Adipokine and cytokine profiles in pediatric epilepsy: a comparative analysis of epilepsy level of control and drug resistance

The role of adipokines and inflammatory cytokines in the pathogenesis of epilepsy has been inconsistently described in the literature. Hence, the presence of distinguishing serum inflammatory markers for epilepsy, controlled epilepsy (CE), and uncontrolled epilepsy (UCE), including drug-resistant epilepsy (DRE) and non-drug-resistant epilepsy (NDRE), remains unclear. Therefore, the aim of this cross-sectional study was to characterize the serum levels of leptin, adiponectin, resistin, and an extended panel of inflammatory cytokines among the aforementioned groups of pediatric patients and in comparison with healthy controls (HCs). The study demonstrated that leptin and adiponectin levels were significantly higher in pediatric patients with epilepsy than in HCs, while resistin levels were significantly lower. The levels of adiponectin and resistin, but not leptin, were significantly higher in DRE than in CE. TNF-α levels were significantly higher in the DRE group than in the uncontrolled NDRE or CE groups. Binary logistic regression analysis showed that only resistin and TNF-α had significant predictive value for DRE compared with other epilepsy patients. Multiple linear regression analysis demonstrated that mannose-binding lectin (MBL), resistin, and body mass index (BMI) were the strongest predictors of leptin levels in pediatric epilepsy. Leptin levels, a shorter duration of time since the last seizure, and age were the strongest predictors of higher resistin levels. The presence of developmental delay and lower patient weight predicted higher adiponectin levels. These findings may aid in distinguishing patients with DRE, NDRE, and CE. Resistin and TNF-α might be potential new targets for disease-modifying, anti-inflammatory therapy in pediatric epilepsy, particularly for DRE.