HUMORAL AND CELLULAR IMMUNE PARAMETERS IN UNTREATED AND PHENYTOIN-TREATED OR CARBAMAZEPINE-TREATED EPILEPTIC PATIENTS

The peripheral blood lymphocyte subsets, serum immunoglobulins (Ig A, G, M), and C3 and C4 complement protein concentrations were determined in 40 healthy subjects, 30 phenytoin-treated, 22 carbamazepine-treate d and 38 untreated epileptic patients. The levels of B-lymphocytes, Ig M and C3 complement proteins were found to be significantly higher in untreated epileptics than in healthy controls (P<0.01, P<0.02 and P<0. 05, respectively). The absolute number of B-lymphocytes appeared to be unaffected by phenytoin or carbamazepine treatment; however, IgM leve ls were significantly lower in carbamazepine-treated patients than bot h epileptic (P<0.01) and healthy (P<0.05) controls. Phenytoin-treated patients had a significant reduction in the mean IgA and IgG levels co mpared to healthy and epileptic controls (P<0.05). With both drug trea tments, significantly lower T-suppressor lymphocyte counts and thus hi gher T-helper to T-suppressor lymphocyte ratios were observed with res pect to healthy and epileptic controls. Our results demonstrate that w hile phenytoin decreases serum IgA and IgG levels, carbamazepine reduc es IgM levels significantly, and untreated epileptics show immune prof iles significantly different to those of healthy subjects, suggesting that epilepsy per se may be associated with certain immune aberrations induced by antiepileptic drugs.