Pengaruh Vitamin D terhadap Respons Terapi pada Anak Epilepsi Resisten Obat melalui Modulasi Jalur Glial Cell Line-Derived Neurotrophic Factor dan Interleukin-1β

Abstract

Introduction. Drug-Resistant Epilepsy (DRE) is defined as failure of two anti-epileptic drugs (AEDs) to control seizures continuously. Vitamin D could be alternative therapy by increasing GDNF and decreasing IL-1β, but its role in epilepsy was still limited. This study aims to analyze the effects of vitamin D supplementation on the therapeutic response in DRE patients. Methods. This double-blind, randomized controlled trial was conducted on DRE patients treated at Adam Malik Hospital. Children on chronic AED treatment, still experiencing seizures, not taking vitamin D, compliant with medication, and whose parents agreed to participate were included in the study. Patients with medical conditions or treatment affecting bone metabolism, hypersensitivity to vitamin D, or those who dropped out were excluded. Participants were randomly selected and received either vitamin D supplementation or placebo for 12 weeks. Results. Most subjects had vitamin D deficiency with high seizure frequency that was not controlled by conventional AEDs. After supplementation, serum vitamin D levels increased significantly (from 25.11 ± 9.27 to 38.21 ± 11.34), accompanied by significant decrease in GDNF (from 3.46 ± 2.73 to 1.72 ± 1.53), IL-1β levels (from 385.27 ± 313.20 to 191.57 ± 140.01), and seizure frequency (from 125.54 ± 186.34 to 23.24 ± 42.37). A significant negative correlation was found between the increase in vitamin D levels and reduction in seizure frequency, but no correlation was observed between changes in GDNF and IL-1β levels with seizure frequency. Conclusion. Vitamin D supplementation can reduce seizure frequency but not through modulation of GDNF and IL-1β.