Effect of Levetiracetam add-on therapy on expression of multidrug resistant-associated protein 1 and 2 in peripheral blood mononuclear cells of children with intractable epilepsy / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the changes of multidrug resistant-associated protein (MRP) 1 expression and MRP2 expression in the peripheral blood mononuclear cells in intractable epileptic children after accepting the Levetiracetam (LEV) add-on therapy.Methods From June 2012 to September 2015,68 intractable epileptic children who had been diagnosed at the Outpatient Department of the Xuzhou Children's Hospital were randomly selected and given the LEV add-on therapy.The expressions of MRP1 and MRP2 in their peripheral blood mononuclear cells were detected by real-time fluorescence quantitative polymerase chain reaction and Western blot before the LEV add-on therapy and 6 months after the LEV add-on therapy.Results (1) Compared to the expressions of MRP1 mRNA and MRP2 mRNA in the peripheral blood mononuclear of intractable epileptic children before therapy,the expressions of MRP1 mRNA (0.23 ± 0.02) and MRP2 mRNA (0.17 ±0.03) after therapy were obviously down-regulated with significant differences(tMRP1 =32.77,P ＜ 0.01;tMRP2 =26.73,P ＜ 0.01).(2) The relative expressions of protein of MRP1 and MRP2 in the peripheral blood mononuclear of intractable epileptic children before therapy were 0.59 ± 0.03,0.53 ± 0.02 respectively,and they were 0.39 ± 0.03,0.38 ± 0.02 after therapy.Compared with those before therapy,the protein expressions of MRP1 and MRP2 were down-regulated,and the differences were significant (tMRP1 =11.55,P＜0.01;tMRP2 =9.87,P＜0.01).Conclusions The expressions of MRP1 and MRP2 mRNA and protein in the peripheral blood mononuclear cells in some intractable epileptic children can be down-regulated if patients receive the LEV add-on therapy,and LEV may control the seizures of intractable epileptic children by down-regulating the expressions of MRP1 and MRP2,then reduce the occurrence and development of drug-resistant epilepsy.