Evaluation of serum ghrelin, nesfatin-1, irisin, and vasoactive intestinal peptide levels in temporal lobe epilepsy patients with and without drug resistance: a cross-sectional study

SUMMARY OBJECTIVE: Epilepsy is a common disorder that affects the nervous systems of 1% of worldwide population. In epilepsy, one-third of patients are unresponsive to current drug therapies and develop drug-resistant epilepsy. Alterations in ghrelin, nesfatin-1, and irisin levels with epilepsy were reported in previous studies. Vasoactive intestinal peptide is among the most common neuropeptides in the hippocampus, which is the focus of the seizures in temporal lobe epilepsy. However, there is also lack of evidence of whether these four neuropeptide levels are altered with drug resistant temporal lobe epilepsy or not. The aim herein was the evaluation of the serum levels of nesfatin-1, ghrelin, irisin, and Vasoactive intestinal peptide in drug-resistant temporal lobe epilepsy patients and temporal lobe epilepsy (TLE) without drug resistance, and to compare them to healthy controls. METHODS: This cross-sectional study group included 58 temporal lobe epilepsy patients (24 with drug resistant temporal lobe epilepsy and 34 with temporal lobe epilepsy who were not drug-resistant) and 28 healthy subjects. Nesfatin-1, ghrelin, irisin, and Vasoactive intestinal peptide serum levels were determined using enzyme-linked immunosorbent assay. RESULTS: The serum ghrelin levels of patients with drug resistant temporal lobe epilepsy were seen to have significantly decreased when compared to those of the control group (p<0.05). Serum nesfatin-1, vasoactive intestinal peptide, and irisin levels were seen to have decreased in the drug resistant temporal lobe epilepsy group when compared to those of the control and temporal lobe epilepsy groups; however, the difference was non-significant (p>0.05). CONCLUSIONS: The results herein suggested that ghrelin might contribute to the pathophysiology of drug resistant temporal lobe epilepsy. However, further studies are needed to confirm this hypothesis.

The possible effects of altitude and climate on the development of the frontal sinus in adults / Los posibles efectos de la altitud y el clima sobre el desarrollo del seno frontal en adultos

Climatic and altitude features of living region may affect human body. Many changes in several tissues and organs and several health problems due to climatic and altitude effects were defined in the literature. However, there were limited number of studies which evaluated correlation between development of frontal sinus and climatic/altitude effect. In this study, widths, heights, AP lengths and volumes of frontal sinus were compared by Paranasal CT scans in populations living in Van which has colder climate and higher altitude and Manisa which has milder climate and lower altitude. It was found that widths, antero-posterior lengths and volumes of frontal sinus were higher in populations living in colder climate and higher altitude according to populations living in milder climate and lower altitude. Heights of frontal sinuses were on the contrary of this. These results were found appropriate to increasing of cephalic index in cold climate according to Allen's Rule. We suggest that larger population study should be made with peoples having the same or similar race and genetic structure in different climate and altitude regions and the proportional comparison of frontal sinus measurements with cephalic index should be considered in future studies.

Las características climáticas y de altitud de una región pueden afectar al cuerpo humano. En la literatura se han identificado muchos cambios en varios tejidos y órganos, como así también numerosos problemas de salud debido a los efectos climáticos y de altitud. Sin embargo, existe un número limitado de estudios que han evaluado la correlación entre el desarrollo del seno frontal y el efecto climático / altitud. En este estudio, los anchos, alturas, longitudes antero-posteriores y volúmenes de seno frontal se compararon mediante tomografía computarizada paranasal en poblaciones que viven en Van, que tiene un clima más frío y mayor altitud, y Manisa, que tiene un clima más suave y menor altitud. Se encontró que los anchos, las longitudes antero-posteriores y los volúmenes de los senos frontales eran mayores en poblaciones que vivían en un clima más frío y de mayor altitud respecto a poblaciones que vivían en clima más suave y con menor altitud. En relación a la altura de los senos frontales, se dio la situación contraria a lo anterior. Estos resultados se encontraron adecuados con el aumento del índice cefálico en la región de clima frío, de acuerdo con la Regla de Allen. Sugerimos que se realice un estudio poblacional más amplio con poblaciones de raza y estructura genética iguales o similares en diferentes regiones climáticas y de altitud. La comparación proporcional de las mediciones de los senos frontales con índice cefálico debería considerarse en futuros estudios.