A Cross‐Sectional Study to Assess the Modulation of Wnt Inhibitors following Anti‐Epileptic Drug Therapy and their Correlation with Vitamin D and Receptor Activator of Nuclear Factor κ B Ligand in Indian Women with Epilepsy. Issue 3 (15th April 2018)

• Record Type: Journal Article
• Authors: Parveen, Bushra; Tripathi, Manjari; Vohora, Divya
• Is Part Of: Basic & clinical pharmacology & toxicology. Volume 123:Issue 3(2018)
• Page Start: 271
• Page End: 276
• Publication Date: 2018-04-15
• Subjects: Pharmacology -- Periodicals; Toxicology -- Periodicals; Pharmacology -- Periodicals; Toxicology -- Periodicals; Pharmacology, Clinical -- Periodicals; Computer network resources; Electronic journals; 615.1
• DOI: 10.1111/bcpt.12996
• Languages: English
• ISSNs: 1742-7835

Abstract

Abstract: Long‐term anti‐epileptic drug (AED) therapy compromises bone health. Although vitamin D deficiency is proposed to be involved, it alone is not held responsible. This accounts for investigating other mechanisms in bone accrual. Recent studies have shown modulation of inhibitors of wnt pathway, sclerostin and dickkopf‐1 (DKK‐1), in glucocorticoids‐induced osteoporosis. We investigated whether AED monotherapy modulates wnt inhibitors in Indian women with epilepsy. Women of age > 20–40 years with the diagnosis of epilepsy and receiving AEDs (carbamazepine, valproate and levetiracetam) for at least a year were enrolled. The results were compared with age‐matched healthy controls with no evidence of metabolic bone disease. Women undergoing treatment with AEDs (mean duration: 50.59 ± 37.929 months) exhibited higher serum sclerostin and receptor activator of nuclear factor κ B ligand (RANKL) and lower vitamin D (25‐hydroxy vitamin D) and DKK‐1 levels when compared to age‐matched healthy controls. Sclerostin showed a positive correlation with RANKL, while DKK‐1 presented no such relationship. However, no association was evident after adjusting for age, duration of treatment and total daily dose. Although a correlation between wnt inhibitors and RANKL could not be obtained, AEDs displayed changes in serum levels of wnt inhibitors in persons with epilepsy and hence these drugs may compromise bone health through a disturbance in wnt signalling mechanisms.