Oxidative stress in children receiving valproic acid.
OBJECTIVE: To determine whether valproic acid (VPA) influences urinary levels of 15-F(2t)-isoprostane (15-F(2t)-IsoP), a marker of oxidative stress, in children. STUDY DESIGN: Morning urine samples were collected from children with epilepsy receiving VPA (n = 25), carbamazepine (n = 16), or clobazam (n = 12) for >/= 4 weeks and from age-matched control subjects (n = 39). Urinary 15-F(2t)-IsoP levels were determined by enzyme-linked immunosorbent assay. RESULTS: The mean (+/-standard deviation) urine 15-F(2t)-IsoP levels (nmol/mmol Cr) were: valproic acid (0.36 +/- 0.15); carbamazepine (0.24 +/- 0.10); clobazam (0.23 +/- 0.10); control group (0.20 +/- 0.09). Patients treated with VPA had significantly elevated 15-F(2t)-IsoP levels when compared with the control, carbamazepine, and clobazam groups (P < .05). Multiple linear regression analysis demonstrated that younger patient age and exposure to second-hand smoke were significant predictors of elevated urine 15-F(2t)-IsoP levels within the control group (r(2) = 0.261, P = .05 and P = .01, respectively). Subjects not exposed to second-hand smoke receiving valproic acid therapy had a significantly elevated mean urine 15-F(2t)-IsoP level compared to subjects not exposed to second-hand smoke in the carbamazepine, clobazam and control groups (P < .05). CONCLUSIONS: These data demonstrate that treatment of children with VPA is associated with higher urinary levels of 15-F(2t)-IsoP, a marker of oxidative stress.[1]References
- Oxidative stress in children receiving valproic acid. Michoulas, A., Tong, V., Teng, X.W., Chang, T.K., Abbott, F.S., Farrell, K. J. Pediatr. (2006) [Pubmed]
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