THE INFLUENCE OF LEVETIRACETAM AND NICOTINAMIDE UPON INTERLEUKIN-1-PRODUCING ACTIVITY OF BLOOD MONONUCLEAR CELLS IN PATEINTS SUFFERING FROM EPILEPSY

Introduction. Mechanisms of epileptiform signs precipitation and development are recognized as dependent upon cytokines level, including interleukin-1 (IL-1). Antiepleptic drugs are able to affect the level of cytokines both in blood and nervous tissue.

Objective is to determine the functional capacity of those cells which are the sources of IL-1 and peculiaities of this ability under conditions of antiepileptic treatment.

Material and methods. All measurements have been performed in children who suffered from temporal epilepsy in accordance to the next scheme: on the third day after abandoning the traditional pharmacotherapy (15 children), after a month long treatment with levetiracetam (LVR) (15 children); after a month long treatment with LVR combined with nicotinamide during the last two weeks of LVR treatment (22 children). LVR (UCB Pharma, Germany) was given twice per day starting with 250 (in children up to 12 years) and 500 (more than 12 years old) mg per one administration with the consequent increasing of dosage of LVR up to 1500–2000 mg. Nicotinamide (5.0% solution) was used in a dosage of 10.0 мг twice per day i. m. With the aim of determination of the functional state of mononuclear cells the index of lymphocytes proliferative activity (ILPA) was determined. It was recalculated as a ratio between relative amount of blast cells in those samples where bacterial lipopolysaccharide (LPS) and phytohemagglutinin (PhGA) activation was performed to the relative number of blast cells in those samples which contained not-activated monocytes and PhGA-activated lymphocytes. The relative number of blast — transformed lymphocytes has been determined as well.

Results of investigation. The ILPA index in traditionally treated patients exceeded such one determined in practically healthy persons 2.16 times (p<0.05). At the same time in patients treated with LVR ILPA was higher when compared to control group 1.59 times (p<0.05) and it was reduced when compared with traditionally treated patients by 26.6% (p<0.05). Combined treatment with LVR and nicotinamide (one week administration) resulted in heightening of investigated index, which exceeded such one in control group by 44.1% (p<0.05). At the same time it was diminished by 33.5% in comparison with such one determined in traditionally treated patients (p<0.05). A two-week administration of nicotinamide in combination with LVR resulted in the reduction of ILPA, which was greater when compared with the similar index in control group by 14.2% (p>0.05), and it continued to be less in comparison with the ILPA, which was determined in children treated with LVR by 28.2% (p<0.05).

Conclusions. 1. The heightened activity of mononuclear cells stimulated with LPS is observed in children who suffered from temporal complex partial epilepsy, which was resistant to traditional treatment, which is in favor for increased ability of mononuclear cells to produce IL-1.

2. Levetiracetam administration in combination with nicotinamide induced potentiated effect of normalization of IL-1-producing activity of blood mononuclear cells.