Effects of valproic acid, carbamazepine, and phenobarbitone on the fatty acid composition of erythrocyte membranes in children.
OBJECTIVE
To investigate a possible relation between antiepileptic drugs (AEDs) and the fatty acid composition of membranes.


METHODS
Fatty acid (FA) composition of erythrocytes was studied in children with epilepsy receiving AED monotherapy. Children taking valproate (VPA, n = 28), carbamazepine (CBZ, n = 17), or phenobarbitone (PB, n = 14) were compared with healthy controls (n = 25). FAs were measured by capillary-gas chromatography (GC-FID).


RESULTS
Significant changes (p < 0.05) in the FA composition of membranes were found. In children treated with VPA, C13:0 was decreased (8.2 +/- 2% vs. 10.7 +/- 4% in controls) and C14:0 increased (1.4 +/- 0.5% vs.1 +/- 0.5% in controls). C17:0 again was reduced (9.9 +/- 4% vs. 13.2 +/- 6% in controls), whereas the long-chained acids were enhanced: C18:2n-6 (6 +/- 2.4% vs. 3.9 +/- 2.5% in controls), and C20:4n-6 (1.9 +/- 1.7% vs. 1.4 +/- 0.5% in controls). The nonidentified FAs also increased with VPA therapy: 2.5 +/- 0.8% versus 1.7 +/- 0.9% in controls. Children treated with CBZ showed only minimal changes of FA composition: C13:0 was decreased compared with controls (8 +/- 2% vs. 10.7 +/- 4%). No changes were seen in patients taking PB. The mean corpuscular volume (MCV) showed important differences between the study groups: MCV was 84.7 +/- 6.0 fl during VPA therapy (p < 0.001) and 85.7 +/- 4.1 fl with CBZ (p < 0.001). During PB, the MCV increased to 82.87 +/- 3.29 fl compared with controls (78.73 +/- 4.92 fl; p < 0.01).


CONCLUSIONS
VPA therapy is associated with changes of the FA composition of membranes, which is not the case with PB therapy. The implications of this finding remain to be established.
König
Stephan A
SA
University Children's Hospital, University of Mannheim, Theodor-Kutzer-Ufer, 68167 Mannheim, Germany. drstkoenig@aol.com
Knolle
Julia
J
Friedewald
Steffen
S
Koelfen
Wolfgang
W
Longin
Elke
E
Lenz
Tamara
T
Hannak
Dieter
D
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D004910:Erythrocyte Membrane / Q000187:drug effects*; D005227:Fatty Acids / Q000097:blood*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010634:Phenobarbital / Q000627:therapeutic use*; D012016:Reference Values; D014635:Valproic Acid / Q000627:therapeutic use*
D000927:Anticonvulsants; D005227:Fatty Acids; D002220:Carbamazepine; D014635:Valproic Acid; D010634:Phenobarbital