Relationship between serum P-glycoprotein and claudin-5 levels with epilepsy and cognitive impairment in children
10.3760/cma.j.issn.1673-4912.2024.11.008
- VernacularTitle:血清P-糖蛋白、紧密连接蛋白-5水平与小儿癫痫病情、认知功能损害的关系
- Author:
Guosheng XIE
1
;
Na ZHANG
;
Yanling ZHANG
;
Fang WANG
;
Xiaojing YAN
Author Information
1. 邢台市人民医院儿三科054001
- Keywords:
Epilepsy;
Children;
P-glycoprotein;
Claudin-5;
Cognitive impairment
- From:
Chinese Pediatric Emergency Medicine
2024;31(11):841-845
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relationship between the levels of serum P-glycoprotein（P-gp）and claudin-5 with epilepsy and cognitive impairment in children.Methods:A total of 120 children with epilepsy admitted to Xingtai People's Hospital from June 2020 to June 2022 were retrospectively selected as the epilepsy group，and divided into the general tonic-clonic seizure group（ n=44）and the focal seizure group（ n=76）according to the type of epilepsy，and also divided into the cognitive normal group（ n=88）and the cognitive impairment group（ n=32）according to the cognitive function of the children. Another 100 healthy children in the hospital were selected as the control group. Serum P-gp and claudin-5 levels were detected by enzyme-linked immunosorbent assay and compared between the two groups. Pearson correlation was used to analyze the relationship between serum P-gp，claudin-5 levels and epilepsy condition in children. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum P-gp and claudin-5 for cognitive impairment in children with epilepsy. Results:The serum P-gp level in the epilepsy group was higher than that in the control group[(3.11±0.34) ng/L vs. (1.33±0.17) ng/L]，and the serum claudin-5 level was lower than that in the control group[(0.66±0.12) ng/mL vs. (1.66±0.28) ng/mL] , and the differences were statistically significant (all P<0.05). The serum P-gp level in the generalized tonic-clonic seizure group was higher than that in the focal seizure group [(5.62±1.02) ng/mL vs. (2.55±0.28) ng/mL]，and the serum claudin-5 level was lower than that in the focal seizure group[(0.40±0.05) ng/mL vs. (1.10±0. 25) ng/mL] , and the differences were all statistically significant (all P<0.05). Pearson correlation analysis showed that serum P-gp was positively correlated with negatively correlated with national hospital seizure severity scale(NHS3) score in pediatric epilepsy（ r=0.447， P<0.05），and serum claudin-5 was NHS3 score in pediatric epilepsy（ r=-0.485， P<0.05）. The serum P-gp level in the cognitive impairment group was higher than that in the cognitive normal group [(5.87±1.05) ng/L vs. (2.44±0.26) ng/L]，and the serum claudin-5 level was lower than that in the cognitive normal group [(0.32±0.03) ng/mL vs. (0.86±0.08) ng/mL], and the differences were all statistically significant (all P<0.05). ROC curve analysis showed that the area under the curve（AUC）of serum P-gp for evaluating cognitive impairment in children with epilepsy was 0.831（95% CI 0.781-0.881），the AUC of serum claudin-5 for evaluating cognitive impairment was 0.854（95% CI 0.804-0.904），and the AUC of the combination was 0.905（95% CI 0.855-0.955）. Conclusion:Serum P-gp level is increased and claudin-5 level is decreased in children with epilepsy，and both levels are closely associated with the disease condition and cognitive impairment，with the combination of the two indexes more effective than either indicator in diagnosing cognitive impairment in pediatric epilepsy.
