Valproát – anti epileptikum s protinádorovými účinky

Valpro ic Acid – Anti epileptics with Antine oplastic Effects

Valpro ic acid is a bro ad- spectrum anti epileptic drug with low toxicitiy profile. It has been marketed since 1967, firstly bro ught o ut in France. Its importance in the clinical practice is a ugmented by the use in other indicati ons. Valpro ic acid is also prescribed in the tre atment of he adache, affective disorders and spinal muscular atrophy. Recently, valpro ic acid has appe ared in the focus of attenti on in the ne uro oncology fi eld as well. As histone de acetylase inhibitor it ca uses hyperacetylati on and reexpressi on of growth regulatory genes and as a consequence induces apoptosis. In preclinical studi es it has been proved that valpro ic acid is able to inhibit cell proliferati on and migrati on and incre ases the imunogenicity of tumoral cells. Brain tumors are often accompani ed by the symptomatic epileptic seizures depending on the histology and localisati on of the tumor. The epilepsy is not seldom farmacoresistant. Being able to take advantage of anti epileptic and antitumoral effect of valpro ic effect, we get a specific opti on in the tre atment of symptomatic seizures in brain tumors. With o ur present knowledge the indicati on of valpro ic acid as an anti epileptic drug with antitumoral effects needs more investigati ons.

Key words:
valpro ic acid – anti epileptic drug – oncology

Authors: P. Cahová; H. Ošlejšková
Authors‘ workplace: Klinika dětské neurologie LF MU a FN Brno
Published in: Cesk Slov Neurol N 2009; 72/105(3): 217-221
Category: Review Article

Overview

Valproát je anti epileptikum se širokým spektrem účinku a nízko u toxicito u uvedené poprvé na trh v roce 1967 ve Francii. Významný je v klinické praxi i pro své další indikace, a to v oblasti terapi e bolesti hlavy, afektivních bipolárních poruch a spinální svalové atrofi e. V posledních letech se valproát dostává do popředí zájmu i na poli ne uro onkologi e. Jako inhibitor histonových de acetyláz způsobuje hyperacetylaci a reexpresi růstových regulačních genů, a tím následně navozuje apoptózu. Při dávkách užívaných v epileptologii byl prokázán jeho vliv na snížení schopnosti proliferace a migrace nádorových buněk a zvýšení jejich imunogenicity. Mozkové nádory jso u často spojeny s výskytem symptomatické epilepsi e v závislosti na histologickém typu nádoru a jeho lokalizaci, epilepsi e bývá nezřídka farmakorezistentní. So učasným využitím anti epileptických a antitumorózních účinků valproátu se nám otevírají nové možnosti rozšiřující jeho indikaci v léčbě symptomatické epilepsi e u nádorů mozku, a to v kontextu onkologické terapi e. Jeho indikace jako anti epileptika s protinádorovým účinkem však bude vyžadovat další studi e.

Klíčová slova:
valproát – anti epileptikum – onkologi e

MUDr. Pavlína Cahová
Klinika dětské neurologie LF MU a FN Brno,
Centrum pro epilepsie Brno
Černopolní 9
613 00 Brno
e‑mail: pavlina.cahova@seznam.cz

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