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Yavuz M, Akkol S, Onat F. Alpha-2a adrenergic receptor activation in genetic absence epilepsy: An absence status model? Epilepsia Open 2024; 9:534-547. [PMID: 38071480 PMCID: PMC10984306 DOI: 10.1002/epi4.12879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 12/07/2023] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE The objective of the study was to propose a candidate animal model of absence status epilepticus induced by specific alpha-2a adrenergic receptor (α2AR) activation. We also aim to investigate the responsiveness of this model to classical anti-status or anti-absence medications. METHODS An α2AR agonist, dexmedetomidine (DEX), was injected intracerebroventricularly into adult rats with genetic absence epilepsy, and their electroencephalography (EEG) was recorded. The total duration, number, and mean duration of each spike-and-wave discharges (SWDs) were evaluated. The blocks of absence status events were classified as the initial and second sets of absence statuses. Ethosuximide (ETX) was administered as a pretreatment to another group of rats and later injected with 2.5 μg DEX. In addition, ETX, valproic acid (VPA), diazepam (DIAZ), and atipamezole (ATI) were administered after induced status-like events following DEX administration. Power spectral characteristics and coherence analysis were performed on the EEG to assess the absence status events and sleep. RESULTS The 2.5 μg dose of DEX increased the total SWD duration and induced continuous SWDs up to 26 min. Following the initial absence status event, sleep was induced; then, the second period of absence status-like activities were initiated. ETX pretreatment blocked the occurrence of absence status-like activities. Power spectral density analyses revealed that DEX-induced post-sleep activities had higher power in delta frequency band (1-4 Hz) and attenuated power of 7 Hz harmonics (14 and 21 Hz) than the pre-injection seizure. The mean duration of SWDs were decreased in all the groups, but occasional prolonged activities were seen in ETX or VPA-injected rats but not with DIAZ or ATI. SIGNIFICANCE This study presents an absence status epilepticus animal model that is activated by α2AR activation to investigate the pathophysiological role of absence status. Unlike other agents ATI switched off the second set of absence statuses to normal SWDs, without sedation or lethargy, can show it may preferentially block absence status-like activity. THE PLAIN LANGUAGE SUMMARY This study proposes a rat model for prolonged seizures, resembling absence status epilepticus. Activating the brain's alpha-2a adrenergic receptor with dexmedetomidine induced seizures lasting up to 26 minutes. Ethosuximide pretreatment and post-treatment with valproic acid, diazepam, and atipamezole decreased induced seizures. The findings suggest this model is valuable for studying absence status epilepticus. In addition, atipamezole normalized abnormal seizures without sedation, hinting at its potential for targeted treatment and further research.
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Affiliation(s)
- Melis Yavuz
- Department of Pharmacology, Faculty of PharmacyAcibadem Mehmet Ali Aydinlar University UniversityIstanbulTurkey
| | - Serdar Akkol
- Department of NeurologyUniversity of Alabama at Birmingham Medical CenterBirminghamAlabamaUSA
| | - Filiz Onat
- Department of Medical Pharmacology, School of MedicineMarmara UniversityIstanbulTurkey
- Department of Medical Pharmacology, School of MedicineAcibadem Mehmet Ali Aydinlar UniversityIstanbulTurkey
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2
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Lee DY, Kim C, Yu DH, Park RW. Safety outcomes of antipsychotics classes in drug-naïve patients with first-episode schizophrenia: A nationwide cohort study in South Korea. Asian J Psychiatr 2024; 91:103857. [PMID: 38128353 DOI: 10.1016/j.ajp.2023.103857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Given the similar efficacies across antipsychotic medications for schizophrenia, understanding their safety profiles, particularly concerning receptor-binding differences, is crucial for optimal drug selection, especially for patients with first episode schizophrenia. We aimed to compare the safety outcomes of second-generation antipsychotics. METHODS We conducted a retrospective cohort study with new user active comparator design using a nationwide claims database in South Korea. Participants were drug-naïve adult patients with first-episode schizophrenia. Three representative drugs with different pharmacologic profiles were compared: risperidone, olanzapine, and aripiprazole. Propensity scores were used to match the study groups, and the Cox proportional hazard model was used to calculate hazard ratios. Sensitivity analyses were performed in various epidemiological settings. Seventeen safety outcomes, including neuropsychiatric, cardiometabolic and gastrointestinal events, were assessed, with upper-respiratory-tract infection as a negative control outcome. RESULTS A total of 1044, 2078, and 3634 participants were matched for olanzapine vs. risperidone, olanzapine vs. aripiprazole, and risperidone vs. aripiprazole comparisons, respectively. For parkinsonism, there was a significant difference in outcomes between the risperidone and aripiprazole groups (HR 1.80 [95% CI 1.13-2.91]), with consistent sensitivity analysis results. There were no significant differences in other neuropsychiatry outcomes or in the risk of cardiometabolic and gastrointestinal outcomes between any of the comparative group pairs. CONCLUSIONS The risk of drug-induced parkinsonism was significantly higher with risperidone than with aripiprazole. Although olanzapine is known for its metabolic risk, there were no significant differences in risk between the other pairs.
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Affiliation(s)
- Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
| | - Chungsoo Kim
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea
| | - Dong Han Yu
- Big Data Department, Health Insurance Review and Assessment Service, Wonju, South Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea; Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea.
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3
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Pisani F, Pisani LR, Barbieri MA, de Leon J, Spina E. Optimization of Therapy in Patients with Epilepsy and Psychiatric Comorbidities: Key Points. Curr Neuropharmacol 2023; 21:1755-1766. [PMID: 35619263 PMCID: PMC10514544 DOI: 10.2174/1570159x20666220526144314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/24/2022] [Accepted: 05/25/2022] [Indexed: 11/22/2022] Open
Abstract
Psychiatric disorder comorbidity in patients with epilepsy (PWE) is very frequent with a mean percentage prevalence of up to 50% and even higher. Such a high frequency suggests that epilepsy and psychiatric disorders might share common pathological pathways. Various aspects contribute in making the matter very complex from a therapeutic point of view. Some antiseizure medications (ASMs), namely valproic acid, carbamazepine, and lamotrigine, have mood-stabilising effects and are routinely used for the treatment of bipolar disorder in patients who do not have epilepsy. Pregabalin and, to a lesser extent, gabapentin, exerts anxiolytic effects. However, several ASMs, in particular levetiracetam, topiramate, and perampanel, may contribute to psychiatric disorders, including depression, aggressive behaviour, and even psychosis. If these ASMs are prescribed, the patient should be monitored closely. A careful selection should be made also with psychotropic drugs. Although most of these can be safely used at therapeutic doses, bupropion, some tricyclic antidepressants, maprotiline, and clozapine may alter seizure threshold and facilitate epileptic seizures. Interactions between ASMs and psychotropic medication may make it difficult to predict individual response. Pharmacokinetic interactions can be assessed with drug monitoring and are consequently much better documented than pharmacodynamic interactions. Another aspect that needs a careful evaluation is patient adherence to treatment. Prevalence of non-adherence in PWE and psychiatric comorbidities is reported to reach values even higher than 70%. A careful evaluation of all these aspects contributes in optimizing therapy with a positive impact on seizure control, psychiatric wellbeing, and quality of life.
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Affiliation(s)
- Francesco Pisani
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | | | | | - Jose de Leon
- Mental Health Research Center at Eastern State Hospital, Lexington, KY, USA and Psychiatry and Biomedical Research Centre in Mental Health Net (CIBERSAM), Santiago Apostol Hospital, University of the Basque Country, Vitoria, Spain
| | - Edoardo Spina
- Department of Clinical and Experimental Medicine, University of Messina, Italy
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4
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De Sarro C, Tallarico M, Pisano M, Gallelli L, Citraro R, De Sarro G, Leo A. Liraglutide chronic treatment prevents development of tolerance to antiseizure effects of diazepam in genetically epilepsy prone rats. Eur J Pharmacol 2022; 928:175098. [PMID: 35700834 DOI: 10.1016/j.ejphar.2022.175098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
Glucagon-like peptide-1 (GLP-1) is a hormone that can regulate several neuronal functions. The modulation of GLP-1 receptors emerged as a potential target to treat several neurological diseases, such as epilepsy. Here, we studied the effects of acute and chronic treatment with liraglutide (LIRA), in genetically epilepsy prone rats (GEPR-9s). We have also investigated the possible development of tolerance to antiseizure effects of diazepam, and how LIRA could affect this phenomenon over the same period of treatment. The present data indicate that an acute treatment with LIRA did not diminish the severity score of audiogenic seizures (AGS) in GEPR-9s. By contrast, a chronic treatment with LIRA has shown only a modest antiseizure effect that was maintained until the end of treatment, in GEPR-9s. Not surprisingly, acute administration of diazepam reduced, in a dose dependent manner, the severity of the AGS in GEPR-9s. However, when diazepam was chronically administered, an evident development of tolerance to its antiseizure effects was detected. Interestingly, following an add-on treatment with LIRA, a reduced development of tolerance and an enhanced diazepam antiseizure effect was observed in GEPR-9s. Overall, an add-on therapy with LIRA demonstrate benefits superior to single antiseizure medications and could be utilized to treat epilepsy as well as associated issues. Therefore, the potential use of GLP1 analogs for the treatment of epilepsy in combination with existing antiseizure medications could thus add a new and long-awaited dimension to its management.
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Affiliation(s)
- Caterina De Sarro
- System and Applied Pharmacology@University Magna Grecia, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Martina Tallarico
- System and Applied Pharmacology@University Magna Grecia, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Maria Pisano
- System and Applied Pharmacology@University Magna Grecia, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Luca Gallelli
- System and Applied Pharmacology@University Magna Grecia, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rita Citraro
- System and Applied Pharmacology@University Magna Grecia, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy.
| | - Giovambattista De Sarro
- System and Applied Pharmacology@University Magna Grecia, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy.
| | - Antonio Leo
- System and Applied Pharmacology@University Magna Grecia, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
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5
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Detyniecki K. Do Psychotropic Drugs Cause Epileptic Seizures? A Review of the Available Evidence. Curr Top Behav Neurosci 2021; 55:267-279. [PMID: 34241816 DOI: 10.1007/7854_2021_226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Psychiatric comorbidities in patients with epilepsy are common. A bidirectional relationship has been well described where not only patients with epilepsy have a higher prevalence of psychiatric comorbidities but also patients with primary psychiatric disorders are at an increased risk of developing seizures. The aim of this review is to highlight the complex relationship between epilepsy and common psychiatric disorders and to answer the question whether psychotropic medications are proconvulsant by reviewing the preclinical and clinical literature. The evidence shows that the majority of psychotropic medications are not proconvulsant when used in therapeutic doses with the exception of a subset of medications, mainly bupropion IR and certain antipsychotic drugs such as clozapine. An effective treatment of psychiatric comorbidities in patients with epilepsy must consider not only the potential therapeutic effect of the drug, but also its potential iatrogenic effects on the seizure disorder.
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Affiliation(s)
- Kamil Detyniecki
- Comprehensive Epilepsy Center, University of Miami Miller School of Medicine, Miami, FL, USA.
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6
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Goossens MG, Boon P, Wadman W, Van den Haute C, Baekelandt V, Verstraete AG, Vonck K, Larsen LE, Sprengers M, Carrette E, Desloovere J, Meurs A, Delbeke J, Vanhove C, Raedt R. Long-term chemogenetic suppression of seizures in a multifocal rat model of temporal lobe epilepsy. Epilepsia 2021; 62:659-670. [PMID: 33570167 DOI: 10.1111/epi.16840] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVE One third of epilepsy patients do not become seizure-free using conventional medication. Therefore, there is a need for alternative treatments. Preclinical research using designer receptors exclusively activated by designer drugs (DREADDs) has demonstrated initial success in suppressing epileptic activity. Here, we evaluated whether long-term chemogenetic seizure suppression could be obtained in the intraperitoneal kainic acid rat model of temporal lobe epilepsy, when DREADDs were selectively expressed in excitatory hippocampal neurons. METHODS Epileptic male Sprague Dawley rats received unilateral hippocampal injections of adeno-associated viral vector encoding the inhibitory DREADD hM4D(Gi), preceded by a cell-specific promotor targeting excitatory neurons. The effect of clozapine-mediated DREADD activation on dentate gyrus evoked potentials and spontaneous electrographic seizures was evaluated. Animals were systemically treated with single (.1 mg/kg/24 h) or repeated (.1 mg/kg/6 h) injections of clozapine. In addition, long-term continuous release of clozapine and olanzapine (2.8 mg/kg/7 days) using implantable minipumps was evaluated. All treatments were administered during the chronic epileptic phase and between 1.5 and 13.5 months after viral transduction. RESULTS In the DREADD group, dentate gyrus evoked potentials were inhibited after clozapine treatment. Only in DREADD-expressing animals, clozapine reduced seizure frequency during the first 6 h postinjection. When administered repeatedly, seizures were suppressed during the entire day. Long-term treatment with clozapine and olanzapine both resulted in significant seizure-suppressing effects for multiple days. Histological analysis revealed DREADD expression in both hippocampi and some cortical regions. However, lesions were also detected at the site of vector injection. SIGNIFICANCE This study shows that inhibition of the hippocampus using chemogenetics results in potent seizure-suppressing effects in the intraperitoneal kainic acid rat model, even 1 year after viral transduction. Despite a need for further optimization, chemogenetic neuromodulation represents a promising treatment prospect for temporal lobe epilepsy.
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Affiliation(s)
| | - Paul Boon
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Wytse Wadman
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Chris Van den Haute
- Laboratory for Neurobiology and Gene Therapy, Center for Molecular Medicine and Leuven Brain Institute, KU Leuven, Leuven, Belgium.,Leuven Viral Vector Core, Center for Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Veerle Baekelandt
- Laboratory for Neurobiology and Gene Therapy, Center for Molecular Medicine and Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Alain G Verstraete
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium.,Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Kristl Vonck
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Lars E Larsen
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Mathieu Sprengers
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Evelien Carrette
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Jana Desloovere
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Alfred Meurs
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Jean Delbeke
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Christian Vanhove
- IBiTech, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Robrecht Raedt
- 4BRAIN, Department of Head and Skin, Ghent University, Ghent, Belgium
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7
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Leo A, Nesci V, Tallarico M, Amodio N, Gallo Cantafio EM, De Sarro G, Constanti A, Russo E, Citraro R. IL-6 Receptor Blockade by Tocilizumab Has Anti-absence and Anti-epileptogenic Effects in the WAG/Rij Rat Model of Absence Epilepsy. Neurotherapeutics 2020; 17:2004-2014. [PMID: 32681356 PMCID: PMC7851197 DOI: 10.1007/s13311-020-00893-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Increased expression of interleukin-6 (IL-6) both in cerebrospinal fluid (CSF) and plasma is closely associated with convulsive epilepsy and symptom severity of depression. By comparison, at present, little is known about the role of this cytokine in childhood (non-convulsive) absence epilepsy. The aim of this work was to investigate the potential effects of acute and chronic treatment with tocilizumab (TCZ, 10 and 30 mg/kg/day), on absence seizures, their development, and related psychiatric comorbidity in WAG/Rij rats. It is known that lipopolysaccharide (LPS)-induced changes in inflammatory processes increase absence epileptic activity. In order to study the central effects of TCZ, we investigated whether administration of this anti-IL-6R antibody could modulate the lipopolysaccharide (LPS) or IL-6-evoked changes in absence epileptic activity in WAG/Rij rats. Our results demonstrate that TCZ, at both doses, significantly reduced the development of absence seizures in adult WAG/Rij rats at 6 months of age (1 month after treatment suspension) compared with untreated controls, thus showing disease-modifying effects. Decreased absence seizure development at 6 months of age was also accompanied by reduced comorbid depressive-like behavior, whereas no effects were observed on anxiety-related behavior. Acute treatment with TCZ, at 30 mg/kg, had anti-absence properties lasting ~25 h. The co-administration TCZ with i.c.v. LPS or IL-6 showed that TCZ inhibited the worsening of absence seizures induced by both proinflammatory agents in the WAG/Rij rats, supporting a central anti-inflammatory-like protective action. These results suggest the possible role of IL-6 and consequent neuroinflammation in the epileptogenic process underlying the development and maintenance of absence seizures in WAG/Rij rats. Accordingly, IL-6 signaling could be a promising pharmacological target in absence epilepsy and depressive-like comorbidity.
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MESH Headings
- Animals
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Monoclonal, Humanized/therapeutic use
- Disease Models, Animal
- Dose-Response Relationship, Drug
- Epilepsy, Absence/drug therapy
- Epilepsy, Absence/genetics
- Epilepsy, Absence/metabolism
- Male
- Rats
- Rats, Transgenic
- Rats, Wistar
- Receptors, Interleukin-6/antagonists & inhibitors
- Receptors, Interleukin-6/metabolism
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Affiliation(s)
- Antonio Leo
- Science of Health Department, School of Medicine and Surgery, Magna Græcia University of Catanzaro, Viale Europa - Germaneto, 88100, Catanzaro, Italy
| | - Valentina Nesci
- Science of Health Department, School of Medicine and Surgery, Magna Græcia University of Catanzaro, Viale Europa - Germaneto, 88100, Catanzaro, Italy
| | - Martina Tallarico
- Science of Health Department, School of Medicine and Surgery, Magna Græcia University of Catanzaro, Viale Europa - Germaneto, 88100, Catanzaro, Italy
| | - Nicola Amodio
- Experimental and Clinical Medicine Department, School of Medicine and Surgery, Magna Græcia University, Catanzaro, Italy
| | - Eugenia M Gallo Cantafio
- Science of Health Department, School of Medicine and Surgery, Magna Græcia University of Catanzaro, Viale Europa - Germaneto, 88100, Catanzaro, Italy
| | - Giovambattista De Sarro
- Science of Health Department, School of Medicine and Surgery, Magna Græcia University of Catanzaro, Viale Europa - Germaneto, 88100, Catanzaro, Italy
| | | | - Emilio Russo
- Science of Health Department, School of Medicine and Surgery, Magna Græcia University of Catanzaro, Viale Europa - Germaneto, 88100, Catanzaro, Italy.
| | - Rita Citraro
- Science of Health Department, School of Medicine and Surgery, Magna Græcia University of Catanzaro, Viale Europa - Germaneto, 88100, Catanzaro, Italy
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8
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Samanta S, O’Hagan S, Swainston N, Roberts TJ, Kell DB. VAE-Sim: A Novel Molecular Similarity Measure Based on a Variational Autoencoder. Molecules 2020; 25:E3446. [PMID: 32751155 PMCID: PMC7435890 DOI: 10.3390/molecules25153446] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/21/2020] [Accepted: 07/28/2020] [Indexed: 01/13/2023] Open
Abstract
Molecular similarity is an elusive but core "unsupervised" cheminformatics concept, yet different "fingerprint" encodings of molecular structures return very different similarity values, even when using the same similarity metric. Each encoding may be of value when applied to other problems with objective or target functions, implying that a priori none are "better" than the others, nor than encoding-free metrics such as maximum common substructure (MCSS). We here introduce a novel approach to molecular similarity, in the form of a variational autoencoder (VAE). This learns the joint distribution p(z|x) where z is a latent vector and x are the (same) input/output data. It takes the form of a "bowtie"-shaped artificial neural network. In the middle is a "bottleneck layer" or latent vector in which inputs are transformed into, and represented as, a vector of numbers (encoding), with a reverse process (decoding) seeking to return the SMILES string that was the input. We train a VAE on over six million druglike molecules and natural products (including over one million in the final holdout set). The VAE vector distances provide a rapid and novel metric for molecular similarity that is both easily and rapidly calculated. We describe the method and its application to a typical similarity problem in cheminformatics.
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Affiliation(s)
- Soumitra Samanta
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Crown St, Liverpool L69 7ZB, UK; (S.S.); (N.S.); (T.J.R.)
| | - Steve O’Hagan
- Department of Chemistry, The Manchester Institute of Biotechnology, The University of Manchester, 131 Princess St, Manchester M1 7DN, UK;
| | - Neil Swainston
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Crown St, Liverpool L69 7ZB, UK; (S.S.); (N.S.); (T.J.R.)
| | - Timothy J. Roberts
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Crown St, Liverpool L69 7ZB, UK; (S.S.); (N.S.); (T.J.R.)
| | - Douglas B. Kell
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Crown St, Liverpool L69 7ZB, UK; (S.S.); (N.S.); (T.J.R.)
- Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, Building 220, Kemitorvet, 2800 Kgs Lyngby, Denmark
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Leo A, De Caro C, Nesci V, Tallarico M, De Sarro G, Russo E, Citraro R. Modeling poststroke epilepsy and preclinical development of drugs for poststroke epilepsy. Epilepsy Behav 2020; 104:106472. [PMID: 31427267 DOI: 10.1016/j.yebeh.2019.106472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 12/21/2022]
Abstract
Stroke is a severe clinical issue for global public health, representing the third leading cause of death and a major cause of disability in developed countries. Progresses in the pharmacological treatment of the acute stroke have given rise to a significant decrease in its mortality rate. However, as a result, there has been an increasing number of stroke survivors living with disability worldwide. Poststroke epilepsy (PSE) is a common clinical complication following stroke. Seizures can arise in close temporal association with stroke damage and/or after a variably longer interval. Overall, PSE have a good prognosis; in fact, its responding rate to antiepileptic drugs (AEDs) is higher than other types of epilepsy. However, regarding pharmacological treatment, some issues are still unresolved. To this aim, a deeper understanding of mechanisms underlying the transformation of infarcted tissue into an epileptic focus or better from a nonepileptic brain to an epileptic brain is also mandatory for PSE. However, studying epileptogenesis in patients with PSE clearly has several limitations and difficulties; therefore, modeling PSE is crucial. Until now, different experimental models have been used to study the etiopathology of cerebrovascular stroke with or without infarction, but few studies focused on poststroke epileptogenesis and PSE. In this review, we show a brief overview on the features emerging from preclinical research into experimental PSE, which could affect the discovery of biomarkers and therapy strategies for poststroke epileptogenesis. This article is part of the Special Issue "Seizures & Stroke".
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Affiliation(s)
- Antonio Leo
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Viale Europa e Germaneto, 88100 Catanzaro, Italy
| | - Carmen De Caro
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Viale Europa e Germaneto, 88100 Catanzaro, Italy
| | - Valentina Nesci
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Viale Europa e Germaneto, 88100 Catanzaro, Italy
| | - Martina Tallarico
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Viale Europa e Germaneto, 88100 Catanzaro, Italy
| | - Giovambattista De Sarro
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Viale Europa e Germaneto, 88100 Catanzaro, Italy
| | - Emilio Russo
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Viale Europa e Germaneto, 88100 Catanzaro, Italy.
| | - Rita Citraro
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Viale Europa e Germaneto, 88100 Catanzaro, Italy
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10
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Citraro R, Iannone M, Leo A, De Caro C, Nesci V, Tallarico M, Abdalla K, Palma E, Arturi F, De Sarro G, Constanti A, Russo E. Evaluation of the effects of liraglutide on the development of epilepsy and behavioural alterations in two animal models of epileptogenesis. Brain Res Bull 2019; 153:133-142. [DOI: 10.1016/j.brainresbull.2019.08.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/27/2019] [Accepted: 08/02/2019] [Indexed: 01/22/2023]
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11
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Leo A, Caro CD, Nesci V, Palma E, Tallarico M, Iannone M, Constanti A, Sarro GD, Russo E, Citraro R. Antiepileptogenic effects of Ethosuximide and Levetiracetam in WAG/Rij rats are only temporary. Pharmacol Rep 2019; 71:833-838. [PMID: 31386986 DOI: 10.1016/j.pharep.2019.04.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 03/22/2019] [Accepted: 04/23/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND WAG/Rij rats represent a validated genetic animal model of epileptogenesis, absence epilepsy and depressive-like comorbidity. Some treatments (e.g. ethosuximide), using specific protocols, prevent the development of spontaneous absence seizures. Accordingly, ethosuximide increases remission occurrence in children with childhood absence epilepsy in comparison to valproic acid. Considering that in this animal model, antiepileptogenic effects are, in some cases, not retained over time, we studied whether the antiepileptogenic effects of both ethosuximide and levetiracetam (which also possesses antiepileptogenic effects in this and other animal epilepsy models) would be retained 5 months after drug suspension. METHODS WAG/Rij rats of ˜1 month of age were treated long-term with one of the two drugs at a dose of ˜80 mg/kg/day for 17 consecutive weeks; 1 and 5 months after drug suspension, the development of absence seizures as well as depressive-like behaviour were assessed by EEG recordings and the forced swimming test (FST). RESULTS In agreement with a previous report, both drugs continued to show antiepileptogenic effects 1 month after their discontinuation. Furthermore, ethosuximide improved depressive-like behaviour, whereas in contrast, levetiracetam worsened this symptom. However, none of the drugs maintained their antiepileptogenic effects 5 months after suspension, and in addition, animal behaviour in the FST returned to control conditions. CONCLUSION Overall, these results demonstrate that the antiepileptogenic effects of both ethosuximide and levetiracetam on absence seizure development and associated depressive-like behaviour in this model are only temporary.
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Affiliation(s)
- Antonio Leo
- University of Catanzaro, School of Medicine, Science of Health Department, Catanzaro, Italy
| | - Carmen De Caro
- University of Catanzaro, School of Medicine, Science of Health Department, Catanzaro, Italy
| | - Valentina Nesci
- University of Catanzaro, School of Medicine, Science of Health Department, Catanzaro, Italy
| | - Ernesto Palma
- University of Catanzaro, School of Medicine, Science of Health Department, Catanzaro, Italy
| | - Martina Tallarico
- University of Catanzaro, School of Medicine, Science of Health Department, Catanzaro, Italy; CNR, Institute of Neurological Sciences, Pharmacology Section, Roccelletta di Borgia, Catanzaro, Italy
| | - Michelangelo Iannone
- CNR, Institute of Neurological Sciences, Pharmacology Section, Roccelletta di Borgia, Catanzaro, Italy
| | | | | | - Emilio Russo
- University of Catanzaro, School of Medicine, Science of Health Department, Catanzaro, Italy
| | - Rita Citraro
- University of Catanzaro, School of Medicine, Science of Health Department, Catanzaro, Italy.
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Perampanel chronic treatment does not induce tolerance and decreases tolerance to clobazam in genetically epilepsy prone rats. Epilepsy Res 2018; 146:94-102. [DOI: 10.1016/j.eplepsyres.2018.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 02/08/2018] [Accepted: 07/24/2018] [Indexed: 11/24/2022]
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Leo A, Citraro R, Amodio N, De Sarro C, Gallo Cantafio ME, Constanti A, De Sarro G, Russo E. Fingolimod Exerts only Temporary Antiepileptogenic Effects but Longer-Lasting Positive Effects on Behavior in the WAG/Rij Rat Absence Epilepsy Model. Neurotherapeutics 2017; 14:1134-1147. [PMID: 28653281 PMCID: PMC5722759 DOI: 10.1007/s13311-017-0550-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
One of the major challenges in the epilepsy field is identifying disease-modifying drugs in order to prevent or delay spontaneous recurrent seizure onset or to cure already established epilepsy. It has been recently reported that fingolimod, currently approved for the treatment of relapsing-remitting multiple sclerosis, has demonstrated antiepileptogenic effects in 2 different preclinical models of acquired epilepsy. However, to date, no data exist regarding the role of fingolimod against genetic epilepsy. Therefore, we have addressed this issue by studying the effects of fingolimod in Wistar Albino Glaxo/Rijswijk (WAG/Rij) rats, a well-established genetic model of absence epilepsy, epileptogenesis, and neuropsychiatric comorbidity. Our results have demonstrated that an early long-term treatment with fingolimod (1 mg/kg/day), started before absence seizure onset, has both antiepileptogenic and antidepressant-like effects in WAG/Rij rats. However, these effects were transitory, as 5 months after treatment discontinuation, both absence seizure and depressive like-behavior returned to control levels. Furthermore, a temporary reduction of mTOR signaling pathway activity, indicated by reduced phosphorylated mammalian target of rapamycin and phosphorylated p70S6k levels, and by increased phosphorylated Akt in WAG/Rij rats of 6 months of age accompanied the transitory antiepileptogenic effects of fingolimod. Surprisingly, fingolimod has demonstrated longer-lasting positive effects on cognitive decline in this strain. This effect was accompanied by an increased acetylation of lysine 8 of histone H4 (at both 6 and 10 months of age). In conclusion, our results support the antiepileptogenic effects of fingolimod. However, the antiepileptogenic effects were transitory. Moreover, fingolimod might also have a positive impact on animal behavior and particularly in protecting the development of memory decline.
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Affiliation(s)
- Antonio Leo
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Rita Citraro
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Nicola Amodio
- Department of Experimental and Clinical Medicine, Magna Graecia University and Translational Medical Oncology Unit, Salvatore Venuta University Campus, Catanzaro, Italy
| | - Caterina De Sarro
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Maria Eugenia Gallo Cantafio
- Department of Experimental and Clinical Medicine, Magna Graecia University and Translational Medical Oncology Unit, Salvatore Venuta University Campus, Catanzaro, Italy
| | | | - Giovambattista De Sarro
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Emilio Russo
- Science of Health Department, School of Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.
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Genetically epilepsy-prone rats (GEPRs) and DBA/2 mice: Two animal models of audiogenic reflex epilepsy for the evaluation of new generation AEDs. Epilepsy Behav 2017; 71:165-173. [PMID: 26254980 DOI: 10.1016/j.yebeh.2015.06.030] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/12/2015] [Accepted: 06/17/2015] [Indexed: 01/08/2023]
Abstract
This review summarizes the current knowledge about DBA/2 mice and genetically epilepsy-prone rats (GEPRs) and discusses the contribution of such animal models on the investigation of possible new therapeutic targets and new anticonvulsant compounds for the treatment of epilepsy. Also, possible chemical or physical agents acting as proconvulsant agents are described. Abnormal activities of enzymes involved in catecholamine and serotonin synthesis and metabolism were reported in these models, and as a result of all these abnormalities, seizure susceptibility in both animals is greatly affected by pharmacological manipulations of the brain levels of monoamines and, prevalently, serotonin. In addition, both genetic epileptic models permit the evaluation of pharmacodynamic and pharmacokinetic interactions among several drugs measuring plasma and/or brain level of each compound. Audiogenic models of epilepsy have been used not only for reflex epilepsy studies, but also as animal models of epileptogenesis. The seizure predisposition (epileptiform response to sound stimulation) and substantial characterization of behavioral, cellular, and molecular alterations in both acute and chronic (kindling) protocols potentiate the usefulness of these models in elucidating ictogenesis, epileptogenesis, and their mechanisms. This article is part of a Special Issue entitled "Genetic and Reflex Epilepsies, Audiogenic Seizures and Strains: From Experimental Models to the Clinic".
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Cannabidiol and epilepsy: Rationale and therapeutic potential. Pharmacol Res 2016; 107:85-92. [PMID: 26976797 DOI: 10.1016/j.phrs.2016.03.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/07/2016] [Accepted: 03/08/2016] [Indexed: 12/30/2022]
Abstract
Despite the introduction of new antiepileptic drugs (AEDs), the quality of life and therapeutic response for patients with epilepsy remains still poor. Unfortunately, besides several advantages, these new AEDs have not satisfactorily reduced the number of refractory patients. Therefore, the need for different other therapeutic options to manage epilepsy is still a current issue. To this purpose, emphasis has been given to phytocannabinoids, which have been medicinally used since ancient time in the treatment of neurological disorders including epilepsy. In particular, the nonpsychoactive compound cannabidiol (CBD) has shown anticonvulsant properties, both in preclinical and clinical studies, with a yet not completely clarified mechanism of action. However, it should be made clear that most phytocannabinoids do not act on the endocannabinoid system as in the case of CBD. In in vivo preclinical studies, CBD has shown significant anticonvulsant effects mainly in acute animal models of seizures, whereas restricted data exist in chronic models of epilepsy as well as in animal models of epileptogenesis. Likewise, clinical evidence seems to indicate that CBD is able to manage epilepsy both in adults and children affected by refractory seizures, with a favourable side effect profile. However, to date, clinical trials are both qualitatively and numerically limited, thus yet inconsistent. Therefore, further preclinical and clinical studies are undoubtedly needed to better evaluate the potential therapeutic profile of CBD in epilepsy, although the actually available data is promising.
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Shafaroodi H, Oveisi S, Hosseini M, Niknahad H, Moezi L. The effect of acute aripiprazole treatment on chemically and electrically induced seizures in mice: The role of nitric oxide. Epilepsy Behav 2015; 48:35-40. [PMID: 26037847 DOI: 10.1016/j.yebeh.2015.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 05/07/2015] [Accepted: 05/09/2015] [Indexed: 11/29/2022]
Abstract
Aripiprazole is an antipsychotic drug which acts through dopamine and serotonin receptors. Aripiprazole was noted to have antiseizure effects in a study on mice, while it induced seizures in a few human case reports. Dopaminergic and serotonergic systems relate to nitric oxide, and aripiprazole also has effects on dopamine and serotonin receptors. This study investigated the effects of aripiprazole on seizures and the potential role of nitric oxide in the process. The following three models were examined to explore the role of aripiprazole on seizures in mice: 1 - pentylenetetrazole administered intravenously, 2 - pentylenetetrazole administered intraperitoneally, and 3 - electroshock. Aripiprazole administration delayed clonic seizure in intravenous and intraperitoneal pentylenetetrazole models. In the electroshock-induced seizure model, tonic seizure and mortality protection percent were increased after aripiprazole administration. In intraperitoneal administration of pentylenetetrazole, aripiprazole effects on clonic seizure latency were significantly decreased when l-NAME - a nonselective nitric oxide synthase (NOS) inhibitor, 7-nitroindazole - a selective neuronal NOS (nNOS) inhibitor, or aminoguanidine - a selective inducible NOS (iNOS) inhibitor was injected before aripiprazole administration. In the intravenous pentylenetetrazole method, administration of l-NAME or aminoguanidine inhibited aripiprazole effects on clonic seizure threshold. Aminoguanidine or l-NAME administration decreased aripiprazole-induced protection against tonic seizures and death in the electroshock model. In both intravenous and intraperitoneal seizure models, aripiprazole and l-arginine coadministration delayed the onset of clonic seizures. Moreover, it increased protection against tonic seizures and death in intraperitoneal pentylenetetrazole and electroshock models. In conclusion, the release of nitric oxide via iNOS or nNOS may be involved in anticonvulsant properties of aripiprazole.
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Affiliation(s)
- Hamed Shafaroodi
- Department of Pharmacology and Toxicology, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Simin Oveisi
- Department of Pharmacology and Toxicology, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Mahsa Hosseini
- Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Niknahad
- Department of Pharmacology and Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Moezi
- Department of Pharmacology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Citraro R, Leo A, De Fazio P, De Sarro G, Russo E. Antidepressants but not antipsychotics have antiepileptogenic effects with limited effects on comorbid depressive-like behaviour in the WAG/Rij rat model of absence epilepsy. Br J Pharmacol 2015; 172:3177-88. [PMID: 25754610 DOI: 10.1111/bph.13121] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 01/22/2015] [Accepted: 02/21/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND PURPOSE Two of the most relevant unmet needs in epilepsy are represented by the development of disease-modifying drugs able to affect epileptogenesis and/or the study of related neuropsychiatric comorbidities. No systematic study has investigated the effects of chronic treatment with antipsychotics or antidepressants on epileptogenesis. However, such drugs are known to influence seizure threshold. EXPERIMENTAL APPROACH We evaluated the effects of an early long-term treatment (ELTT; 17 weeks), started before seizure onset (P45), with fluoxetine (selective 5-HT-reuptake inhibitor), duloxetine (dual-acting 5-HT-noradrenaline reuptake inhibitor), haloperidol (typical antipsychotic drug), risperidone and quetiapine (atypical antipsychotic drugs) on the development of absence seizures and comorbid depressive-like behaviour in the WAG/Rij rat model. Furthermore, we studied the effects of these drugs on established absence seizures in adult (6-month-old) rats after a chronic 7 weeks treatment. KEY RESULTS ELTT with all antipsychotics did not affect the development of seizures, whereas, both ELTT haloperidol (1 mg · kg(-1) day(-1)) and risperidone (0.5 mg · kg(-1) day(-1)) increased immobility time in the forced swimming test and increased absence seizures only in adult rats (7 weeks treatment). In contrast, both fluoxetine (30 mg · kg(-1) day(-1)) and duloxetine (10-30 mg · kg(-1) day(-1)) exhibited clear antiepileptogenic effects. Duloxetine decreased and fluoxetine increased absence seizures in adult rats. Duloxetine did not affect immobility time; fluoxetine 30 mg · kg(-1) day(-1) reduced immobility time while at 10 mg · kg(-1) day(-1) an increase was observed. CONCLUSIONS AND IMPLICATIONS In this animal model, antipsychotics had no antiepileptogenic effects and might worsen depressive-like comorbidity, while antidepressants have potential antiepileptogenic effects even though they have limited effects on comorbid depressive-like behaviour.
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Affiliation(s)
- Rita Citraro
- Pharmacology Unit, Science of Health Department School of Medicine and Surgery, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - Antonio Leo
- Pharmacology Unit, Science of Health Department School of Medicine and Surgery, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - Pasquale De Fazio
- Psichiatry Unit, Science of Health Department School of Medicine and Surgery, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - Giovambattista De Sarro
- Pharmacology Unit, Science of Health Department School of Medicine and Surgery, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - Emilio Russo
- Pharmacology Unit, Science of Health Department School of Medicine and Surgery, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
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