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Polet SS, de Koning TJ, Lambrechts RA, Tijssen MAJ, Sibon OCM, Gorter JA. Conventional and novel anti-seizure medications reveal a particular role for GABA A in a North Sea progressive myoclonus Epilepsy Drosophila model. Epilepsy Res 2024; 203:107380. [PMID: 38781737 DOI: 10.1016/j.eplepsyres.2024.107380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/01/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE North Sea Progressive Myoclonus Epilepsy (NS-PME) is a rare genetic disorder characterized by ataxia, myoclonus and seizures with a progressive course. Although the cause of NS-PME is known, namely a homozygous mutation in the GOSR2 gene (c.430 G>T; p. Gly144Trp), sufficient treatment is lacking. Despite combinations of on average 3-5 anti-seizure medications (ASMs), debilitating myoclonus and seizures persist. Here we aimed to gain insight into the most effective anti-convulsive target in NS-PME by evaluating the individual effects of ASMs in a NS-PME Drosophila model. METHOD A previously generated Drosophila model for NS-PME was used displaying progressive heat-sensitive seizures. We used this model to test 1. a first-generation ASM (sodium barbital), 2. common ASMs used in NS-PME (clonazepam, valproic acid, levetiracetam, ethosuximide) and 3. a novel third-generation ASM (ganaxolone) with similar mode of action to sodium barbital. Compounds were administered by adding them to the food in a range of concentrations. After 7 days of treatment, the percentage of heat-induced seizures was determined and compared to non-treated but affected controls. RESULTS As previously reported in the NS-PME Drosophila model, sodium barbital resulted in significant seizure suppression, with increasing effect at higher dosages. Of the commonly prescribed ASMs, clonazepam and ethosuximide resulted in significant seizure suppression, whereas both valproic acid and levetiracetam did not show any changes in seizures. Interestingly, ganaxolone did result in seizure suppression as well. CONCLUSION Of the six drugs tested, three of the four that resulted in seizure suppression (sodium barbital, clonazepam, ganaxolone) are primary known for their direct effect on GABAA receptors. This suggests that GABAA could be a potentially important target in the treatment of NS-PME. Consequently, these findings add rationale to the exploration of the clinical effect of ganaxolone in NS-PME and other progressive myoclonus epilepsies.
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Affiliation(s)
- Sjoukje S Polet
- Department of Neurology, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands.
| | - Tom J de Koning
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands; Department of Neurology and Medical Genetics, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands; Department of Clinical Sciences, Pediatrics, Lund University, Lund BMC I12, 221 84, Sweden
| | - Roald A Lambrechts
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands; Department of Neurology, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands
| | - Marina A J Tijssen
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands; Department of Neurology, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands
| | - Ody C M Sibon
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands; Department of Biomedical Sciences (BMS), University Medical Center Groningen, University of Groningen, 30.001 FB32, Groningen 9700 AD, the Netherlands
| | - Jenke A Gorter
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, University of Groningen, 30.001 AB51, Groningen 9700 RB, the Netherlands; Department of Biomedical Sciences (BMS), University Medical Center Groningen, University of Groningen, 30.001 FB32, Groningen 9700 AD, the Netherlands
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Li B, Ma Y, Wang X, Zhao D, Wang Z, Wang G, Li C, Yang L, Ji H, Liu K, Chen Q, Yang Y, Ma W, Du J, Ma L, Zhang L, Qiang Y. Ketogenic Diets Alter the Gut Microbiome, Resulting in Decreased Susceptibility to and Cognitive Impairment in Rats with Pilocarpine-Induced Status Epilepticus. Neurochem Res 2024:10.1007/s11064-024-04168-y. [PMID: 38935224 DOI: 10.1007/s11064-024-04168-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/13/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024]
Abstract
A ketogenic diet (KD) is a high-fat, low-carbohydrate, and low-protein diet that exerts antiepileptic effects by attenuating spontaneous recurrent seizures, ameliorating learning and memory impairments, and modulating the gut microbiota composition. However, the role of the gut microbiome in the antiepileptic effects of a KD on temporal lobe epilepsy (TLE) induced by lithium-pilocarpine in adult rats is still unknown. Our study provides evidence demonstrating that a KD effectively mitigates seizure behavior and reduces acute-phase epileptic brain activity and that KD treatment alleviates hippocampal neuronal damage and improves cognitive impairment induced by TLE. We also observed that the beneficial effects of a KD are compromised when the gut microbiota is disrupted through antibiotic administration. Analysis of gut microbiota components via 16S rRNA gene sequencing in fecal samples collected from TLE rats fed either a KD or a normal diet. The Chao1 and ACE indices showed decreased species variety in KD-fed rats compared to TLE rats fed a normal diet. A KD increased the levels of Actinobacteriota, Verrucomicrobiota and Proteobacteria and decreased the level of Bacteroidetes. Interestingly, the abundances of Actinobacteriota and Verrucomicrobiota were positively correlated with learning and memory ability, and the abundance of Proteobacteria was positively correlated with seizure susceptibility. In conclusion, our study revealed the significant antiepileptic and neuroprotective effects of a KD on pilocarpine-induced epilepsy in rats, primarily mediated through the modulation of the gut microbiota. However, whether the gut microbiota mediates the antiseizure effects of a KD still needs to be better elucidated.
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Affiliation(s)
- Bianli Li
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, 750001, Ningxia, China
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Yue Ma
- Shenzhen MicroBT Technology Co., LTD, Yuehai Street, Nanshan District, Shenzhen, 518000, Guangdong, China
| | - Xuhui Wang
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Di Zhao
- Department of Respiratory Medicine, People's Hospital of Ningxia Hui Autonomous Region, 301 Zhengyuan North Road, Yinchuan, 750001, Ningxia, China
| | - Ziqin Wang
- Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, 410008, Hunan, China
| | - Guoyang Wang
- Third Clinical School of Medicine, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Chunyi Li
- Basic Medical School, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Lin Yang
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Hui Ji
- Third Clinical School of Medicine, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Kunmei Liu
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Qiuyuan Chen
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Yong Yang
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Wenqian Ma
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China
| | - Jianbin Du
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, 750001, Ningxia, China
| | - Lei Ma
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, 750001, Ningxia, China.
| | - Lianxiang Zhang
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China.
| | - Yuanyuan Qiang
- Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750001, Ningxia, China.
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3
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Karandienė J, Endzinienė M, Liaušienė K, Jurkevičienė G. The Assessment of the Efficacy, Safety, and Challenges of Ketogenic Diet Therapy in Children with Epilepsy: The First Experience of a Single Center. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:919. [PMID: 38929536 PMCID: PMC11205304 DOI: 10.3390/medicina60060919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Ketogenic diet therapy (KDT) has been used as a non-pharmacological treatment for childhood refractory epilepsy. Its efficacy and safety have been described in numerous studies and reviews. However, there have been fewer studies evaluating the challenges experienced by patients and their family members when starting KDT. When implementing a new treatment method, challenges arise for both the healthcare professionals and patients, making it important to summarize the initial results and compare them with the experiences of other centers. To analyze and evaluate the efficacy and safety of KDT in children with epilepsy, as well as to consider the challenges faced by their parents/caregivers. Materials and Methods: A retrospective analysis of patients' data (N = 30) and an analysis of the completed questionnaires of the parents/caregivers (N = 22) occurred. Results: In the study group, 66.7% of the patients had a >50% decrease in seizure frequency, and 2/3 of them had a >90% decrease in seizure frequency or were seizure-free, which enabled reducing the anti-seizure medications in 36.4% of the patients, as well as reducing the hospital visits. Cognitive improvement and better alertness were subjectively reported by 59.1% of the parents/caregivers. No dangerous long-term adverse effects of KDT have been observed in the study group. The patients with generalized epilepsy experienced significantly more adverse events. Most of the adverse effects of KDT were related to the digestive system, but usually they were temporary and controllable. The challenges of the parents/caregivers were mostly related to social life issues and financial difficulties; the medical-related challenges were minimal. Conclusions: KDT is an effective and safe treatment option for children with drug-resistant epilepsy, and the challenges faced by families are resolvable. In order to ensure effective KDT, a multidisciplinary team is required. This would ensure smooth and comprehensive care and the timely resolution of emerging problems. The cooperation of the families undergoing KDT is also important, enabling them to share their experiences.
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Affiliation(s)
- Jurgita Karandienė
- Neurology Department, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, 50161 Kaunas, Lithuania;
| | - Milda Endzinienė
- Neurology Department, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, 50161 Kaunas, Lithuania;
- Neurology Department, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania;
| | | | - Giedrė Jurkevičienė
- Neurology Department, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania;
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4
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Lin M, Gong J, Wu L, Lin X, Zhang Y, Lin W, Huang H, Zhu C. ADCY3: the pivotal gene in classical ketogenic diet for the treatment of epilepsy. Front Cell Neurosci 2024; 18:1305867. [PMID: 38841200 PMCID: PMC11150708 DOI: 10.3389/fncel.2024.1305867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/15/2024] [Indexed: 06/07/2024] Open
Abstract
Objective Epilepsy is a common neurological disorder characterized by recurrent epilepsy episodes. As a non-pharmacological treatment, the ketogenic diet has been widely applied in treating epilepsy. However, the exact therapeutic mechanism of the ketogenic diet for epilepsy remains unclear. This study investigates the molecular mechanisms of the ketogenic diet in regulating fatty acid metabolism and activating the ADCY3-initiated cAMP signaling pathway to enhance neuronal inhibition and thereby treat epilepsy. Methods and results Meta-analysis reveals that the ketogenic diet is superior to the conventional diet in treating epilepsy. Animal experiments demonstrate that the ketogenic diet is more effective than the conventional diet in treating epilepsy, with the best results achieved using the classic ketogenic diet. Transcriptome sequencing analysis identifies six essential genes, among which ADCY3 shows increased expression in the ketogenic diet. In vivo experiments confirm that the activation of the cAMP-PKA signaling pathway by ADCY3 enhances neuronal inhibition and improves epilepsy control. Conclusion Clinical observations indicate that the ketogenic diet improves patient epilepsy episodes by regulating the ADCY3-initiated cAMP signaling pathway.
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Affiliation(s)
- Mingxing Lin
- Department of Pediatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jiayin Gong
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Luyan Wu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xin Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yuying Zhang
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wanhui Lin
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huapin Huang
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fuzhou, China
- Department of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
| | - Chaofeng Zhu
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
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Liu Y, Fan L, Yang H, Wang D, Liu R, Shan T, Xia X. Ketogenic therapy towards precision medicine for brain diseases. Front Nutr 2024; 11:1266690. [PMID: 38450235 PMCID: PMC10915067 DOI: 10.3389/fnut.2024.1266690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024] Open
Abstract
Precision nutrition and nutrigenomics are emerging in the development of therapies for multiple diseases. The ketogenic diet (KD) is the most widely used clinical diet, providing high fat, low carbohydrate, and adequate protein. KD produces ketones and alters the metabolism of patients. Growing evidence suggests that KD has therapeutic effects in a wide range of neuronal diseases including epilepsy, neurodegeneration, cancer, and metabolic disorders. Although KD is considered to be a low-side-effect diet treatment, its therapeutic mechanism has not yet been fully elucidated. Also, its induced keto-response among different populations has not been elucidated. Understanding the ketone metabolism in health and disease is critical for the development of KD-associated therapeutics and synergistic therapy under any physiological background. Here, we review the current advances and known heterogeneity of the KD response and discuss the prospects for KD therapy from a precision nutrition perspective.
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Affiliation(s)
- Yang Liu
- Translational Medicine Center, Huaihe Hospital of Henan University, Henan University, Kaifeng, China
- Henan Key Laboratory of Brain Targeted Bio-nanomedicine, School of Life Sciences, Henan University, Kaifeng, China
| | - Linlin Fan
- Henan Key Laboratory of Brain Targeted Bio-nanomedicine, School of Life Sciences, Henan University, Kaifeng, China
| | - Haoying Yang
- Henan Key Laboratory of Brain Targeted Bio-nanomedicine, School of Life Sciences, Henan University, Kaifeng, China
| | - Danli Wang
- Zhoushan People’s Hospital, Zhoushan, China
| | - Runhan Liu
- Henan Key Laboratory of Brain Targeted Bio-nanomedicine, School of Life Sciences, Henan University, Kaifeng, China
| | - Tikun Shan
- Neurosurgery Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Xue Xia
- Henan Key Laboratory of Brain Targeted Bio-nanomedicine, School of Life Sciences, Henan University, Kaifeng, China
- School of Environmental and Life Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, NSW, Australia
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Rugiel M, Setkowicz-Janeczko Z, Kosiek W, Rauk Z, Kawon K, Chwiej J. Does Ketogenic Diet Used in Pregnancy Affect the Nervous System Development in Offspring?─FTIR Microspectroscopy Study. ACS Chem Neurosci 2023; 14:2775-2791. [PMID: 37471579 PMCID: PMC10401638 DOI: 10.1021/acschemneuro.3c00331] [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: 05/18/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
Anti-seizure medications used during pregnancy may have transient or long-lasting impact on the nervous system of the offspring. Therefore, there is a great need to search for alternative therapies for pregnant women suffering from seizures. One of the solutions may be the use of the ketogenic diet (KD), which has been successfully applied as a treatment of drug-resistant epilepsy in children and adults. However, the risks associated with the use of this dietary therapy during pregnancy are unknown and more investigation in this area is needed. To shed some light on this problem, we attempted to determine the potential abnormalities in brain biomolecular composition that may occur in the offspring after the prenatal exposure to KD. To achieve this, the female Wistar rats were, during pregnancy, fed with either ketogenic or standard laboratory diet, and for further studies, their male offspring at 2, 6, or 14 days of age were used. Fourier transform infrared microspectroscopy was applied for topographic and quantitative analysis of main biological macromolecules (proteins, lipids, compounds containing phosphate and carbonyl groups, and cholesterol) in brain samples. Performed chemical mapping and further semi-quantitative and statistical analysis showed that the use of the KD during pregnancy, in general, does not lead to the brain biochemical anomalies in 2 and 6 days old rats. The exception from this rule was increased relative (comparing to proteins) content of compounds containing phosphate groups in white matter and cortex of 2 days old rats exposed prenatally to KD. Greater number of abnormalities was found in brains of the 14 days old offspring of KD-fed mothers. They included the increase of the relative level of compounds containing carbonyl groups (in cortex as well as multiform and molecular cells of the hippocampal formation) as well as the decrease of the relative content of lipids and their structural changes (in white matter). What is more, the surface of the internal capsule (structure of the white matter) determined for this age group was smaller in animals subjected to prenatal KD exposure. The observed changes seem to arise from the elevated exposition to ketone bodies during a fetus life and the disturbance of lipid metabolism after prenatal exposure to the KD. These changes may be also associated with the processes of compensation of mother organism, which slowly began to make up for the deficiencies in carbohydrates postpartum.
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Affiliation(s)
- Marzena Rugiel
- Faculty
of Physics and Applied Computer Science, AGH University of Krakow, Krakow 30-059, Poland
| | | | - Wojciech Kosiek
- Institute
of Zoology and Biomedical Research, Jagiellonian
University, Krakow 31-007, Poland
| | - Zuzanna Rauk
- Institute
of Zoology and Biomedical Research, Jagiellonian
University, Krakow 31-007, Poland
| | - Kamil Kawon
- Faculty
of Physics and Applied Computer Science, AGH University of Krakow, Krakow 30-059, Poland
| | - Joanna Chwiej
- Faculty
of Physics and Applied Computer Science, AGH University of Krakow, Krakow 30-059, Poland
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Assanga SBI, Luján LML, McCarty MF, Di Nicolantonio JJ. Nutraceutical and Dietary Resources for Breast Cancer Prevention – Highlighting Strategies for Suppressing Breast Aromatase Expression. PHARMANUTRITION 2022. [DOI: 10.1016/j.phanu.2022.100327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Tong X, Cai Q, Cao D, Yu L, Sun D, Yang G, Wang J, Li H, Li Z, Wang J, Huang S, Ding M, Fang F, Wang Q, Luo R, Liao J, Qin J. Chinese expert recommendations on ketogenic diet therapy for super-refractory status epilepticus. ACTA EPILEPTOLOGICA 2022. [DOI: 10.1186/s42494-021-00078-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractSuper-refractory status epilepticus (SRSE) is a serious and life-threatening neurological condition. Ketogenic diet (KD) is a diet characterized by high fat, low carbohydrate, and moderate protein. As KD shows effectiveness in controlling seizures in more than half of SRSE patients, it can be a treatment option for SRSE. Currently, KD treatment for SRSE is based on personal experience and observational evidence has been published. In the context of a lack of a validated guideline, we convened a multicenter expert panel within the China Association Against Epilepsy (CAAE) Ketogenic Diet Commission to work out the Chinese expert recommendations on KD for SRSE. We summarize and discuss the latest clinical practice of KD for SRSE in critical care settings. Recommendations are given on patient selection, the timing of KD, diet implementation, and follow-up. More research data are needed in this area to support better clinical practice.
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Punicalagin and Ketogenic Amino Acids Loaded Organic Lipid Carriers Enhance the Bioavailability, Mitochondrial β-Oxidation, and Ketogenesis in Maturing Adipocytes. NANOMATERIALS 2022; 12:nano12030368. [PMID: 35159714 PMCID: PMC8839784 DOI: 10.3390/nano12030368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/21/2021] [Accepted: 01/04/2022] [Indexed: 01/30/2023]
Abstract
The identification of lipolytic bioactive compounds via the functional stimulation of carbohydrate response element-binding protein-1 (CREBp-1) and AMP-activated protein kinase (AMPK) is most warranted. Nano lipid carriers (NLCs) are currently being considered within drug delivery development as they facilitate controlled drug release and have intracellular bioavailability after encapsulating the active principles with lipid matrix. The present study has been designed to synthesize punicalagin, and ketogenic amino acids (KAA) loaded with organic lipid carriers to optimize the liposome-assisted intracellular delivery’s bioavailability. Punicalagin (PUNI) and KAA (tryptophan, methionine, threonine, lysine, and leucine) were encapsulated with chia seed phospholipids by homogenization, emulsification, and cold ultra-sonication method to obtain nano lipid carriers (NLC). The physicochemical characterization of NLCs has been carried out using Zetasizer, FT-IR, and TEM analysis. Punicalagin and ketogenic amino acid-loaded NLCs (NLC-PUNI-KAA) were identified with an average diameter of 240 to 800 nm. The biosafety of NLC-PUNI-KAA has been evaluated in human mesenchymal stem cells. PI staining confirmed that a 0.4, 0.8 or 1.6μg/dL dose of NLC-PUNI-KAA potentially maintains nuclear integration. NLC-PUNI-KAA treated with maturing adipocytes decreased lipid accumulation and significantly increased the gene expression levels of fatty acid beta-oxidation (PPARγC1α, UCP-1 and PRDM-16) pathways when compared to free PUNI (5 μg/dL) treatment. The lipolytic potential has been confirmed by the functional activation of AMPK and CREBp-1 protein levels. In conclusion, NLC-PUNI-KAA treatment effectively increased mitochondrial efficiency more than free punicalagin or orlistat treated maturing adipocyte. Enhanced lipolysis and decreased hypertrophic adipocyte resulted in decreased adipokine secretion, which has been associated with the suppression of obesity-associated comorbidities and vascular cell inflammation. The bioefficacy and lipolytic potential of water-soluble punicalagin have been improved after functional modification into NLCs.
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García-Rodríguez D, Giménez-Cassina A. Ketone Bodies in the Brain Beyond Fuel Metabolism: From Excitability to Gene Expression and Cell Signaling. Front Mol Neurosci 2021; 14:732120. [PMID: 34512261 PMCID: PMC8429829 DOI: 10.3389/fnmol.2021.732120] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022] Open
Abstract
Ketone bodies are metabolites that replace glucose as the main fuel of the brain in situations of glucose scarcity, including prolonged fasting, extenuating exercise, or pathological conditions such as diabetes. Beyond their role as an alternative fuel for the brain, the impact of ketone bodies on neuronal physiology has been highlighted by the use of the so-called “ketogenic diets,” which were proposed about a century ago to treat infantile seizures. These diets mimic fasting by reducing drastically the intake of carbohydrates and proteins and replacing them with fat, thus promoting ketogenesis. The fact that ketogenic diets have such a profound effect on epileptic seizures points to complex biological effects of ketone bodies in addition to their role as a source of ATP. In this review, we specifically focus on the ability of ketone bodies to regulate neuronal excitability and their effects on gene expression to respond to oxidative stress. Finally, we also discuss their capacity as signaling molecules in brain cells.
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Affiliation(s)
- Darío García-Rodríguez
- Department of Molecular Biology, Centro de Biología Molecular "Severo Ochoa" (CBMSO UAM-CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - Alfredo Giménez-Cassina
- Department of Molecular Biology, Centro de Biología Molecular "Severo Ochoa" (CBMSO UAM-CSIC), Universidad Autónoma de Madrid, Madrid, Spain
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Ameli PA, Ammar AA, Owusu KA, Maciel CB. Evaluation and Management of Seizures and Status Epilepticus. Neurol Clin 2021; 39:513-544. [PMID: 33896531 DOI: 10.1016/j.ncl.2021.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Seizures are frequently triggered by an inciting event and result from uninhibited excitation and/or decreased inhibition of a pool of neurons. If physiologic seizure abortive mechanisms fail, the ensuing unrestrained synchronization of neurons-status epilepticus-can be life-threatening and is associated with the potential for marked morbidity in survivors and high medical care costs. Prognosis is intimately related to etiology and its response to therapeutic measures. Timely implementation of pharmacologic therapy while concurrently performing a stepwise workup for etiology are paramount. Neurodiagnostic testing should guide titration of pharmacologic therapies, and help determine if there is a role for immune modulation.
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Affiliation(s)
- Pouya Alexander Ameli
- Department of Neurology, University of Florida McKnight Brain Institute, 1149 Newell Drive, Gainesville, FL 32610, USA; Department of Neurosurgery, University of Florida McKnight Brain Institute, 1149 Newell Drive, Gainesville, FL 32610, USA
| | - Abdalla A Ammar
- Department of Pharmacy, Yale New Haven Health, 55 Park Street, New Haven, CT 06511, USA
| | - Kent A Owusu
- Department of Pharmacy, Yale New Haven Health, 55 Park Street, New Haven, CT 06511, USA; Care Signature, Yale New Haven Health, 20 York Street, New Haven, CT, 06510, USA
| | - Carolina B Maciel
- Department of Neurology, University of Florida McKnight Brain Institute, 1149 Newell Drive, Gainesville, FL 32610, USA; Department of Neurosurgery, University of Florida McKnight Brain Institute, 1149 Newell Drive, Gainesville, FL 32610, USA; Department of Neurology, Yale University, 20 York Street, New Haven, CT, 06510, USA; Department of Neurology, University of Utah, 383 Colorow Drive, Salt Lake City, UT, 84132, USA.
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