .05). Risk ratio was found to be 0.79, 95% CI: 0.64 to 0.97. we concluded that incidence of diarrhea and its severity reduced in children received zinc daily for 4 months.

This trial was registered at www.clinicaltrials.gov as NCT05002101.

The Relationship between Hair Zinc Levels and Drug-resistant Epilepsy in Children at Sanglah Hospital

BACKGROUND: Drug-resistant epilepsy (DRE) is epilepsy that is failed to achieve free of seizure after adequate trials of two tolerated and appropriately chosen antiepileptic drugs. Zinc deficiency could trigger the onset of various neurological disorders, including seizures in epilepsy. AIM: The objective of the study was to determine the relationship between hair zinc levels and DRE in children at Sanglah Hospital, Denpasar. METHODS: This is an analytic observational study using a cross-sectional design, involving 74 subjects. The inclusion criteria were children aged 1 month–18 years who had been diagnosed with epilepsy. Chi-square test and multivariate analysis with logistic regression were used to assess the relation between hair zinc levels and DRE in children. RESULTS: Multivariate analysis found a relationship between low hair zinc level and DRE in children (PR 8.0; 95% CI 2.0–32.2; p = 0.003). The duration of therapy (PR 16.0; 95% CI 3.9–65.4; p = 0.000) and structural abnormalities (PR 4.1; 95% CI 1.1–14.9; p = 0.028) also increased the risk of DRE in this study. CONCLUSION: Low hair zinc level is associated with DRE in children.