The Effects Of Anti-Seizure Medications On Patients With Antibody Deficiency Syndrome

Abstract

RationaleAntibody deficiency is associated with both primary and secondary immunodeficiency. Secondary immunodeficiency is often caused by medications including antiepileptic drugs (AEDs). It is unknown how AEDs affect ADS patients. This study examined whether ADS subjects treated with AEDs (test group) will reveal differences as compared to control ADS subjects.MethodsClinical features and laboratory findings in the test group (children N=8, adults N=5), were retrospectively reviewed in comparison with control ADS subjects (children N=18, adults N=5). In the test group, AEDs were mainly prescribed for seizure disorders (grand mal and/or partial complex seizures with variable etiology). Most of the test group subjects were prescribed multiple AEDs in the past and/or currently.ResultsChildren in the test group had lower levels of IgM /IgA than control ADS children (IgM 57.2 ± 32.2 vs 101.4 ± 48.6 mg/dL, IgA 37.7±25.4 vs 85.0 ± 50.9 mg/dL, respectively). However, there were no differences in total and isotype switched memory B cell numbers between the test and control groups irrespective of age. In cytokine production by peripheral blood mononuclear cells (PBMCs), the test group revealed lower IL-6, IL-12, and TNF-alpha production in response to TLR7/8 agonist (p<0.05) but IL-10 production in response to T cell mitogens was higher in the test group (p<0.05).ConclusionsLower IgM /IgA levels in the test group children may be associated with lower IL-6 production and higher IL-10 production by PBMCs in the test group, since IL-10 is a suppressive cytokine and IL-6 promotes B cell maturation. RationaleAntibody deficiency is associated with both primary and secondary immunodeficiency. Secondary immunodeficiency is often caused by medications including antiepileptic drugs (AEDs). It is unknown how AEDs affect ADS patients. This study examined whether ADS subjects treated with AEDs (test group) will reveal differences as compared to control ADS subjects. Antibody deficiency is associated with both primary and secondary immunodeficiency. Secondary immunodeficiency is often caused by medications including antiepileptic drugs (AEDs). It is unknown how AEDs affect ADS patients. This study examined whether ADS subjects treated with AEDs (test group) will reveal differences as compared to control ADS subjects. MethodsClinical features and laboratory findings in the test group (children N=8, adults N=5), were retrospectively reviewed in comparison with control ADS subjects (children N=18, adults N=5). In the test group, AEDs were mainly prescribed for seizure disorders (grand mal and/or partial complex seizures with variable etiology). Most of the test group subjects were prescribed multiple AEDs in the past and/or currently. Clinical features and laboratory findings in the test group (children N=8, adults N=5), were retrospectively reviewed in comparison with control ADS subjects (children N=18, adults N=5). In the test group, AEDs were mainly prescribed for seizure disorders (grand mal and/or partial complex seizures with variable etiology). Most of the test group subjects were prescribed multiple AEDs in the past and/or currently. ResultsChildren in the test group had lower levels of IgM /IgA than control ADS children (IgM 57.2 ± 32.2 vs 101.4 ± 48.6 mg/dL, IgA 37.7±25.4 vs 85.0 ± 50.9 mg/dL, respectively). However, there were no differences in total and isotype switched memory B cell numbers between the test and control groups irrespective of age. In cytokine production by peripheral blood mononuclear cells (PBMCs), the test group revealed lower IL-6, IL-12, and TNF-alpha production in response to TLR7/8 agonist (p<0.05) but IL-10 production in response to T cell mitogens was higher in the test group (p<0.05). Children in the test group had lower levels of IgM /IgA than control ADS children (IgM 57.2 ± 32.2 vs 101.4 ± 48.6 mg/dL, IgA 37.7±25.4 vs 85.0 ± 50.9 mg/dL, respectively). However, there were no differences in total and isotype switched memory B cell numbers between the test and control groups irrespective of age. In cytokine production by peripheral blood mononuclear cells (PBMCs), the test group revealed lower IL-6, IL-12, and TNF-alpha production in response to TLR7/8 agonist (p<0.05) but IL-10 production in response to T cell mitogens was higher in the test group (p<0.05). ConclusionsLower IgM /IgA levels in the test group children may be associated with lower IL-6 production and higher IL-10 production by PBMCs in the test group, since IL-10 is a suppressive cytokine and IL-6 promotes B cell maturation. Lower IgM /IgA levels in the test group children may be associated with lower IL-6 production and higher IL-10 production by PBMCs in the test group, since IL-10 is a suppressive cytokine and IL-6 promotes B cell maturation.