Inflammation and oxidative stress in epileptic children: from molecular mechanisms to clinical application of ketogenic diet
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Azam Ildarabadi
Abstract
Childhood epilepsy affects up to 1 % of children. It has been shown that 30 % of patients are resistant to drug treatments, making further investigation of other potential treatment strategies necessary. One such approach is the ketogenic diet (KD) showing promising results and potential benefits beyond the use of current antiepileptic drugs. This study aims to investigate the effects of KD on inflammation and oxidative stress, as one of the main suggested mechanisms of neuroprotection, in children with epilepsy. This narrative review was conducted using the Medline and Google Scholar databases, and by searching epilepsy, drug-resistant epilepsy, child, children, ketogenic, ketogenic diet, diet, ketogenic, keto, ketone bodies (BHB), PUFA, gut microbiota, inflammation, inflammation mediators, neurogenic inflammation, neuroinflammation, inflammatory marker, adenosine modulation, mitochondrial function, MTOR pathway, Nrf2 pathway, mitochondrial dysfunction, PPARɣ, oxidative stress, ROS/RNS, and stress oxidative as keywords. Compelling evidence underscores inflammation and oxidative stress as pivotal factors in epilepsy, even in cases with genetic origins. The ketogenic diet effectively addresses these factors by reducing ROS and RNS, enhancing antioxidant defenses, improving mitochondrial function, and regulating inflammatory genes. Additionally, KD curbs pro-inflammatory cytokine and chemokine production by dampening NF-κB activation, inhibiting the NLRP3 inflammasome, increasing brain adenosine levels, mTOR pathway inhibition, upregulating PPARɣ expression, and promoting a healthy gut microbiota while emphasizing the consumption of healthy fats. KD could be considered a promising therapeutic intervention in patients with epilepsy particularly in drug-resistant epilepsy cases, due to its targeted approach addressing oxidative stress and inflammatory mechanisms.
Acknowledgment
We would like to thank Dr. Noosha Samieefar for her invaluable comments on our manuscript.
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Research ethics: Not applicable.
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Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: Not applicable.
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Articles in the same Issue
- Frontmatter
- Studying the Alzheimer’s disease continuum using EEG and fMRI in single-modality and multi-modality settings
- Diversity of amyloid beta peptide actions
- Empowering brain cancer diagnosis: harnessing artificial intelligence for advanced imaging insights
- Diagnostic machine learning applications on clinical populations using functional near infrared spectroscopy: a review
- Exploring the latest findings on endovascular treatments for giant aneurysms: a review
- Evolving frontiers: endovascular strategies for the treatment of delayed cerebral ischemia
- Inflammation and oxidative stress in epileptic children: from molecular mechanisms to clinical application of ketogenic diet
Articles in the same Issue
- Frontmatter
- Studying the Alzheimer’s disease continuum using EEG and fMRI in single-modality and multi-modality settings
- Diversity of amyloid beta peptide actions
- Empowering brain cancer diagnosis: harnessing artificial intelligence for advanced imaging insights
- Diagnostic machine learning applications on clinical populations using functional near infrared spectroscopy: a review
- Exploring the latest findings on endovascular treatments for giant aneurysms: a review
- Evolving frontiers: endovascular strategies for the treatment of delayed cerebral ischemia
- Inflammation and oxidative stress in epileptic children: from molecular mechanisms to clinical application of ketogenic diet