Personalized medicine approaches in epilepsy

Area of Science:

• Neurology
• Pharmacology
• Genetics

Background:

• Epilepsy impacts 50 million globally, with a third experiencing treatment-resistant seizures.
• Factors like age, sex, and pre-diagnosis seizure frequency influence remission likelihood.
• Neuroinflammation and genetic predispositions are increasingly recognized in epilepsy pathophysiology and drug resistance.

Purpose of the Study:

• To review current stratification approaches for epilepsy treatment.
• To explore potential biomarkers and drug targets for resistant epilepsy.
• To highlight the role of pharmacogenetics in managing adverse drug reactions.

Main Methods:

• Review of current literature on epilepsy treatment stratification.
• Analysis of neuroinflammatory markers and genetic polymorphisms.
• Examination of pharmacogenetic screening for adverse drug reactions.

Main Results:

• High-mobility group box 1 isoforms show potential as biomarkers for treatment stratification and drug targets.
• Transporter polymorphisms offer insights into epilepsy's intrinsic severity and drug resistance.
• Specific human leucocyte antigen (HLA) polymorphisms are associated with severe adverse reactions to anti-epileptic drugs (AEDs).

Conclusions:

• Stratification strategies are crucial for addressing therapeutic challenges in epilepsy.
• Biomarkers and genetic insights can guide personalized treatment approaches.
• Pharmacogenetic screening, particularly for HLA variations, can prevent severe adverse drug reactions, improving AED tolerability and compliance.