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. 2012 Aug 29:12:85.
doi: 10.1186/1471-2377-12-85.

Ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) is increased in cerebrospinal fluid and plasma of patients after epileptic seizure

Stefania Mondello  1 , Johanna Palmio, Jackson Streeter, Ronald L Hayes, Jukka Peltola, Andreas Jeromin
Affiliations
Free PMC article

Ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) is increased in cerebrospinal fluid and plasma of patients after epileptic seizure

Stefania Mondello et al. BMC Neurol. .
Free PMC article

Abstract

Background: Clinical and experimental studies have demonstrated that seizures can cause molecular and cellular responses resulting in neuronal damage. At present, there are no valid tests for assessing organic damage to the brain associated with seizure. The aim of this study was to investigate cerebrospinal fluid (CSF) and plasma concentrations of Ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), a sensitive indicator of acute injury to brain neurons, in patients with tonic-clonic or partial secondarily generalized seizures due to various etiologies.

Methods: CSF and plasma concentrations of UCH-L1 were assessed in 52 patients within 48 hours after epileptic seizure and in 19 controls using ELISA assays.

Results: CSF obtained within 48 hours after seizure or status epilepticus (SE) presented significantly higher levels of UCH-L1 compared to controls (p = 0.008). Plasma UCH-L1 concentrations were negatively correlated with time to sample withdrawal. An analysis conducted using only the first 12 hours post-seizure revealed significant differences between concentrations of UCH-L1 in plasma and controls (p = 0.025). CSF and plasma concentrations were strongly correlated with age in patients with seizure, but not in control patients. Plasma UCH-L1 levels were also significantly higher in patients after recurrent seizures (n = 4) than in those after one or two seizures (p = 0.013 and p = 0.024, respectively).

Conclusion: Our results suggest that determining levels of neuronal proteins may provide valuable information on the assessment of brain damage following seizure. These data might allow clinicians to make more accurate therapeutic decisions, to identify patients at risk of progression and, ultimately, to provide new opportunities for monitoring therapy and targeted therapeutic interventions.

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Figures

Figure 1
Figure 1
UCH-L1 concentration in CSF and plasma of patients within 48 hrs and within 12 hrs after seizure and in controls. The red horizontal line represents the median. Significant differences are indicated with * (P < .05) (Mann–Whitney U-test).
Figure 2
Figure 2
UCH-L1 concentration in CSF and plasma and age in patients with epileptic seizure. Biomarkers were positively correlated with age in patients with epileptic seizure. Linear regression line and 95% CI were given (on the right) (n = 51).
Figure 3
Figure 3
Plasma UCH-L1 concentration in patients within 48 hrs after single or recurrent seizures, or status epilepticus. The red horizontal line represents the median. Significant differences are indicated with * (P < .05) (Mann–Whitney U-test).
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