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Löscher W, Howe CL. Molecular Mechanisms in the Genesis of Seizures and Epilepsy Associated With Viral Infection. Front Mol Neurosci 2022; 15:870868. [PMID: 35615063 PMCID: PMC9125338 DOI: 10.3389/fnmol.2022.870868] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/05/2022] [Indexed: 12/16/2022] Open
Abstract
Seizures are a common presenting symptom during viral infections of the central nervous system (CNS) and can occur during the initial phase of infection ("early" or acute symptomatic seizures), after recovery ("late" or spontaneous seizures, indicating the development of acquired epilepsy), or both. The development of acute and delayed seizures may have shared as well as unique pathogenic mechanisms and prognostic implications. Based on an extensive review of the literature, we present an overview of viruses that are associated with early and late seizures in humans. We then describe potential pathophysiologic mechanisms underlying ictogenesis and epileptogenesis, including routes of neuroinvasion, viral control and clearance, systemic inflammation, alterations of the blood-brain barrier, neuroinflammation, and inflammation-induced molecular reorganization of synapses and neural circuits. We provide clinical and animal model findings to highlight commonalities and differences in these processes across various neurotropic or neuropathogenic viruses, including herpesviruses, SARS-CoV-2, flaviviruses, and picornaviruses. In addition, we extensively review the literature regarding Theiler's murine encephalomyelitis virus (TMEV). This picornavirus, although not pathogenic for humans, is possibly the best-characterized model for understanding the molecular mechanisms that drive seizures, epilepsy, and hippocampal damage during viral infection. An enhanced understanding of these mechanisms derived from the TMEV model may lead to novel therapeutic interventions that interfere with ictogenesis and epileptogenesis, even within non-infectious contexts.
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Affiliation(s)
- Wolfgang Löscher
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany,Center for Systems Neuroscience, Hannover, Germany,*Correspondence: Wolfgang Löscher,
| | - Charles L. Howe
- Division of Experimental Neurology, Department of Neurology, Mayo Clinic, Rochester, MN, United States,Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, United States
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Ahmed S, Pande AH, Sharma SS. Therapeutic potential of ApoE-mimetic peptides in CNS disorders: Current perspective. Exp Neurol 2022; 353:114051. [DOI: 10.1016/j.expneurol.2022.114051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/23/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023]
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Multi-omics in mesial temporal lobe epilepsy with hippocampal sclerosis: Clues into the underlying mechanisms leading to disease. Seizure 2021; 90:34-50. [DOI: 10.1016/j.seizure.2021.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
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Xu T, Zhang H, Qiu X, Meng Y. Genetic influence of Apolipoprotein E gene ε2/ε3/ε4 isoforms on odds of mesial temporal lobe epilepsy. Afr Health Sci 2021; 21:866-874. [PMID: 34795746 PMCID: PMC8568259 DOI: 10.4314/ahs.v21i2.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The potential correlation between the ε2/ε3/ε4 variants of the ApoE (Apolipoprotein E) gene and the odds of mesial temporal lobe epilepsy was investigated. METHODS The database searching for eligible studies was performed in October 2020. A series of pooling analyses were conducted. RESULTS We enrolled a total of twelve case-control studies for pooling. Within the pooling analysis of ε4, there was an increased risk of mesial temporal lobe epilepsy in cases under the models of carrier ε4 vs. ε3, ε3ε4 vs. ε3ε3, and ε3ε4+ε4ε4 vs. ε3ε3 [P < 0.05, odds ratio (OR) > 1], compared with controls. Moreover, we observed similar positive results in the subgroup analyses of "China" and "Population-based control" under the genetic models of ε4 (P < 0.05, OR > 1). Nevertheless, we did not detect the significant difference between the mesial temporal lobe epilepsy cases and controls in the pooling analyses of ε2 (all P > 0.05). CONCLUSION The ε3ε4 genotype of ApoE seems to be linked to the risk of mesial temporal lobe epilepsy for patients in China. More sample sizes are required to confirm the potential role of ApoE isoforms in the susceptibility to diverse types of epilepsy from different origins.
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Chaves J, Martins-Ferreira R, Carvalho C, Bettencourt A, Brás S, Chorão R, Freitas J, Samões R, Lopes J, Ramalheira J, Silva BM, Pinho e Costa P, da Silva AM, Leal B. Apolipoprotein E isoforms and susceptibility to genetic generalized epilepsies. Int J Neurosci 2020; 130:892-897. [DOI: 10.1080/00207454.2019.1709840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- João Chaves
- Unidade Multidisciplinar de Investigação Biomédica, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS-UP), Porto, Portugal
- Serviço de Neurologia, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - Ricardo Martins-Ferreira
- Unidade Multidisciplinar de Investigação Biomédica, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS-UP), Porto, Portugal
- Laboratório Imunogenética - Departamento de Patologia e Imunologia Molecular, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal
| | - Cláudia Carvalho
- Unidade Multidisciplinar de Investigação Biomédica, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS-UP), Porto, Portugal
- Laboratório Imunogenética - Departamento de Patologia e Imunologia Molecular, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal
| | - Andreia Bettencourt
- Unidade Multidisciplinar de Investigação Biomédica, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS-UP), Porto, Portugal
- Laboratório Imunogenética - Departamento de Patologia e Imunologia Molecular, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal
| | - Sandra Brás
- Laboratório Imunogenética - Departamento de Patologia e Imunologia Molecular, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal
| | - Rui Chorão
- Serviço de Neurologia, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - Joel Freitas
- Serviço de Neurologia, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - Raquel Samões
- Serviço de Neurologia, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - João Lopes
- Serviço de Neurofisiologia, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - João Ramalheira
- Serviço de Neurofisiologia, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - Berta M. Silva
- Unidade Multidisciplinar de Investigação Biomédica, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS-UP), Porto, Portugal
- Laboratório Imunogenética - Departamento de Patologia e Imunologia Molecular, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal
| | - Paulo Pinho e Costa
- Unidade Multidisciplinar de Investigação Biomédica, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS-UP), Porto, Portugal
- Departamento de Genética, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
| | - António Martins da Silva
- Unidade Multidisciplinar de Investigação Biomédica, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS-UP), Porto, Portugal
- Serviço de Neurofisiologia, Hospital de Santo António - Centro Hospitalar do Porto, Porto, Portugal
| | - Bárbara Leal
- Unidade Multidisciplinar de Investigação Biomédica, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (UMIB/ICBAS-UP), Porto, Portugal
- Laboratório Imunogenética - Departamento de Patologia e Imunologia Molecular, Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto (ICBAS/UP), Porto, Portugal
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Liang Y, Zhou Z, Wang H, Cheng X, Zhong S, Zhao C. Association of apolipoprotein E genotypes with epilepsy risk: A systematic review and meta-analysis. Epilepsy Behav 2019; 98:27-35. [PMID: 31299529 DOI: 10.1016/j.yebeh.2019.06.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/12/2019] [Accepted: 06/12/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The objective of this study was to identify the association between certain genotypes or alleles of the APOE (Apolipoprotein E) gene and the epilepsy risk. METHODS All studies on human APOE genotypes associated with epilepsy were included. Separate meta-analyses were conducted between the patients with epilepsy and the control group from the following three aspects: ε4 carriers or ε2 carriers vs ε3/ε3 (the ε2/ε4 genotype was excluded), ε4 carriers vs ε2 carriers, and five genotypes vs ε3/ε3. The subgroup analysis was conducted on the ethnicity, the control group was healthy or not, and type of epilepsy. RESULTS Nine studies with 2210 individuals were included. Compared with ε3/ε3 genotype, ε4 carriers increased the epilepsy risk (odds ratios [ORs]: 1.27; 95% confidence intervals [CI]: 1.01 to 1.59; P = 0.042), while ε2 carriers had no association with epilepsy risk (OR: 0.88; 95% CI: 0.66 to 1.18; P = 0.184). The risk of epilepsy was 1.45 times greater in ε4 carriers compared with ε2 carriers (OR: 1.45; 95% CI: 1.02 to 2.04; P = 0.037). When the number of APOE ε4 allele increased, the ORs increased progressively (no ε4 alleles, OR: 0.88, 95% CI: 0.66 to 1.18; one ε4 allele, OR: 1.25, 95% CI: 0.99 to 1.57; two ε4 alleles, OR: 1.84, 95% CI: 0.83 to 4.10). Apolipoprotein E ε4 carriers had a higher epilepsy risk in the population without primary diseases (OR: 1.43; 95% CI: 1.09 to 1.88), and a higher risk in Asian populations (OR: 1.67; 95% CI: 1.12 to 2.49). CONCLUSIONS Apolipoprotein E ε4 allele genotype was associated with an increased epilepsy risk, which was more prominent in the Asian and the population without primary diseases. These findings may be used to guide the directions of prevention and treatment on epilepsy. Larger clinical studies are needed.
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Affiliation(s)
- Yifan Liang
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Zhike Zhou
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang, China
| | - Huibin Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xi Cheng
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Shanshan Zhong
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Chuansheng Zhao
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China.
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Najm R, Jones EA, Huang Y. Apolipoprotein E4, inhibitory network dysfunction, and Alzheimer's disease. Mol Neurodegener 2019; 14:24. [PMID: 31186040 PMCID: PMC6558779 DOI: 10.1186/s13024-019-0324-6] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 05/23/2019] [Indexed: 02/08/2023] Open
Abstract
Apolipoprotein (apo) E4 is the major genetic risk factor for Alzheimer's disease (AD), increasing risk and decreasing age of disease onset. Many studies have demonstrated the detrimental effects of apoE4 in varying cellular contexts. However, the underlying mechanisms explaining how apoE4 leads to cognitive decline are not fully understood. Recently, the combination of human induced pluripotent stem cell (hiPSC) modeling of neurological diseases in vitro and electrophysiological studies in vivo have begun to unravel the intersection between apoE4, neuronal subtype dysfunction or loss, subsequent network deficits, and eventual cognitive decline. In this review, we provide an overview of the literature describing apoE4's detrimental effects in the central nervous system (CNS), specifically focusing on its contribution to neuronal subtype dysfunction or loss. We focus on γ-aminobutyric acid (GABA)-expressing interneurons in the hippocampus, which are selectively vulnerable to apoE4-mediated neurotoxicity. Additionally, we discuss the importance of the GABAergic inhibitory network to proper cognitive function and how dysfunction of this network manifests in AD. Finally, we examine how apoE4-mediated GABAergic interneuron loss can lead to inhibitory network deficits and how this deficit results in cognitive decline. We propose the following working model: Aging and/or stress induces neuronal expression of apoE. GABAergic interneurons are selectively vulnerable to intracellularly produced apoE4, through a tau dependent mechanism, which leads to their dysfunction and eventual death. In turn, GABAergic interneuron loss causes hyperexcitability and dysregulation of neural networks in the hippocampus and cortex. This dysfunction results in learning, memory, and other cognitive deficits that are the central features of AD.
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Affiliation(s)
- Ramsey Najm
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA
- Developmental and Stem Cell Biology Graduate Program, University of California, San Francisco, CA, 94143, USA
| | - Emily A Jones
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA
- Biomedical Sciences Graduate Program, University of California, San Francisco, CA, 94143, USA
| | - Yadong Huang
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA.
- Developmental and Stem Cell Biology Graduate Program, University of California, San Francisco, CA, 94143, USA.
- Biomedical Sciences Graduate Program, University of California, San Francisco, CA, 94143, USA.
- Department of Neurology, University of California, San Francisco, CA, 94143, USA.
- Department of Pathology, University of California, San Francisco, CA, 94143, USA.
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Role of t-PA and PAI-1 variants in temporal lobe epilepsy in Chinese Han population. BMC Neurol 2019; 19:13. [PMID: 30669988 PMCID: PMC6343363 DOI: 10.1186/s12883-019-1239-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 01/07/2019] [Indexed: 02/08/2023] Open
Abstract
Background Epilepsy is one of the most common chronic disabling neurologic diseases. The purpose of our study was to investigate whether there is an association between t-PA (tissue plasminogen activator, rs2020918 and rs4646972), PAI-1 (plasminogen activator inhibitor 1, rs1799768) polymorphisms and susceptibility to temporal lobe epilepsy (TLE) in Chinese Han population. Method One hundred and twenty-one cases of patients who were diagnosed as TLE and 146 normal controls were enrolled and the genotypes of t-PA and PAI-1 were detected by polymerase chain reaction-ligase detection reaction (PCR-LDR) method after the genomic DNA being extracted from peripheral blood. Result There were significant differences for the genotypic frequencies at the two polymorphic sites in t-PA gene between TLE patients and controls (P = 0.019; P = 0.001). Furthermore, the frequency of rs2020918 (C > T) with T (CT + TT) and rs4646972 (311 bp insertion/−) with 311 bp deletion (311 bp/− + −/−) was significantly higher among TLE patients relative to controls respectively (P = 0.006; P = 0.001). However, no significant difference in genotypic and allelic frequency was found at the polymorphic site in PAI-1 gene between TLE patients and controls (P = 0.735). Conclusion We reported for the first time to our knowledge the significant role of the two SNPs in t-PA gene (rs2020918 and rs4646972) in developing susceptibility to TLE in Chinese Han population.
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Itzhaki RF. Corroboration of a Major Role for Herpes Simplex Virus Type 1 in Alzheimer's Disease. Front Aging Neurosci 2018; 10:324. [PMID: 30405395 PMCID: PMC6202583 DOI: 10.3389/fnagi.2018.00324] [Citation(s) in RCA: 143] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 09/25/2018] [Indexed: 01/10/2023] Open
Abstract
Strong evidence has emerged recently for the concept that herpes simplex virus type 1 (HSV1) is a major risk for Alzheimer’s disease (AD). This concept proposes that latent HSV1 in brain of carriers of the type 4 allele of the apolipoprotein E gene (APOE-ε4) is reactivated intermittently by events such as immunosuppression, peripheral infection, and inflammation, the consequent damage accumulating, and culminating eventually in the development of AD. Population data to investigate this epidemiologically, e.g., to find if subjects treated with antivirals might be protected from developing dementia—are available in Taiwan, from the National Health Insurance Research Database, in which 99.9% of the population has been enrolled. This is being extensively mined for information on microbial infections and disease. Three publications have now appeared describing data on the development of senile dementia (SD), and the treatment of those with marked overt signs of disease caused by varicella zoster virus (VZV), or by HSV. The striking results show that the risk of SD is much greater in those who are HSV-seropositive than in seronegative subjects, and that antiviral treatment causes a dramatic decrease in number of subjects who later develop SD. It should be stressed that these results apply only to those with severe cases of HSV1 or VZV infection, but when considered with the over 150 publications that strongly support an HSV1 role in AD, they greatly justify usage of antiherpes antivirals to treat AD. Three other studies are described which directly relate to HSV1 and AD: they deal respectively with lysosomal changes in HSV1-infected cell cultures, with evidence for a role of human herpes virus type 6 and 7 (HHV6 and HHV7) in AD, and viral effects on host gene expression, and with the antiviral characteristics of beta amyloid (Aβ). Three indirectly relevant studies deal respectively with schizophrenia, relating to antiviral treatment to target HSV1, with the likelihood that HSV1 is a cause of fibromyalgia (FM), and with FM being associated with later development of SD. Studies on the link between epilepsy, AD and herpes simplex encephalitis (HSE) are described also, as are the possible roles of APOE-ε4, HHV6 and HSV1 in epilepsy.
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Affiliation(s)
- Ruth F Itzhaki
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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Sociodemographic risk factors for febrile seizures: A school-based study from Izmir, Turkey. Seizure 2018; 61:45-49. [PMID: 30081300 DOI: 10.1016/j.seizure.2018.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/23/2018] [Accepted: 07/25/2018] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Despite the fact that socioeconomic and environmental factors of a population are changing over time, there are few studies focusing on the effects of sociodemographic factors on the prevalence of febrile seizures (FS). This study was designed to find out the prevalence of FS and to investigate the effect of socio-cultural and economic factors on this prevalence among the Turkish school children. METHODS A school-based, cross-sectional study was conducted in first and second-class children. Data were collected through a questionnaire from the parents who agreed to be involved in the study. The survey had questions about some socioeconomic and demographic features of the children and febrile seizure episodes. RESULTS 3806 children and parent pairs accepted to participate in the survey. Febrile seizure prevalence was 4.8%. It was found that the prevalence of FS was significantly associated with the chronic illnesses of a child that requires continuous medication, developmental delay of a child, NICU history, gestational hypertension history of a mother, and lower educational level of a mother. Recurrence of FS was observed in 32.9% of children. Children whose first FS was seen below the 39 °C had 1.9 times more recurrence risk. CONCLUSION FS prevalence rate has declined from 9.7% to 4.3% in our study population within ten years. It was thought that advancing healthcare systems in our country might be decreased the prevalence. Our study enabled us to find out sociodemographic risk factors of FS, but further studies are needed in order to confirm the effect of sociodemographic factors on FS prevalence.
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