Plasma Plasminogen Activator Inhibitor-1 as a Biomarker for Disease Activity and Pharmaco-Response Prediction in
Xiao Xiao1, Xiao-Yan Shi1, Jun Feng1
1Department of Neurology, Children's Hospital of Soochow University, Suzhou, Jiangsu, 215025, People's Republic of China.
Insights
Plasma plasminogen activator inhibitor-1 (PAI-1) is elevated in children with active epilepsy and predicts drug resistance. This finding may identify new therapeutic targets for pediatric epilepsy.
Area of Science:
- Biochemistry
- Neurology
- Pediatrics
Background:
- Epilepsy is a significant neurological disorder in children.
- Identifying biomarkers for seizure severity and treatment response is crucial.
- Plasma plasminogen activator inhibitor-1 (PAI-1) has been implicated in various inflammatory and neurological conditions.
Purpose of the Study:
- To investigate the clinical relevance of plasma PAI-1 in pediatric epilepsy.
- To assess associations between PAI-1 levels, seizure severity, and therapeutic outcomes.
- To explore PAI-1 as a potential biomarker for pharmaco-resistant epilepsy.
Main Methods:
- A prospective cohort study design was employed.
- Plasma PAI-1 levels were quantified using ELISA in children with active epilepsy, seizure-free patients, and healthy controls.
- Subgroup analyses examined the impact of anti-epileptic drug (AED) treatment and long-term drug response.
Main Results:
- PAI-1 levels were significantly higher in children with active epilepsy compared to controls (2.1-fold) and those in remission (1.3-fold).
- No significant difference in PAI-1 levels was found between AED-treated and untreated subgroups.
- Baseline PAI-1 levels predicted 12-month pharmaco-responses, with higher concentrations in pharmaco-resistant patients (12% increase).
Conclusions:
- Plasma PAI-1 is a potential biomarker for identifying children at high risk for pharmaco-resistant epilepsy.
- Elevated PAI-1 may indicate underlying inflammatory or synaptic pathologies.
- These findings suggest novel therapeutic targets beyond conventional AEDs for epilepsy.
Purpose:
To investigate the clinical relevance of plasma plasminogen activator inhibitor-1 (PAI-1) in pediatric epilepsy, focusing on its associations with seizure severities and therapeutic outcomes.
Methods:
We conducted a prospective cohort study to compare the plasma PAI-1 levels quantified by ELISA across children with active epilepsy, seizure-free patients, and healthy controls. Furthermore, subgroup analyses were conducted to assess the impact of AED treatment or long-term drug response to the plasma PAI-1 levels.
Results:
PAI-1 levels were 2.1-fold higher in the seizure group than in the control group (p < 0.0001), and 1.3-fold higher than in remission patients (p < 0.0001). No significant difference was observed between the anti-epileptic drug-treated and untreated subgroups (p = 0.0689). Baseline PAI-1 levels predicted 12-month pharmaco-responses, with pharmaco-resistant patients showing 12% higher PAI-1 concentrations than responders (p = 0.0234).
Conclusion:
Our findings establish plasma PAI-1 as a promising biomarker for identifying children at high risk for pharmaco-resistant epilepsy, thereby addressing a high-burden condition. The persistence of PAI-1 elevation hints at underlying inflammatory or synaptic pathologies that may be novel therapeutic targets beyond conventional AEDs.
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