Antiepileptic drugs and MTHFR polymorphisms influence hyper-homocysteinemia recurrence in epileptic patients.
The influence of antiepileptic drugs (AEDs) and/or common polymorphisms (677C --> T, 1298A --> C) of the methylene-tetrahydrofolate-reductase (MTHFR) gene on the recurrence time of hyper-total-homocysteinemia (tHcy > 13 micromol/L) was investigated in 59 hyper-homocysteinemic patients (34M/25F, 20-49 years). Plasma tHcy and folate were assayed before and after 1-month folate supplementation (5 mg/day), and after 2, 4, and 6 months. Four MTHFR polymorphism groups were identified with the following tHcy (micromol/L) and folate (nmol/L) levels (mean +/- SD): (a) MTHFR677TT/1298AA, 24 patients, 36.0 +/- 4.8, 4.1 +/- 0.7; (b) MTHFR677CT/1298AC 27.1 +/- 2.7, 5.3 +/- 1.0 (n = 15); (c) MTHFR677CT/1298AA 16.6 +/- 3.6, 6.8 +/- 1.0 (n = 11), all taking enzyme-inducing AEDs; and (d) MTHFR677TT/1298AA 24.5 +/- 3.2, 5.6 +/- 1.1 (n = 9), treated with new AEDs. After folate therapy, plasma t-Hcy and folate were normal in all patients. At 6 months, 43 patients (72.9%) exhibited hyper-tHcy, the greater proportion belonging to the EI-AED-MTHFR677TT/1298AA (39%). Knowledge of the hyper-tHcy recurrence time after folate therapy discontinuation may help in optimizing folate supplementation pulses.
Belcastro
Vincenzo
V
Department of Neurosciences, of Psychiatric and Anaesthesiological Sciences, First Neurology Clinic, University of Messina, Messina, Italy.
Gaetano
Gorgone
G
Italiano
Domenico
D
Oteri
Giancarla
G
Caccamo
Daniela
D
Pisani
Laura Rosa
LR
Striano
Pasquale
P
Striano
Salvatore
S
Ientile
Riccardo
R
Pisani
Francesco
F
D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy; D005260:Female; D005492:Folic Acid / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000188:drug therapy* / Q000235:genetics*; D008137:Longitudinal Studies; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D012008:Recurrence; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D016896:Treatment Outcome
D000927:Anticonvulsants; D006710:Homocysteine; D005492:Folic Acid; D042965:Methylenetetrahydrofolate Reductase (NADPH2)