Abstract

Introduction: Epilepsy is a common neurological disorder affecting approximately 1% of the global population. A significant proportion of patients develop drug-resistant epilepsy (DRE), which leads to poor outcomes for treatments and low quality of life. The multidrug transporter P-glycoprotein, encoded by the ABCB1 gene, plays a key role in limiting brain penetration of antiepileptic drugs. The C3435T single nucleotide polymorphism (SNP) in ABCB1 has been linked to variable P-glycoprotein expression and AED response. In this study, the prevalence of C3435T genotypes among epilepsy patients and healthy controls in Fars Province, Iran was investigated. Materials and methods: This study involved 50 patients diagnosed with epilepsy and 100 healthy individuals without a history of seizures or epilepsy. Genotyping was conducted using PCR-RFLP analysis. Results: The variant T allele occurred at a frequency of 52% in cases and 54% in controls. However, no significant association between the C3435T polymorphism and epilepsy risk was observed. Interestingly, it was found that the CT genotype was overrepresented in drug-responsive patients compared to those with drug-resistant cases. This suggests that individuals with the CT genotype may have a more favorable response to antiepileptic drug therapy. Conclusion: These findings suggest that the ABCB1 C3435T variant may play a role in influencing seizure control specifically among Iranian patients, but its effects on susceptibility are minimal. Moreover, individuals with the CT genotype may have a more favorable response to antiepileptic drug therapy. Further research involving larger cohorts is needed to fully understand the impact of ABCB1 genetics on determining individual responses to antiepileptic drugs. Such research could also pave the way for personalized management strategies based on pharmacogenomic testing.

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