Today, epilepsy is regarded as the most common neurological disease. AEDs pharmacotherapy, used to treat patients with epilepsy affect plasma concentrations of sulfur amino acids: Hcy, Cys and GSH. These are the main intracellular thiols, whose anabolic and catabolic pathways are closely linked. Through transsulfuration of Hcy arises Cys, who further participates in the synthesis of GSH. It has been shown that the increase of plasmatic Hcy in patients with epilepsy taking AEDs can be affected by a number of factors including diet, type of pharmaceutical preparations taken, the duration of treatment, and genetic factors. The study group consisted of 63 patients with idiopathic epilepsy, 28 women and 35 men, aged from 18 to 65. Among patients with epilepsy 55 people, 24 women and 31 men, aged from 18 to 65 were treated with various AEDs, and 8 patients, 4 women and 4 men, aged between 18 and 65 were before the inclusion the anticonvulsant therapy. A preliminary analysis in our studies was conducted on 38 people from the control group, 28 women and 10 men, aged from 22 to 67, without symptoms of dementia or any other neurological disorders. The concentration to sulfur amino acids (Hcy, Cys, GSH) in plasma has been identified by HPLC (high performance liquid chromatography) with electrochemical detection. The analysis was performed in Thermo Hypersil BDS C18 column (250x4, 6x5 µm) using phosphate buffer with 12.7% acetonitrile as mobile phase for the determination of Hcy and GSH, and phosphate buffer with 10% acetonitrile as buffer mobile phase for the determination of Cys. Studies show that AEDs pharmacotherapy in patients with epilepsy leads to a significant increase in Hcy- treated in polytherapy, especially in the application of VPA and the long-term treatment. In addition, in patients with epilepsy treated with VPA in monotherapy, plasma Cys concentration is significantly reduced. Moreover, it was observed that long-term AEDs treatment and mild HHcy (Hcy>16 µmol/l) in patients with epilepsy leads to a significant increase in GSH concentration. It can be assumed that patients with epilepsy using AEDs are exposed to high oxidative stress, which is an index for the observed higher concentrations of GSH, the main intracellular antioxidant. It also seems that only the combined supplementation of vitamins B and FA in patients with epilepsy treated with AEDs may contribute to the effective regulation of Hcy- the risk factor for vascular diseases.
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