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Chen YC, Zhu GY, Wang X, Shi L, Du TT, Liu DF, Liu YY, Jiang Y, Zhang X, Zhang JG. Anterior thalamic nuclei deep brain stimulation reduces disruption of the blood-brain barrier, albumin extravasation, inflammation and apoptosis in kainic acid-induced epileptic rats. Neurol Res 2017; 39:1103-1113. [PMID: 28918702 DOI: 10.1080/01616412.2017.1379241] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective The therapeutic efficacy of anterior thalamic nuclei deep brain stimulation (ATN-DBS) against seizures has been largely accepted; however, the effects of ATN-DBS on disruption of the blood-brain barrier (BBB), albumin extravasation, inflammation and apoptosis still remain unclear. Methods Rats were distributed into four treatment groups: physiological saline (PS, N = 12), kainic acid (KA, N = 12), KA-sham-DBS (N = 12) and KA-DBS (N = 12). Seizures were monitored using video-electroencephalogram (EEG). One day after surgery, all rats were sacrificed. Then, samples were prepared for quantitative real-time PCR (qPCR), western blot, immunofluorescence (IF) staining, and transmission electron microscopy to evaluate the disruption of the BBB, albumin extravasation, inflammation, and apoptosis. Result Because of the KA injection, the disruption of the BBB, albumin extravasation, inflammation and apoptosis were more severe in the KA and the KA-sham-DBS groups compared to the PS group (all Ps < 0.05 or < 0.01). The ideal outcomes were observed in the KA-DBS group. ATN-DBS produced a 46.3% reduction in seizure frequency and alleviated the disruption of the BBB, albumin extravasation, inflammatory reaction and apoptosis in comparison to the KA-sham-DBS group (all Ps < 0.05 or < 0.01). Conclusion (1) Seizures can be reduced using ATN-DBS in the epileptogenic stage. (2) ATN-DBS can reduce the disruption of the BBB and albumin extravasation. (3) ATN-DBS has an anti-inflammatory effect in epileptic models.
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Affiliation(s)
- Ying-Chuan Chen
- a Department of Neurosurgery , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Guan-Yu Zhu
- a Department of Neurosurgery , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Xiu Wang
- a Department of Neurosurgery , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Lin Shi
- a Department of Neurosurgery , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Ting-Ting Du
- a Department of Neurosurgery , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - De-Feng Liu
- a Department of Neurosurgery , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Yu-Ye Liu
- a Department of Neurosurgery , Beijing Tiantan Hospital, Capital Medical University , Beijing , China
| | - Yin Jiang
- b Department of Functional Neurosurgery , Beijing Neurosurgical Institute, Capital Medical University , Beijing , China
| | - Xin Zhang
- b Department of Functional Neurosurgery , Beijing Neurosurgical Institute, Capital Medical University , Beijing , China
| | - Jian-Guo Zhang
- a Department of Neurosurgery , Beijing Tiantan Hospital, Capital Medical University , Beijing , China.,b Department of Functional Neurosurgery , Beijing Neurosurgical Institute, Capital Medical University , Beijing , China.,c Beijing Key Laboratory of Neurostimulation , Beijing , China
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Medel-Matus JS, Reynolds A, Shin D, Sankar R, Mazarati A. Regulation of kindling epileptogenesis by hippocampal Toll-like receptors 2. Epilepsia 2017; 58:e122-e126. [PMID: 28632301 PMCID: PMC5554076 DOI: 10.1111/epi.13826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2017] [Indexed: 11/29/2022]
Abstract
This study examined whether Toll-like receptors 2 (TLR2) contribute to rapid kindling epileptogenesis. A TLR2 agonist, lipoteichoic acid (LTA), LTA antibody (LTA-A), or normal saline (control) was administered daily over 3 consecutive days, unilaterally into ventral hippocampus of adult male Wistar rats. Thirty minutes after the last injection, the animals were subjected to a rapid kindling procedure. The ictogenesis was gauged by comparing afterdischarge threshold (ADT) and afterdischarge duration (ADD) before the treatments, after the treatments prior to kindling, and 24 h after kindling. Kindling progression and retention were analyzed using video recording. The results showed that before kindling, LTA produced an ADT reduction. Neither LTA nor LTA-A affected baseline ADD. On kindling progression, LTA accelerated occurrence of generalized seizures, whereas LTA-A delayed this effect. Treatment with LTA-A reduced the number of secondary generalized complex partial seizures. Twenty-four hours after kindling, the rats of both the saline and LTA groups showed increased hippocampal excitability as compared with prekindling parameters. Administration of LTA-A prevented kindling-induced increase of hippocampal excitability. Immunostaining revealed that LTA-A attenuated the inflammatory response produced by seizures. These findings suggest that the activation of TLR2 in the hippocampus may facilitate limbic epileptogenesis.
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Affiliation(s)
| | - Ashley Reynolds
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Don Shin
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Raman Sankar
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
- UCLA Children’s Discovery and Innovation Institute, Los Angeles, California, U.S.A
| | - Andrey Mazarati
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
- UCLA Children’s Discovery and Innovation Institute, Los Angeles, California, U.S.A
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The watch-pat in pediatrics sleep disordered breathing: Pilot study on children with negative nocturnal pulse oximetry. Int J Pediatr Otorhinolaryngol 2017; 97:245-250. [PMID: 28483245 DOI: 10.1016/j.ijporl.2017.04.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The main purpose of this study was to determine the efficacy of Watch-PAT in Pediatric Sleep Disordered Breathing (PSDB) diagnosis in children with symptoms suggestive of PSDB, in which the nocturnal pulse oximetry was negative according to the Brouilette criteria. METHODS We enrolled 28 patients aged between 5 and 12 years (mean age: 7.75 ± 1.69), who underwent the registration with Watch-PAT, that utilizes the Peripheral Arterial Tone (PAT), AHI, RDI, body position, snoring, pulse oximetry and actigraphy. RESULTS Recording Watch-PAT was indicative of PSDB in 10/28 (35.7%) patients; when it was placed the threshold of AHI > 1 the number of positive patients for PSDB increased to 17/28 (60.7%). Exists a positive correlation between pat-RDI (rho = 0.798, p = 0.005) and the snoring > 40% of the time (rho = 0.656, p < 0.001) were correlated with the pat-AHI values. CONCLUSION The recording Watch-PAT appears to permit the defection of a certain number of SDB that might escape to the clinical evaluation and pulse oximetry only.
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Tang-Wai R, Mailo J, Rosenblatt B. Breaking the cycle: A comparison between intravenous immunoglobulins and high dosage prednisone in the treatment of medically intractable epilepsy in children. Seizure 2017; 47:34-41. [DOI: 10.1016/j.seizure.2017.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/04/2017] [Accepted: 03/04/2017] [Indexed: 11/28/2022] Open
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Maiolino L, Cocuzza S, Conti A, Licciardello L, Serra A, Gallina S. Autoimmune Ear Disease: Clinical and Diagnostic Relevance in Cogan's Sydrome. Audiol Res 2017; 7:162. [PMID: 28458810 PMCID: PMC5391519 DOI: 10.4081/audiores.2017.162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 01/02/2017] [Accepted: 01/02/2017] [Indexed: 12/28/2022] Open
Abstract
The autoimmune inner ear disease is a clinical syndrome with uncertain pathogenesis that is often associated to rapidly progressive hearing loss that, especially at the early stages of disease, may be at monoaural localization, although more often it is at binaural localization. It usually occurs as a sudden deafness, or a rapidly progressive sensorineural hearing loss. In this study a particular form of autoimmune inner ear disease is described, Cogan’s syndrome. Cogan’s syndrome is a chronic inflammatory disorder that most commonly affects young adults. Clinical hallmarks are interstitial keratitis, vestibular and auditory dysfunction. Associations between Cogan’s syndrome and systemic vasculitis, as well as aortitis, also exist. We report a case of a young woman who presented audiological and systemic characteristics attributable to Cogan’s syndrome. In the description of the case we illustrate how the appearance and evolution of the disease presented.
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Falsaperla R, Vitaliti G, Mauceri L, Romano C, Pavone P, Motamed-Gorji N, Matin N, Lubrano R, Corsello G. Levetiracetam in Neonatal Seizures as First-line Treatment: A Prospective Study. J Pediatr Neurosci 2017; 12:24-28. [PMID: 28553374 PMCID: PMC5437782 DOI: 10.4103/jpn.jpn_172_16] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim of the Study: The aim of this study is to evaluate the efficacy and safety of levetiracetam (LEV) as first-line treatment of neonatal seizures. Materials and Methods: This study was conducted in patients of Neonatal Intensive Care Unit of Santo Bambino Hospital, University of Catania, Italy, from January to August 2016. A total of 16 neonates with convulsions not associated with major syndromes, which required anticonvulsant therapy, were included and underwent IV LEV at standard doses. Results: All patients responded to treatment, with a variety range of seizure resolution period (from 24 h to 15 days; mean hours: 96 ± 110.95). No patient required a second anticonvulsant therapy. Regarding safety of LEV, no major side-effects were observed. Conclusions: To our knowledge, it is one of the few studies confirming the efficiency of LEV as first-line treatment in seizures of this age group. LEV was effective in resolving seizures and was safely administered in the current study.
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Affiliation(s)
- Raffaele Falsaperla
- Department of Pediatrics, General Paediatrics Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy
| | - Giovanna Vitaliti
- Department of Pediatrics, General Paediatrics Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy
| | - Laura Mauceri
- Department of Pediatrics, General Paediatrics Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy
| | - Catia Romano
- Department of Pediatrics, General Paediatrics Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy
| | - Piero Pavone
- Department of Pediatrics, General Paediatrics Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy
| | | | - Nassim Matin
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Riccardo Lubrano
- Department of Paediatrics, Paediatric Nephrology Operative Unit, La Sapienza University of Rome, Rome, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care, Neonatal Intensive Care Unit, AOUP, University of Palermo, Palermo, Italy
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Lascano AM, Korff CM, Picard F. Seizures and Epilepsies due to Channelopathies and Neurotransmitter Receptor Dysfunction: A Parallel between Genetic and Immune Aspects. Mol Syndromol 2016; 7:197-209. [PMID: 27781030 DOI: 10.1159/000447707] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Despite intensive research activity leading to many important discoveries, the pathophysiological mechanisms underlying seizures and epilepsy remain poorly understood. An important number of specific gene defects have been related to various forms of epilepsies, and autoimmunity and epilepsy have been associated for a long time. Certain central nervous system proteins have been involved in epilepsy or acute neurological diseases with seizures either due to underlying gene defects or immune dysfunction. Here, we focus on 2 of them that have been the object of particular attention and in-depth research over the past years: the N-methyl-D-aspartate receptor and the leucin-rich glioma-inactivated protein 1 (LGI1). We also describe illustrative examples of situations in which genetics and immunology meet in the complex pathways that underlie seizures and epilepsy.
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Affiliation(s)
- Agustina M Lascano
- EEG and Epilepsy Exploration Unit, University Hospitals Geneva, Geneva, Switzerland
| | - Christian M Korff
- Pediatric Neurology Unit, Child and Adolescent Department, University Hospitals Geneva, Geneva, Switzerland
| | - Fabienne Picard
- EEG and Epilepsy Exploration Unit, University Hospitals Geneva, Geneva, Switzerland
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Hu QP, Mao DA. Histone deacetylase inhibitor SAHA attenuates post-seizure hippocampal microglia TLR4/MYD88 signaling and inhibits TLR4 gene expression via histone acetylation. BMC Neurosci 2016; 17:22. [PMID: 27193049 PMCID: PMC4872358 DOI: 10.1186/s12868-016-0264-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 05/11/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Epilepsy is a common neurological disorder characterized by recurrent unprovoked seizures. Seizure-induced TLR4/MYD88 signaling plays a critical role in activating microglia and triggering neuron apoptosis. SAHA is a histone deacetylase inhibitor that regulates gene expression by increasing chromatin histone acetylation. In this study, we investigated the role of SAHA in TLR4/MYD88 signaling in a rat seizure model. RESULTS Sprague-Dawley rats with kainic acid (KA)-induced seizures were treated with SAHA. The expression of TLR4, MYD88, NF-κB P65 and IL-1β in hippocampus was detected at hour 2 and 6 and day 1, 2, and 3 post seizure. SAHA pretreatment increased seizure latency and decreased seizure scores. The expression levels of TLR4, MYD88, NF-κB and IL-1β increased significantly in both activated microglia and apoptotic neurons after KA treatment. The effects were attenuated by SAHA. Chromatin immunoprecipitation assays indicated that the H3 histone acetylation levels significantly decreased while H3K9 levels significantly increased in the KA treatment group. The H3 and H3K9 acetylation levels returned to control levels after SAHA (50 mg/kg) pretreatment. There was a positive correlation between the expression of TLR4 and the acetylation levels of H3K9. CONCLUSIONS Histone deacetylase inhibitor SAHA can suppress seizure-induced TLR4/MYD88 signaling and inhibit TLR4 gene expression through histone acetylation regulation. This suggests that SAHA may protect against seizure-induced brain damage.
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Affiliation(s)
- Qing-Peng Hu
- Department of Pediatrics, The Second Xiang-Ya Hospital, Central South University, 139 Middle Renmin Road, Changsha, 410011, Hunan, China
| | - Ding-An Mao
- Department of Pediatrics, The Second Xiang-Ya Hospital, Central South University, 139 Middle Renmin Road, Changsha, 410011, Hunan, China.
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