Perfil de estrés oxidativo y de modulación del sistema de adenosina: Relación con la epileptogenicidad y el riesgo de Muerte Súbita Inesperada en Epilepsia (SUDEP)

Lilia Morales Chacón; Sandra Orozco Suarez; Lídice Galán García; Nancy Pavón Fuentes; Juan Manuel Gallardo; Nelson Ernesto Quintanal Cordero; Antoni Camins Espuny; Luisa Rocha Arrieta

doi:10.47924/neurotarget2025478

Authors

Lilia Morales Chacón International University of La Rioja, Logroño, Spain. University of Barcelona. https://orcid.org/0000-0003-0205-0733
Sandra Orozco Suarez Specialty Hospital, 21st Century National Medical Center (IMSS).
Lídice Galán García Cuban Neuroscience Center. Havana, Cuba.
Nancy Pavón Fuentes International Center for Neurological Restoration. Havana, Cuba.
Juan Manuel Gallardo Specialty Hospital, National Medical Center, 21st Century IMSS.
Nelson Ernesto Quintanal Cordero CENIT Foundation for Neuroscience Research. Buenos Aires, Argentina.
Antoni Camins Espuny University of Barcelona. Barcelona. Spain.
Luisa Rocha Arrieta CINVESTAV South Headquarters, Mexico.

DOI:

https://doi.org/10.47924/neurotarget2025478

Keywords:

drug-resistant focal epilepsy, oxidative stress, adenosine, SUDEP

Abstract

Purpose. To determine the relationship between oxidative stress and modulation of the adenosine system profile with the epileptogenicity and stratification of sudden unexpected death in epilepsy (SUDEP) risk in temporal and extratemporal drug-resistant focal epilepsy (DRFE).
Methods: Serum samples from 21 patients with EFFR were evaluated. Healthy participants matched for age and sex were also studied. Adenosine and serum concentrations of malonyldialdehyde (MDA) lipid peroxidation, nitric oxide (NOx) production, advanced protein oxidation and glycation products (AGE), and vitamin C were quantified. Multiple regression analysis (automatic, step-by-step) was used to delineate significant markers associated with clinical variables and SUDEP risk. A cluster analysis was performed using validation techniques based on bootstrap.
Results. Adenosine values were markedly greater in patients with DRFE t(33)=1.87, p<0.05. Serum concentrations of oxidative stress products were also significantly higher in patients than in the control group: AGE t(38) =2.577, p<0.01, NOx: t(37)=2.03, p<0.04, MDA: t(38)=3.62, p<0.0008, VitC: t(37)=2.52, p<0.016. There was a proportional directly correlation between the seizure onset age and serum AGE concentrations. (F(5,12) =2.22, p<0.118. The univariate hypothesis test (t-test) showed a trend towards higher adenosine concentrations in patients with high SUDEP risk: 126.81 vs 95.58 t(16)=1.758, p=0. 097.
Conclusions: There are increased profiles of adenosine and oxidative stress toxicity in DRFE patients, with higher prevalence in temporal lobe epilepsy patients. These profiles are associated with epileptogenicity, and are not influenced by anti-seizure medication. In DRFE patients at high SUDEP risk there is a tendency toward higher adenosine concentrations, lending support to the adenosine hypothesis in SUDEP pathophysiology.

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