Peran Vitamin D pada Epilepsi Anak
DOI:
https://doi.org/10.55175/cdk.v46i10.418Keywords:
Epilepsi anak, obat anti-epilepsi, vitamin DAbstract
Vitamin D memiliki peran penting selama perkembangan otak, proliferasi, diferensiasi, neurotrofik, dan neuroprotektif. Bentuk aktif vitamin D menekan inflamasi dan mengubah keseimbangan antara penghambat sitokin dan sitokin eksitasi. Bentuk aktif vitamin D menunjukkan efek imunomodulator dan secara efektif dapat menekan inflamasi, sehingga mempunyai efek antikonvulsan. Penderita epilepsi anak berisiko tinggi mengalami defisiensi vitamin D. Pemakaian obat antiepilepsi sebagai politerapi dihubungkan dengan penurunan kadar vitamin D yang lebih besar dibandingkan obat anti-epilepsi sebagai monoterapi. Pemberian vitamin D harus cukup untuk mempertahankan kadar normal 25(OH) D (≥30 ng/mL). Pemberian vitamin D pada epilepsi dapat meningkatkan batas ambang kejang secara signifikan dan mengurangi keparahan kejang.
Vitamin D has an important role during brain development, proliferation, differentiation, neurotrophic, and neuroprotection. The active form of vitamin D suppresses inflammation and changes the balance between inhibitory cytokines and excitatory cytokines. The active form of vitamin D shows an immunomodulatory effect and can effectively suppress inflammation so that it has an anticonvulsant effect. Epileptic children are in high risk of vitamin D deficiency. Antiepileptic polytherapy is associated with a greater reduction in vitamin D levels than in monotherapy. Vitamin D supplementation must be sufficient to maintain normal level of 25(OH)D (≥30 ng/mL). Vitamin D can significantly increase the seizure threshold and reduce the severity of seizure.
Downloads
References
Cebeci AN, Ekici B. Epilepsy treatment by sacrificing vitamin D. Expert Rev Neurother. 2014;14(5):481-91
Stafstrom CE, Rho JM. Neurophysiology of seizures and epilepsy. In: Swaiman KH, Ashwal S, Ferreiro DM, Schor NF, eds. Pediatric neurology “principle and practice”. 5th Ed. Inggris; 2012.p.711-26
Fisher RS, Acevedo C, Arzimanoglou A, Bogact A, Cross H, Elger CE, et al. A practical clinical definition of epilepsy. Epilepsia 2014;55(4):475-82
Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol. 2013;34(1):47-64
Groves NJ, McGrath JJ, Burne THJ. Vitamin D as a neurosteroid affecting the developing and adult brain. Annual review of nutrition 2014;34:117-41
Sonmez FM. The role of the vitamin D in neurology: Interrelationships between headache, epilepsy and vitamin D deficiency. J Pediatr Neonatal Care. 2016;4(2): 00132
Pendo K, DeGiorgio CM. Vitamin D3 for the treatment of epilepsy: Basic mechanisms, animal models, and clinical trials. Front Neurol. 2016;7:218
Miratashi Yazdi SA, Abbasi M, Miratashi Yazdi SM. Epilepsy and vitamin D: A comprehensive review of current knowledge. Rev Neurosci. 2017;28(2):185-201
Bikle D. Vitamin D metabolism, mechanism of action, and clinical applications. Chem Biol. 2014;21(3):319-29.
Harms LR, Burne TH, Eyles DW, McGrath JJ, Franzcp. Vitamin d and the brain. Best Pract Res Clin Endocrinol Metab. 2011;25(4):657-69.
Yeshokumar AK, Saylor D, Komberg MD, Mowry EM. Evidence for the importance of vitamin D status in neurologic conditions. Curr Treatment Options Neurol. 2015;17(12): 51
Zanatta L, Goulart PB, Goncalves R, Pierozan P, Winkelmann-Duarte EC, Woehl VM, et al. 1α,25-dihydroxyvitamin D(3) mechanism of action: Modulation of L-type calcium channels leading to calcium uptake and intermediate filament phosphorylation in cerebral cortex of young rats. Biochim Biophys Acta. 2012;1823(10):1708-19
Kalia LV, Kalia SK, Salter MW. NMDA receptors in clinical neurology: Excitatory times ahead. Lancet Neurol. 2008;7(8):742-55.
Vyklicky V, Korinek M, Smejkalova T, Balik A, Krausova B, Kaniakova M, et al. Structure, function, and pharmacology of NMDA receptor channels. Physiol Res. 2014;63 (Suppl 1):191-203
Li XH, Hou XY, Chen R. The roles of vitamin B12 and vitamin D in children with intractable epilepsy. Int J Clin Exp Med. 2015;8(1):764-9
Vezzani A, Balosso S, Ravizza T. The role of cytokines in the pathophysiology of epilepsy. Brain Behav Immun. 2008;22(6):797-803
Kanter-Schlifke I, Georgievska B, Kirik D, Kokaia M. Seizure suppression by GDNF gene therapy in animal models of epilepsy. Mol Ther. 2007;15(6):1106-13
He Xin, Jiang P, Zhu W, Xue Y, Li M, Dang R, et al. Effect of antiepileptic therapy on serum 25 (OH) D3 and 24, 25 (OH)2D3 levels in epileptic children. Ann Nutr Metab. 2016;68(2):119-27
Offermann G, Pinto V, Kruse R. Antiepileptic drugs and vitamin D supplementation. Epilepsia. 1979;20(1):3-15.
Durá-travé T, Victoriano FG, Chacon MM, Gonzalez PM, Albesa SA, Petri MEY. Vitamin d deficiency in children with epilepsy taking valproate and levetiracetam as monotherapy. Epilepsy research. 2018;139:80-4
Lee YJ, Park KM, Kim YM, Yeon GM, Nam SO. Longitudinal change of vitamin D status in children with epilepsy on antiepileptic drugs: prevalence and risk factors. Pediatric neurology. 2015;52(2):153-9
Teagarden DL, Meador JK, Loring DW. Low vitamin D levels are common in patients with epilepsy. Epilepsy research. 2014;108(8):1352-6.
Holick MF, Binkley NC, Ferrari HAB, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2011;96(7):1911-30
Christiansen C, Rødbro, Paul, Sjö O. “Anticonvulsant action” of vitamin D in epileptic patients? A controlled pilot study. Br Med J. 1974; 2.5913:258-9
Hollo A, Clemens Z, Kamondi, Lakatos P, Szűcs A. Correction of vitamin D deficiency improves seizure control in epilepsy: A pilot study. Epilepsy & Behavior. 2012;24(1):131-3
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 https://creativecommons.org/licenses/by-nc/4.0/
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
