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Luo Y, Shen G, Wang G, Lou C, Cao J, Zhu X, Zhang X, Liu Z, Fang M. Upregulations of High mobility group box 1 and TLR4/NF-κB signaling pathway in hippocampus and serum of rats with febrile seizure. Int J Neurosci 2023:1-9. [PMID: 37128910 DOI: 10.1080/00207454.2023.2208278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE The aim of this study was to explore the alternations regarding the HMGB1 and TLR4/NF-κB signaling pathway in juvenile rats with febrile seizure (FS). MATERIALS AND METHODS During the animal modeling of the FS, seizures were triggered every four days by hot water (45 °C), and repeated ten times. After forty days' modeling, rats were divided into different groups according to the degree of seizure (FS (0) - FS (V)). Reverse transcription-polymerase chain reaction (RT-PCR) was used to evaluate the mRNA expressions of the HMGB1, TLR4 and NF-κB in the hippocampus, while Western-blot (WB) and immunofluorescence (IF) were employed to assess protein expressions. The enzyme-linked immunosorbent assay (ELISA) was used for analyzing the protein expressions in peripheral blood. RESULTS The mRNA levels of the HMGB1, TLR4 and NF-κB in the hippocampus of both FS (V) and FS (IV) groups were significantly higher than WT, while there was no difference between FS (III) and WT. Concerning protein expressions, increased levels of the HMGB1, TLR4, and NF-κB in FS (V) were observed with a good consistency between the WB and IF, while no significant upregulation was shown in FS (IV). The ELISA results showed that the significance of the augmented proteins between the FS (V) and WT were smaller in the serum than the hippocampus. CONCLUSIONS Our study shows seizure degree-related upregulations of HMGB1 and TLR4/NF-κB signaling pathway both in hippocampus and serum of juvenile rats with FS, suggesting the involvement of TLR/NF-κB pathway in inflammation promoted by HMGB1 during FS.
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Affiliation(s)
- Yuhuan Luo
- Department of Pediatrics, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Guanghong Shen
- The Affiliated People's Hospital of Hangzhou Medical College, Hangzhou Medical College, Hangzhou, China
| | - Guo Wang
- Department of Pediatrics, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chengjian Lou
- Department of Neurosurgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Jianqing Cao
- The Fourth School of Clinical Medicine, Graduate School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xuefen Zhu
- Neonatal Intensive Care Unit, Hangzhou First People's Hospital Qianjiang Xincheng, Hangzhou, China
| | - Xinjuan Zhang
- Department of Pediatrics, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhanli Liu
- Department of Pediatrics, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Neurology, Hangzhou Children's Hospital, Hangzhou, China
| | - Marong Fang
- Institute of Neuroscience, Zhejiang University School of Medicine, Hangzhou, China
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Liu B, Wang Y, He D, Han G, Wang H, Lin Y, Zhang T, Yi C, Li H. LTBP1 Gene Expression in the Cerebral Cortex and its Neuroprotective Mechanism in Mice with Postischemic Stroke Epilepsy. Curr Pharm Biotechnol 2023; 24:317-329. [PMID: 35676846 DOI: 10.2174/1389201023666220608091511] [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: 02/08/2022] [Revised: 03/08/2022] [Accepted: 03/30/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed at exploring the expression level of LTBP1 in the mouse model of epilepsy. The mechanism of LTBP1 in epileptic cerebral neural stem cells was deeply investigated to control the occurrence of epilepsy with neuroprotection. METHODS qRT-PCR was conducted for the expression levels of LTBP1 in clinical human epileptic tissues and neural stem cells, as well as normal cerebral tissues and neural stem cells. The mouse model of postischemic stroke epilepsy (PSE) was established by the middle cerebral artery occlusion (MCAO). Then, qRT-PCR was conducted again for the expression levels of LTBP1 in mouse epileptic tissues and neural stem cells as well as normal cerebral tissues and neural stem cells. The activation and inhibitory vectors of LTBP1 were constructed to detect the effects of LTBP1 on the proliferation of cerebral neural stem cells in the PSE model combined with CCK-8. Finally, Western blot was conducted for the specific mechanism of LTBP1 affecting the development of epileptic cells. RESULTS Racine score and epilepsy index of 15 mice showed epilepsy symptoms after the determination with MCAO, showing a successful establishment of the PSE model. LTBP1 expression in both diseased epileptic tissues and cells was higher than that in normal clinical epileptic tissues and cells. Meanwhile, qRT-PCR showed higher LTBP1 expression in both mouse epileptic tissues and their neural stem cells compared to that in normal tissues and cells. CCK-8 showed that the activation of LTBP1 stimulated the increased proliferative capacity of epileptic cells, while the inhibition of LTBP1 expression controlled the proliferation of epileptic cells. Western blot showed an elevated expression of TGFβ/SMAD signaling pathway-associated protein SMAD1/5/8 after activating LTBP1. The expression of molecular MMP-13 associated with the occurrence of inflammation was also activated. CONCLUSION LTBP1 can affect the changes in inflammation-related pathways by activating the TGFβ/SMAD signaling pathway and stimulate the development of epilepsy, and the inhibition of LTBP1 expression can control the occurrence of epilepsy with neuroprotection.
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Affiliation(s)
- Bo Liu
- Department of Neurology, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, 161000, China
| | - Yan Wang
- Department of Neurology, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, 161000, China
| | - Dongruo He
- Department of Neurophysiology, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, 161000, China
| | - Guochao Han
- Department of Neurophysiology, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, 161000, China
| | - Hao Wang
- Department of Neurophysiology, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, 161000, China
| | - Yuan Lin
- Department of Neurophysiology, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, 161000, China
| | - Tianyu Zhang
- Department of CT, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, 161000, China
| | - Chao Yi
- Department of Neurosurgery, Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, 161000, China
| | - Hui Li
- Department of Neurophysiology, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, 161000, China
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Li H, Yang Y, Hu M, Cao X, Ding C, Sun Q, Li R, Liu R, Xu X, Wang Y. The correlation of temporal changes of neutrophil-lymphocyte ratio with seizure severity and the following seizure tendency in patients with epilepsy. Front Neurol 2022; 13:964923. [PMID: 36341114 PMCID: PMC9630561 DOI: 10.3389/fneur.2022.964923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background Changes in the neutrophil-lymphocyte ratio (NLR) has been reported to be associated with epilepsy. Here we aim to investigate the correlation of temporal changes of NLR level with seizure severity and the follow-up seizure attacks in patients with epilepsy (PWE). Methods We performed a retrospective analysis of the laboratory data including leukocyte count and NLR within 24 h of acute seizure and during the follow-up period of 5–14 days after acute seizure (NLR1, NLR2, respectively) in 115 PWE, and 98 healthy individuals were included as controls in this study. The correlation of laboratory data with seizure types, etiology of epilepsy, anti-seizure drugs (ASDs), seizure severity, and the follow-up seizure attacks in PWE was studied. Results Leukocyte count (P < 0.001) and NLR level (P < 0.001) were found significantly different between PWE and controls. On the other hand, a multivariable logistic regression analysis showed that NLR1 level (OR = 2.992, P = 0.001) and admission leukocyte (OR = 2.307, P = 0.002) were both independently associated with acute epileptic seizures. Especially, higher NLR1 level was significantly associated with status epileptics (P = 0.013) and recurrent seizures after admission (P < 0.001). Furthermore, the multivariable logistic regression analysis indicated that higher NLR1 was a predictor for the tendency of the following recurrent seizure attacks (OR = 1.144, P = 0.002). NLR2 was inversely correlated with ASDs taken (P = 0.011). Levels of NLR1 (r = 0.441, P < 0.001) and NLR2 (r = 0.241, P = 0.009) were both positively correlated with seizure severity. Conclusions Seizures were correlated with the alterations of systemic inflammation reflected by leukocyte and NLR. NLR1 and admission leukocyte were both independently associated with acute epileptic seizures. Higher NLR1 was associated with status epilepticus and independently predicted the tendency of the following epileptic seizures. NLR2 was significantly associated with ASDs taken. Besides, NLR may be used as a biomarker for seizure severity.
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Affiliation(s)
- Hanli Li
- Department of Neurology, Epilepsy and Headache Group, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yujing Yang
- Department of Neurology, Epilepsy and Headache Group, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mingwei Hu
- Department of Neurology, Epilepsy and Headache Group, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoyan Cao
- Department of Neurology, Epilepsy and Headache Group, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chuhan Ding
- Department of Neurology, Epilepsy and Headache Group, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qibing Sun
- Department of Neurology, Epilepsy and Headache Group, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ran Li
- Department of Neurology, Epilepsy and Headache Group, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ruonan Liu
- Department of Health Management Center, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xihai Xu
- Department of Health Management Center, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Xihai Xu
| | - Yu Wang
- Department of Neurology, Epilepsy and Headache Group, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Yu Wang
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Wang S, Qi X. The Putative Role of Astaxanthin in Neuroinflammation Modulation: Mechanisms and Therapeutic Potential. Front Pharmacol 2022; 13:916653. [PMID: 35814201 PMCID: PMC9263351 DOI: 10.3389/fphar.2022.916653] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 06/07/2022] [Indexed: 12/03/2022] Open
Abstract
Neuroinflammation is a protective mechanism against insults from exogenous pathogens and endogenous cellular debris and is essential for reestablishing homeostasis in the brain. However, excessive prolonged neuroinflammation inevitably leads to lesions and disease. The use of natural compounds targeting pathways involved in neuroinflammation remains a promising strategy for treating different neurological and neurodegenerative diseases. Astaxanthin, a natural xanthophyll carotenoid, is a well known antioxidant. Mounting evidence has revealed that astaxanthin is neuroprotective and has therapeutic potential by inhibiting neuroinflammation, however, its functional roles and underlying mechanisms in modulating neuroinflammation have not been systematically summarized. Hence, this review summarizes recent progress in this field and provides an update on the medical value of astaxanthin. Astaxanthin modulates neuroinflammation by alleviating oxidative stress, reducing the production of neuroinflammatory factors, inhibiting peripheral inflammation and maintaining the integrity of the blood-brain barrier. Mechanistically, astaxanthin scavenges radicals, triggers the Nrf2-induced activation of the antioxidant system, and suppresses the activation of the NF-κB and mitogen-activated protein kinase pathways. With its good biosafety and high bioavailability, astaxanthin has strong potential for modulating neuroinflammation, although some outstanding issues still require further investigation.
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Higher levels of Bifidobacteria and tumor necrosis factor in children with drug-resistant epilepsy are associated with anti-seizure response to the ketogenic diet. EBioMedicine 2022; 80:104061. [PMID: 35598439 PMCID: PMC9126955 DOI: 10.1016/j.ebiom.2022.104061] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/22/2022] [Accepted: 04/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background Recently, studies have suggested a role for the gut microbiota in epilepsy. Gut microbial changes during ketogenic diet (KD) treatment of drug-resistant epilepsy have been described. Inflammation is associated with certain types of epilepsy and specific inflammation markers decrease during KD. The gut microbiota plays an important role in the regulation of the immune system and inflammation. Methods 28 children with drug-resistant epilepsy treated with the ketogenic diet were followed in this observational study. Fecal and serum samples were collected at baseline and three months after dietary intervention. Findings We identified both gut microbial and inflammatory changes during treatment. KD had a general anti-inflammatory effect. Novel bioinformatics and machine learning approaches identified signatures of specific Bifidobacteria and TNF (tumor necrosis factor) associated with responders before starting KD. During KD, taxonomic and inflammatory profiles between responders and non-responders were more similar than at baseline. Interpretation Our results suggest that children with drug-resistant epilepsy are more likely to benefit from KD treatment when specific Bifidobacteria and TNF are elevated. We here present a novel signature of interaction of the gut microbiota and the immune system associated with anti-epileptic response to KD treatment. This signature could be used as a prognostic biomarker to identify potential responders to KD before starting treatment. Our findings may also contribute to the development of new anti-seizure therapies by targeting specific components of the gut microbiota. Funding This study was supported by the Swedish Brain Foundation, Margarethahemmet Society, Stiftelsen Sunnerdahls Handikappfond, Linnea & Josef Carlssons Foundation, and The McCormick Genomic & Proteomic Center.
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Salave S, Rana D, Pardhe R, Bule P, Benival D. Unravelling Micro and Nano vesicular System in Intranasal Drug Delivery for Epilepsy. Pharm Nanotechnol 2022; 10:PNT-EPUB-122916. [PMID: 35473543 DOI: 10.2174/2211738510666220426115340] [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: 02/17/2022] [Revised: 03/02/2022] [Accepted: 03/10/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Epilepsy is one of the major neurological disorders, affecting about 50 million people globally. Oral, intravenous, and rectal delivery systems are available for the management of epileptic seizures. However, intranasal delivery serves beneficial for delivering anti-epileptic drugs owing to the advantages it offers. OBJECTIVE Various approaches have been developed over the years aiming to attain either a safer or faster brain delivery; a nasal delivery system proposes significant outcomes. The non-invasiveness and high vascularity contribute to the high permeability of the nasal mucosa, allowing rapid drug absorption. This review highlights some of the promising novel approaches delivering antiepileptic drugs efficiently employing the nasal route. METHODS The method includes a collection of data from different search engines like PubMed, ScienceDirect, SciFinder for obtaining appropriate and relevant literature regarding epilepsy, intranasal delivery of antiepileptic agents, and novel therapeutics. RESULTS The present review underlines the majority of work related to intranasal delivery in the treatment of epilepsy, aiming to draw the attention of the researchers towards the easiest and efficient ways of formulation for the delivery of antiepileptics during seizures. CONCLUSION This review intends to provide understanding about the delivery aspects of anti-epileptic drugs, the benefits of intranasal delivery, and the novel approaches employed for the treatment of epilepsy.
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Affiliation(s)
- Sagar Salave
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
| | - Dhwani Rana
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
| | - Rupali Pardhe
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
| | - Prajakta Bule
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
| | - Derajram Benival
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, India
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Zhong K, Qian C, Lyu R, Wang X, Hu Z, Yu J, Ma J, Ye Y. Anti-Epileptic Effect of Crocin on Experimental Temporal Lobe Epilepsy in Mice. Front Pharmacol 2022; 13:757729. [PMID: 35431921 PMCID: PMC9009530 DOI: 10.3389/fphar.2022.757729] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
Temporal lobe epilepsy (TLE) is a common kind of refractory epilepsy. More than 30% TLE patients were multi-drug resistant. Some patients may even develop into status epilepticus (SE) because of failing to control seizures. Thus, one of the avid goals for anti-epileptic drug development is to discover novel potential compounds to treat TLE or even SE. Crocin, an effective component of Crocus sativus L., has been applied in several epileptogenic models to test its anti-epileptic effect. However, it is still controversial and its effect on TLE remains unclear. Therefore, we investigated the effects of crocin on epileptogenesis, generalized seizures (GS) in hippocampal rapid electrical kindling model as well as SE and spotaneous recurrent seizure (SRS) in pilocarpine-induced TLE model in ICR mice in this study. The results showed that seizure stages and cumulative afterdischarge duration were significantly depressed by crocin (20 and 50 mg/kg) during hippocampal rapid kindling acquisition. And crocin (100 mg/kg) significantly reduced the incidence of GS and average seizure stages in fully kindled animals. In pilocarpine-induced TLE model, the latency of SE was significantly prolonged and the mortality of SE was significantly decreased by crocin (100 mg/kg), which can also significantly suppress the number of SRS. The underlying mechanism of crocin may be involved in the protection of neurons, the decrease of tumor necrosis factor-α in the hippocampus and the increase of brain derived neurotrophic factor in the cortex. In conclusion, crocin may be a potential and promising anti-epileptic compound for treatment of TLE.
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Affiliation(s)
- Kai Zhong
- Department of Pharmacology, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, China
| | - Chengyu Qian
- Department of Pharmacology, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, China
| | - Rui Lyu
- Department of Pharmacology, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, China
| | - Xinyi Wang
- Department of Pharmacology, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, China
| | - Zhe Hu
- Department of Pharmacology, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, China
| | - Jie Yu
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jing Ma
- Department of Pharmacy, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yilu Ye
- Department of Pharmacology, School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, China
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Craiu D, Rener Primec Z, Lagae L, Vigevano F, Trinka E, Specchio N, Bakhtadze S, Cazacu C, Golli T, Zuberi SM. Vaccination and childhood epilepsies. Eur J Paediatr Neurol 2022; 36:57-68. [PMID: 34922162 DOI: 10.1016/j.ejpn.2021.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/08/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The evidence relating vaccination to febrile seizures and epilepsy is evaluated with an emphasis on febrile seizures (FS), Dravet syndrome (DS), West syndrome, and other developmental and epileptic encephalopathies. METHODS A systematic literature review using search words vaccination/immunization AND febrile seizures/epilepsy/Dravet/epileptic encephalopathy/developmental encephalopathy was performed. The role of vaccination as the cause/trigger/aggravation factor for FS or epilepsies and preventive measures were analyzed. RESULTS From 1428 results, 846 duplicates and 447 irrelevant articles were eliminated; 120 were analyzed. CONCLUSIONS There is no evidence that vaccinations cause epilepsy in healthy populations. Vaccinations do not cause epileptic encephalopathies but may be non-specific triggers to seizures in underlying structural or genetic etiologies. The first seizure in DS may be earlier in vaccinated versus non-vaccinated patients, but developmental outcome is similar in both groups. Children with a personal or family history of FS or epilepsy should receive all routine vaccinations. This recommendation includes DS. The known risks of the infectious diseases prevented by immunization are well established. Vaccination should be deferred in case of acute illness. Acellular pertussis DTaP (diphtheria-tetanus-pertussis) is recommended. The combination of certain vaccine types may increase the risk of febrile seizures however the public health benefit of separating immunizations has not been proven. Measles-containing vaccine should be administered at age 12-15 months. Routine prophylactic antipyretics are not indicated, as there is no evidence of decreased FS risk and they can attenuate the antibody response following vaccination. Prophylactic measures (preventive antipyretic medication) are recommended in DS due to the increased risk of prolonged seizures with fever.
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Affiliation(s)
- Dana Craiu
- Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Department of Neurosciences, Pediatric Neurology Discipline II, Strada Dionisie Lupu No. 37, postal code: 020021, Bucharest/S2, Romania; Pediatric Neurology Clinic, Center of Expertise for Rare Disorders in Pediatric Neurology, EpiCARE member, Sos. Berceni 10, Bucharest/S4, Romania.
| | - Zvonka Rener Primec
- Department of Child, Adolescent and Developmental Neurology, Children's Hospital, University Medical Center Ljubljana Bohoričeva 20, 1000, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.
| | - Lieven Lagae
- University of Leuven, Department of Development and Regeneration, Section Paediatric Neurology, Herestraat 49, 3000, Leuven, Belgium.
| | - Federico Vigevano
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, Piazza S. Onofrio, 4, 00151, Rome, Italy.
| | - Eugen Trinka
- Department of Neurology, Christian-Doppler Medical Centre, Paracelsus Medical University, Affiliated Member of the European Reference Network, EpiCARE, 5020, Salzburg, Austria; Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University Salzburg, Austria.
| | - Nicola Specchio
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network EpiCARE, Piazza S. Onofrio, 4, 00151, Rome, Italy.
| | - Sophia Bakhtadze
- Department of Paediatric Neurology, Tbilisi State Medical University, 0160, Tbilisi, Georgia.
| | - Cristina Cazacu
- Pediatric Neurology Clinic, Center of Expertise for Rare Disorders in Pediatric Neurology, EpiCARE member, Sos. Berceni 10, Bucharest/S4, Romania.
| | - Tanja Golli
- Department of Child, Adolescent and Developmental Neurology, Children's Hospital, University Medical Center Ljubljana Bohoričeva 20, 1000, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.
| | - Sameer M Zuberi
- Paediatric Neurosciences, Royal Hospital for Children, Glasgow, UK; Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK.
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Wickström R, Ygberg S, Lindefeldt M, Dahlin M. Altered cytokine levels in cerebrospinal fluid following ketogenic diet of children with refractory epilepsy. Epilepsy Res 2021; 177:106775. [PMID: 34597959 DOI: 10.1016/j.eplepsyres.2021.106775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/02/2021] [Accepted: 09/20/2021] [Indexed: 10/20/2022]
Abstract
Ketogenic diet is an effective treatment which has the potential to achieve a significant seizure reduction in drug-resistant epilepsy. The mechanism behind this effect is unclear, but one hypothesis is that the mechanism is anti-inflammatory. In this prospective study on pediatric patients we compared levels of cytokines and chemokines in the cerebrospinal fluid before and after three months on treatment to evaluate a possible anti-inflammatory effect. We analyzed 34 cytokines and chemokines in the cerebrospinal fluid of pediatric patients (n = 21) with refractory epilepsy by a multiplex assay. Beta-hydroxybutyric acid was measured in blood and cerebrospinal fluid. Seizure frequency in relation to diet treatment was assessed. For 9 different cytokines (CCL 7, CCL 21, CCL 22, CCL 25, CCL 27, IL-2, IL-10, CX3CL1 and MIF), a significant decrease ranging from 7 to 27% was seen after three months as compared to levels before the diet. In contrast, no cytokine displayed a significant increase during diet. A seizure reduction ≥ 50 % was seen in 15/21 patients (71 %) but no significant differences in cytokine decreases were found between responders and non-responders during treatment. A non-significant trend towards higher initial pre-treatment levels of cytokines was seen in responders, which were reduced following treatment. The levels of betahydroxybutyric acid were not related to seizure response. We conclude that while it is not possible to state a primary anti-inflammatory effect by dietary treatment from these data, an unequivocal immunological effect is seen and may be a part of the mechanism of ketogenic dietary treatment.
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Affiliation(s)
- Ronny Wickström
- Neuropaediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Sofia Ygberg
- Neuropaediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Marie Lindefeldt
- Neuropaediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Dahlin
- Neuropaediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
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Shao LL, Gao MM, Gong JX, Yang LY. DUSP1 regulates hippocampal damage in epilepsy rats via ERK1/2 pathway. J Chem Neuroanat 2021; 118:102032. [PMID: 34562585 DOI: 10.1016/j.jchemneu.2021.102032] [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] [Received: 06/10/2021] [Revised: 09/03/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate the effects of DUSP1 on the hippocampal injury of young rats with epilepsy (EP) through mediating ERK1/2 signaling pathway. METHODS Young SD rats were selected and divided into Control, EP, EP + LV-GFP, EP + LV-DUSP1, EP + LV-siDUSP1, and EP + LV-siDUSP1 + U0126 groups. Morris Water Maze Test was used to detect the spatial learning and memory. Nissl staining and TUNEL staining were conducted and the inflammatory factors and oxidative stress-related indicators were also measured. Western blotting was utilized to detect the expression of DUSP1 and ERK1/2 pathway. EP cell model was constructed in vitro to verify the in vivo results. RESULTS Compared with Control group, young rats in EP group had decreased spatial learning and memory abilities and increased apoptotic rate and decreased number of Nissl positive cells. Besides, the up-regulated levels in inflammatory factors (IL-1β, IL-6), MDA content, and p-ERK1/2/ERK1/2 protein expression, as well as the down-regulated levels in DUSP1 protein expression and SOD content were also observed in EP rats. The EP rats treated with LV-DUSP1 showed obvious improvements regarding the above indicators, while those treated with LV-siDUSP1 had aggravated injury. But the effect of LV-siDUSP1 can be reversed by the treatment with ERK1/2 pathway inhibitor U0126. Further in vitro investigation verified the in vivo results. CONCLUSION DUSP1 may ameliorate the oxidative stress and inflammatory injury, as well as improve spatial learning and memory abilities via inhibiting ERK1/2 pathway, eventually playing protective roles in hippocampal injury of young rats with EP.
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Affiliation(s)
- Li-Li Shao
- Department of Pediatric, Cangzhou Central Hospital, Cangzhou 061000, PR China.
| | - Miao-Miao Gao
- Department of Pediatric, Cangzhou Central Hospital, Cangzhou 061000, PR China
| | - Jing-Xin Gong
- Department of Pediatric, Cangzhou Central Hospital, Cangzhou 061000, PR China
| | - Li-Yong Yang
- Department of Diagnostic CT, Cangzhou Central Hospital Yanshan Branch, Cangzhou 061399, PR China
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Pan D, Li X, Jiang J, Luo L. Effect of levetiracetam in combination with topiramate on immune function, cognitive function, and neuronal nutritional status of children with intractable epilepsy. Am J Transl Res 2021; 13:10459-10468. [PMID: 34650715 PMCID: PMC8506992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/26/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To determine the effects of levetiracetam in combination with topiramate on immune function, cognitive function, and the neuronal nutritional status of children with intractable epilepsy. METHODS This study enrolled 124 children with intractable epilepsy who were admitted to our hospital. The control group included 58 children treated with topiramate, and the observation group included 66 children treated with levetiracetam and topiramate. Flow cytometry was used to determine CD4+ and CD8+ T cell counts before and after treatment in both groups. RESULTS After treatment, the observation group exhibited significantly higher CD4+ T cell counts and BDNF and NGF levels and significantly lower CD8+ T cell counts and IL-6, IL-1β, and MMP-9 levels than the control group. The FIQ and VIQ of the observation group were also significantly higher than those of the control group. Additionally, the incidence rates of adverse events were not significantly different between the observation and the control groups. Finally, IL-6, IL-1β, and MMP-9 were negatively correlated with full-scale intelligence quotient (FIQ) and virtual inhibitory quotient (VIQ). CONCLUSIONS Levetiracetam in combination with topiramate is associated with reduced inflammatory response and improved immune function, cognitive function, and neuronal nutritional status in children with intractable epilepsy.
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Affiliation(s)
- Danfeng Pan
- Department of Pediatrics, The First People's Hospital of Wenling Wenling 317500, Zhejiang, China
| | - Xiaoxiao Li
- Department of Pediatrics, The First People's Hospital of Wenling Wenling 317500, Zhejiang, China
| | - Jinbiao Jiang
- Department of Pediatrics, The First People's Hospital of Wenling Wenling 317500, Zhejiang, China
| | - Lingling Luo
- Department of Pediatrics, The First People's Hospital of Wenling Wenling 317500, Zhejiang, China
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12
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Wang G, Wang J, Xin C, Xiao J, Liang J, Wu X. Inflammatory response in epilepsy is mediated by glial cell gap junction pathway (Review). Mol Med Rep 2021; 24:493. [PMID: 33955516 PMCID: PMC8127031 DOI: 10.3892/mmr.2021.12132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/21/2021] [Indexed: 01/31/2023] Open
Abstract
Epilepsy is a common neurological disease that affects more than 50 million people worldwide. Neuroinflammation plays an important role in epilepsy. Activation of the immune system and an excessive inflammatory response can increase the frequency of seizures and increase the susceptibility to epilepsy. Therefore, anti-inflammatory therapies may have antiepileptic effects. Connexin 43 (Cx43) is a major component of astroglial hemichannels and gap junctions. Gap junctions are important for the direct exchange of substances and information between cells, as well as regulating the neuroinflammatory response, changing neuronal excitability, neuronal apoptosis, and synaptic remodeling. Cx43-mediated gap junction pathway can be crucial in epilepsy-induced neuroinflammatory cascades. Further, pro-inflammatory cytokines may in turn directly affect the expression of the Cx43 protein in astrocytes. Therefore, examining the association between neuroinflammation and epilepsy can be instrumental in uncovering the pathogenesis of epilepsy, which can lead to the development of novel and more effective antiepileptic drugs.
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Affiliation(s)
- Guangliang Wang
- Department of Cardiology, Dalinghe Hospital of Far Eastern Horizon, Linghai, Liaoning 121200, P.R. China
| | - Jiangtao Wang
- Department of Pediatric Neurology, Jilin University, Changchun, Jilin 130000, P.R. China
| | - Cuijuan Xin
- Department of Pediatric Neurology, Jilin University, Changchun, Jilin 130000, P.R. China
| | - Jinyu Xiao
- Department of Pediatric Neurology, Jilin University, Changchun, Jilin 130000, P.R. China
| | - Jianmin Liang
- Department of Pediatric Neurology, Jilin University, Changchun, Jilin 130000, P.R. China
| | - Xuemei Wu
- Department of Pediatric Neurology, Jilin University, Changchun, Jilin 130000, P.R. China
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13
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He C, Su C, Zhang W, Zhou Q, Shen X, Yang J, Shi N. Modulatory Potential of LncRNA Zfas1 for Inflammation and Neuronal Apoptosis in Temporal Lobe Epilepsy. Yonsei Med J 2021; 62:215-223. [PMID: 33635011 PMCID: PMC7934098 DOI: 10.3349/ymj.2021.62.3.215] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 10/27/2020] [Accepted: 12/24/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE This study aimed to elucidate whether lncRNA ZFAS1 is involved in neuronal apoptosis and inflammation in temporal lobe epilepsy (TLE). MATERIALS AND METHODS Ninety-six TLE patients were recruited, and their peripheral venous blood was gathered to determine Zfas1 expression with polymerase chain reaction. Neurons were separated from hippocampal tissue of newborn SD rats, and si-Zfas1 or pcDNA3.1-Zfas1 was transfected into the neurons. Inflammatory cytokines released by neurons were determined, and neuronal activities were evaluated through MTT assay, colony formation assay, and flow cytometry. RESULTS Serum levels of Zfas1 were higher in TLE patients than in healthy controls (p<0.05). Furthermore, Zfas1 expression in neurons was raised by pcDNA3.1-Zfas1 and declined after silencing of Zfas1 (p<0.05). Transfection of pcDNA-Zfas1 weakened the viability and proliferation of neurons and increased neuronal apoptosis (p<0.05). Meanwhile, pcDNA3.1-Zfas1 transfection promoted lipopolysaccharide-induced release of cytokines, including tumor necrosis factor-α, interleukin (IL)-1, IL-6, and intercellular adhesion molecule-1 (p<0.05), and boosted NF-κB activation by elevating the expression of NF-κB p65, pIκBα, and IKKβ in neurons (p<0.05). CONCLUSION Our results indicated that lncRNA ZFAS1 exacerbates epilepsy development by promoting neuronal apoptosis and inflammation, implying ZFAS1 as a promising treatment target for epilepsy.
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Affiliation(s)
- Chuan He
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical Univeristy, Suzhou, China.
| | - Caixia Su
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical Univeristy, Suzhou, China
| | - Wentong Zhang
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical Univeristy, Suzhou, China
| | - Qin Zhou
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical Univeristy, Suzhou, China
| | - Xu Shen
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical Univeristy, Suzhou, China
| | - Junjie Yang
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical Univeristy, Suzhou, China
| | - Naixian Shi
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical Univeristy, Suzhou, China
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14
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Koh S, Dupuis N, Auvin S. Ketogenic diet and Neuroinflammation. Epilepsy Res 2020; 167:106454. [DOI: 10.1016/j.eplepsyres.2020.106454] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/26/2020] [Accepted: 09/01/2020] [Indexed: 12/13/2022]
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15
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Zhao H, Li S, Xie M, Chen R, Lu H, Wen C, Filiano AJ, Xu Z. Risk of epilepsy in rheumatoid arthritis: a meta-analysis of population based studies and bioinformatics analysis. Ther Adv Chronic Dis 2020; 11:2040622319899300. [PMID: 32095225 PMCID: PMC7011323 DOI: 10.1177/2040622319899300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022] Open
Abstract
Background: An increasing number of studies support an association between rheumatoid
arthritis (RA) and brain disorders. This study aims to determine the
association between RA and epilepsy. Methods: A comprehensive search of databases in both English and Chinese was
performed. Data from the selected studies were extracted and analyzed
independently by two authors. Genes associated with epilepsy and RA were
also collected and analyzed. Results: We included six nationwide population based studies
(n = 7,094,113 cases in total) for the meta-analysis. The
risk of epilepsy was increased in RA patients [risk ratio (RR) = 1.601; 95%
confidence interval (CI): 1.089–2.354; p = 0.017;
n = 3,803,535 cases] and children born to mothers with
RA (RR = 1.475; 95% CI: 1.333–1.633; p < 0.001,
n = 3,290,578 cases). Subgroup analysis and
meta-regression showed the RR of epilepsy in RA was negatively correlated
with age. Furthermore, we found that 433 identified genes in a coexpression
network from the hippocampi of 129 epileptic patients were enriched in the
RA and related Kyoto Encyclopedia of Genes and Genomes pathways, while 13
genes (mainly related to inflammatory cytokines and chemokines) were
identified as potential key genes bridging the RA and epilepsy. Conclusions: Our study, utilizing meta-analysis and bioinformatical data, highlights a
close association between epilepsy and RA. Further studies are still
warranted to expand these findings, especially for a population that is
exposed to RA during fetal and childhood periods.
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Affiliation(s)
- Huawei Zhao
- Department of Pharmacy, Zhejiang University School of Medicine Children's Hospital, Hangzhou, Zhejiang, China
| | - Shan Li
- Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Meijuan Xie
- Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Rongrong Chen
- Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Haimei Lu
- Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chengping Wen
- Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | | | - Zhenghao Xu
- Laboratory of Rheumatology & Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, No.548 Binwen Road, Hangzhou, 310053, China
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16
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Pan HH, Hung TW, Tsai JD, Chen HJ, Liao PF, Sheu JN. Children with allergic rhinitis and a risk of epilepsy: A nationwide cohort study. Seizure 2020; 76:64-71. [PMID: 32028113 DOI: 10.1016/j.seizure.2020.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Little is known about whether allergic disease is associated with a subsequent increased risk of childhood-onset epilepsy. We used a large, population-based cohort study to examine whether children with antecedent allergic rhinitis (AR) were associated with a subsequent increased risk of epilepsy. METHODS This retrospective population-based cohort study was conducted by using data from the 2000-2012 Taiwan's National Health Insurance Research Database. We enrolled 67,537 children aged 0-18 years diagnosed with AR and 67,537 age- and gender-matched children without the diagnosis of AR. The incidence rate (per 10,000 person-years) of epilepsy was calculated. We used Cox proportional hazards regression analysis to estimate hazard ratios (HRs) and 95 % confident interval (CI). RESULTS Of the 135,074 children included in the analyses, those with AR had a higher incidence rate of epilepsy (6.84 versus 3.95 per 10,000 person-years, p < 0.001) and an earlier age at diagnosis of epilepsy than those without AR [8.54 (4.90) versus 9.33 (5.40) years, p = 0.03)]. The Kaplan-Meier survival analysis demonstrated that the children with AR had a higher likelihood of developing epilepsy than those without AR (p < 0.001). After adjusting for confounding factors in multivariate model, children with AR had a 76 % increased risk of epilepsy (HR 1.76, 95 % CI 1.51-2.04) than those without AR. Boys had a 21 % increased risk of epilepsy (HR 1.21, 95 % CI 1.05-1.40) than girls. CONCLUSIONS These results suggest that children with AR were associated with an increased subsequent risk of epilepsy.
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Affiliation(s)
- Hui-Hsien Pan
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Tung-Wei Hung
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Jeng-Dau Tsai
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
| | - Pei-Fen Liao
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Ji-Nan Sheu
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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17
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Anti-Inflammation Associated Protective Mechanism of Berberine and its Derivatives on Attenuating Pentylenetetrazole-Induced Seizures in Zebrafish. J Neuroimmune Pharmacol 2020; 15:309-325. [DOI: 10.1007/s11481-019-09902-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 12/10/2019] [Indexed: 12/13/2022]
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18
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Tu Y, Wang S, Shih H, Wu P, Yu W, Huang C. Epilepsy occurrence after neonatal morbidities in very preterm infants. Epilepsia 2019; 60:2086-2094. [DOI: 10.1111/epi.16340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 08/24/2019] [Accepted: 08/26/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Yi‐Fang Tu
- Department of Pediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Institute of Clinical Medicine College of Medicine National Cheng Kung University Tainan Taiwan
| | - Shan‐Tair Wang
- Institute of Gerontology College of Medicine National Cheng Kung University Tainan Taiwan
| | - Hsin‐I Shih
- Department of Emergency Medicine National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
| | - Po‐Ming Wu
- Department of Pediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Institute of Clinical Medicine College of Medicine National Cheng Kung University Tainan Taiwan
| | - Wen‐Hao Yu
- Department of Pediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Institute of Clinical Medicine College of Medicine National Cheng Kung University Tainan Taiwan
| | - Chao‐Ching Huang
- Department of Pediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
- Department of Pediatrics College of Medicine Taipei Medical University Taipei Taiwan
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19
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Amini E, Golpich M, Farjam AS, Kamalidehghan B, Mohamed Z, Ibrahim NM, Ahmadiani A, Raymond AA. Brain Lipopolysaccharide Preconditioning-Induced Gene Reprogramming Mediates a Tolerance State in Electroconvulsive Shock Model of Epilepsy. Front Pharmacol 2018; 9:416. [PMID: 29765321 PMCID: PMC5938816 DOI: 10.3389/fphar.2018.00416] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/10/2018] [Indexed: 12/25/2022] Open
Abstract
There is increasing evidence pointing toward the role of inflammatory processes in epileptic seizures, and reciprocally, prolonged seizures induce more inflammation in the brain. In this regard, effective strategies to control epilepsy resulting from neuroinflammation could be targeted. Based on the available data, preconditioning (PC) with low dose lipopolysaccharide (LPS) through the regulation of the TLR4 signaling pathway provides neuroprotection against subsequent challenge with injury in the brain. To test this, we examined the effects of a single and chronic brain LPS PC, which is expected to lead to reduction of inflammation against epileptic seizures induced by electroconvulsive shock (ECS). A total of 60 male Sprague Dawley rats were randomly assigned to five groups: control, vehicle (single and chronic), and LPS PC (single and chronic). We first recorded the data regarding the behavioral and histological changes. We further investigated the alterations of gene and protein expression of important mediators in relation to TLR4 and inflammatory signaling pathways. Interestingly, significant increased presence of NFκB inhibitors [Src homology 2-containing inositol phosphatase-1 (SHIP1) and Toll interacting protein (TOLLIP)] was observed in LPS-preconditioned animals. This result was also associated with over-expression of IRF3 activity and anti-inflammatory markers, along with down-regulation of pro-inflammatory mediators. Summarizing, the analysis revealed that PC with LPS prior to seizure induction may have a neuroprotective effect possibly by reprogramming the signaling response to injury.
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Affiliation(s)
- Elham Amini
- Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Mojtaba Golpich
- Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Abdoreza S Farjam
- Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Selangor, Malaysia
| | - Behnam Kamalidehghan
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahurin Mohamed
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norlinah M Ibrahim
- Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Abolhassan Ahmadiani
- Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azman A Raymond
- Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, National University of Malaysia, Kuala Lumpur, Malaysia
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20
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Auvin S, Jeljeli M, Desnous B, Soussi-Yanicostas N, Dournaud P, Sterkers G. Altered vaccine-induced immunity in children with Dravet syndrome. Epilepsia 2018. [PMID: 29512885 DOI: 10.1111/epi.14038] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Dravet syndrome (DS) is a refractory epileptic syndrome. Vaccination is the trigger of the first seizure in about 50% of cases. Fever remains a trigger of seizures during the course of the disease. We compared ex vivo cytokine responses to a combined aluminium-adjuvanted vaccine of children with DS to sex- and age-matched heathy children. Using ex vivo cytokine responses of peripheral-blood mononuclear cells and monocytes, we found that vaccine responsiveness is biased toward a proinflammatory profile in DS with a M1 phenotype of monocytes. We provide new insight into immune mechanisms associated with DS that might guide research for the development of new immunotherapeutic agents in this epilepsy syndrome.
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Affiliation(s)
- Stéphane Auvin
- PROTECT, INSERM, Paris Diderot University, Sorbonne Paris Cité, Paris, France.,APHP, Pediatric Neurology Department, Robert-Debré University Hospital, Paris, France
| | - Mohamed Jeljeli
- APHP, Clinical Immunology Department, Robert-Debré University Hospital, Paris, France
| | - Béatrice Desnous
- PROTECT, INSERM, Paris Diderot University, Sorbonne Paris Cité, Paris, France.,APHP, Pediatric Neurology Department, Robert-Debré University Hospital, Paris, France
| | | | - Pascal Dournaud
- PROTECT, INSERM, Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - Ghislaine Sterkers
- APHP, Clinical Immunology Department, Robert-Debré University Hospital, Paris, France
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21
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Yuen AWC, Walcutt IA, Sander JW. An acidosis-sparing ketogenic (ASK) diet to improve efficacy and reduce adverse effects in the treatment of refractory epilepsy. Epilepsy Behav 2017; 74:15-21. [PMID: 28667864 DOI: 10.1016/j.yebeh.2017.05.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/11/2017] [Accepted: 05/13/2017] [Indexed: 12/13/2022]
Abstract
Diets that increase production of ketone bodies to provide alternative fuel for the brain are evolving from the classic ketogenic diet for epilepsy devised nearly a century ago. The classic ketogenic diet and its more recent variants all appear to have similar efficacy with approximately 50% of users showing a greater than 50% seizure reduction. They all require significant medical and dietetic support, and there are tolerability issues. A review suggests that low-grade chronic metabolic acidosis associated with ketosis is likely to be an important contributor to the short term and long term adverse effects of ketogenic diets. Recent studies, particularly with the characterization of the acid sensing ion channels, suggest that chronic metabolic acidosis may increase the propensity for seizures. It is also known that low-grade chronic metabolic acidosis has a broad range of negative health effects and an increased risk of early mortality in the general population. The modified ketogenic dietary treatment we propose is formulated to limit acidosis by measures that include monitoring protein intake and maximizing consumption of alkaline mineral-rich, low carbohydrate green vegetables. We hypothesize that this acidosis-sparing ketogenic diet is expected to be associated with less adverse effects and improved efficacy. A case history of life-long intractable epilepsy shows this diet to be a successful long-term strategy but, clearly, clinical studies are needed.
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Affiliation(s)
- Alan W C Yuen
- NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, WC1N 3BG London, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, UK.
| | | | - Josemir W Sander
- NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, WC1N 3BG London, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, UK; Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, 2103 SW Heemstede, The Netherlands
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22
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Auvin S, Walker L, Gallentine W, Jozwiak S, Tombini M, Sills GJ. Prospective clinical trials to investigate clinical and molecular biomarkers. Epilepsia 2017; 58 Suppl 3:20-26. [PMID: 28675556 DOI: 10.1111/epi.13782] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 01/11/2023]
Abstract
Among clinical studies, randomized studies as well as well-designed observational studies are providing the highest quality data. In addition, these studies represent a good opportunity to examine biomarkers of ictogenesis and epileptogenesis. To date, no validated molecular or cellular biomarker exists for any aspect of epilepsy. We provide an overview of the inflammatory biomarkers under investigation in prospective clinical studies in epilepsy: proinflammatory cytokines in prolonged febrile seizure; High Mobility Group Box 1 (HMGB1) as a prognosis biomarker in epilepsy and the interaction between inflammation and metabolism, in particular, iron metabolism, in epilepsy. The designs of the European Union EPISTOP project following prospectively patients with tuberous sclerosis from birth to the start of the epilepsy and of the Standard and New Antiepileptic Drugs-II study illustrate how such studies can be used to find new inflammatory biomarkers of ictogenesis and epileptogenesis. If we want to bridge the current gap between having numerous biomarker candidates from preclinical studies and their selective use in clinical practice, we need to explore multiple biologic systems, not just including inflammation. In addition, it is crucial that those involved in the design and support of relevant clinical studies recognize this gap and act accordingly, and in the interests of improving the diagnosis and prognosis for epilepsy.
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Affiliation(s)
- Stéphane Auvin
- Pediatric Neurology Department & INSERM U1141, Robert-Debré University Hospital, APHP, Paris, France
| | - Lauren Walker
- Department of Molecular & Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - William Gallentine
- Department of Pediatrics (Neurology), Duke University Medical Center, Durham, North Carolina, U.S.A
| | - Sergiusz Jozwiak
- Department of Child Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Mario Tombini
- Department of Medicine, Unit of Neurology, Neurophysiology, Neurobiology, Campus Bio-Medico University, Rome, Italy
| | - Graeme J Sills
- Department of Molecular & Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
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23
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Han B, Li X, Hao J. The cholinergic anti-inflammatory pathway: An innovative treatment strategy for neurological diseases. Neurosci Biobehav Rev 2017; 77:358-368. [PMID: 28392244 DOI: 10.1016/j.neubiorev.2017.04.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/28/2017] [Accepted: 04/03/2017] [Indexed: 12/22/2022]
Abstract
Acetylcholine (ACh), as a classical neurotransmitter, regulates the neuronal network in response to internal and external stimuli. In recent decades, the biology of ACh has been endowed with unparalleled new insights, especially with respect to cholinergic anti-inflammatory properties in non-neuronal cells. In fact, a mechanism frequently referred to as the "cholinergic anti-inflammatory pathway" has been termed to describe interactions between the central nervous system (CNS) and the immune system via vagus nerve. As well documented, immune cells express choline acetyltransferase, a direct synthetase for ACh, and other corresponding cholinergic components. Alternatively, the ACh released from immune cells or cholinergic neurons modulates immune function in an autocrine/paracrine manner by acting on its receptors. Moreover, muscarinic or nicotinic ACh receptors on various immune cells and CNS glial cells administer the work of their respective agonists, causing functional and biochemical changes. In this review, we focus on the anti-inflammatory benefits of non-neuronal and neuronal ACh as a means of providing new insights into treating inflammation-related neurological diseases, as exemplified by those described herein.
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Affiliation(s)
- Bin Han
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China.
| | - Xiuping Li
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China.
| | - Junwei Hao
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China.
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24
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Chen L, Liu X, Wang H, Qu M. Gastrodin Attenuates Pentylenetetrazole-Induced Seizures by Modulating the Mitogen-Activated Protein Kinase-Associated Inflammatory Responses in Mice. Neurosci Bull 2016; 33:264-272. [PMID: 27909971 DOI: 10.1007/s12264-016-0084-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 10/14/2016] [Indexed: 01/21/2023] Open
Abstract
Gastrodin, the major component isolated from the rhizome of the Chinese traditional medicinal herb Gastrodia elata ("Tianma"), has a long history in the treatment of epilepsy and other neurological disorders. However, the molecular mechanisms are not clear. Here, we found that gastrodin ameliorated pentylenetetrazole (PTZ)-induced epileptic seizures with improvement of the electroencephalographic pattern in mice. Further studies demonstrated that gastrodin decreased the levels of the pro-inflammatory cytokines interleukin-1β and tumor necrosis factor-α while increasing interleukin-10, an anti-inflammatory cytokine in the brain. Furthermore, gastrodin attenuated the PTZ-induced microglial activation along with inhibition of mitogen-activated protein kinases, cAMP response element binding protein, and NF-κB. Our data suggest that gastrodin attenuates seizures by modulating the mitogen-activated protein kinase-associated inflammatory responses.
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Affiliation(s)
- Liming Chen
- Neurology Department, The First People's Hospital of Jingzhou, The First Affiliated Hospital of Yangtze University, Jingzhou, 434000, China
| | - Xinan Liu
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Hua Wang
- Neurology Department, The First People's Hospital of Jingzhou, The First Affiliated Hospital of Yangtze University, Jingzhou, 434000, China.
| | - Min Qu
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China.
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25
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Zhang Y, Gu R, Jia J, Hou T, Zheng LT, Zhen X. Inhibition of macrophage migration inhibitory factor (MIF) tautomerase activity suppresses microglia-mediated inflammatory responses. Clin Exp Pharmacol Physiol 2016; 43:1134-1144. [DOI: 10.1111/1440-1681.12647] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/03/2016] [Accepted: 08/17/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Yu Zhang
- Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psychiatric Diseases and the Collaborative Innovation Centre for Brain Science; College of Pharmaceutical Sciences; Soochow University; Suzhou Jiangsu China
- Department of Pharmacy; Xiangyang Hospital Affiliated to Hubei University of Medicine; Xiangyang Hubei China
| | - Ruinan Gu
- Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psychiatric Diseases and the Collaborative Innovation Centre for Brain Science; College of Pharmaceutical Sciences; Soochow University; Suzhou Jiangsu China
| | - Jia Jia
- Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psychiatric Diseases and the Collaborative Innovation Centre for Brain Science; College of Pharmaceutical Sciences; Soochow University; Suzhou Jiangsu China
| | - Tingjun Hou
- College of Pharmaceutical Sciences; Zhejiang University; Hangzhou Zhejiang China
| | - Long Tai Zheng
- Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psychiatric Diseases and the Collaborative Innovation Centre for Brain Science; College of Pharmaceutical Sciences; Soochow University; Suzhou Jiangsu China
| | - Xuechu Zhen
- Jiangsu Key Laboratory of Translational Research and Therapy for Neuro-Psychiatric Diseases and the Collaborative Innovation Centre for Brain Science; College of Pharmaceutical Sciences; Soochow University; Suzhou Jiangsu China
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26
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Wang X, Yin H, Rich AM, Sun Y, Tan Z, Luo X, Che N, Wei M, Yin J. MicroRNAs as biomarkers in molecular diagnosis of refractory epilepsy. Chin Neurosurg J 2016. [DOI: 10.1186/s41016-016-0049-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Long X, Hu H, Li S, Chen M, Cai J, Song B. Hippocampal YKL-40 expression in rats after status epilepticus. Epilepsy Res 2016; 125:52-7. [DOI: 10.1016/j.eplepsyres.2016.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/27/2016] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
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28
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Simão F, Habekost Oliveira V, Nunes ML. Enhanced susceptibility to seizures modulated by high interleukin‐1β levels during early life malnutrition. Dev Neurobiol 2016; 76:1150-9. [DOI: 10.1002/dneu.22381] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 12/13/2015] [Accepted: 01/13/2016] [Indexed: 01/21/2023]
Affiliation(s)
- Fabrício Simão
- Neuroscience LaboratoryBiomedical Research Institute, Pontifical Catholic University of Rio Grande Do Sul (PUCRS)Porto Alegre RS Brazil
| | - Victória Habekost Oliveira
- Neuroscience LaboratoryBiomedical Research Institute, Pontifical Catholic University of Rio Grande Do Sul (PUCRS)Porto Alegre RS Brazil
| | - Magda Lahourgue Nunes
- Neuroscience LaboratoryBiomedical Research Institute, Pontifical Catholic University of Rio Grande Do Sul (PUCRS)Porto Alegre RS Brazil
- School of Medicine and Brain Institute (InsCer)Pontifical Catholic University of Rio Grande Do Sul (PUCRS)Porto Alegre RS Brazil
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29
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Strom MA, Silverberg JI. Allergic disease is associated with childhood seizures: An analysis of the 1997-2013 National Health Interview Survey. J Allergy Clin Immunol 2015; 137:951-3.e2. [PMID: 26542034 DOI: 10.1016/j.jaci.2015.09.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 09/16/2015] [Accepted: 09/17/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Mark A Strom
- Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, Ill
| | - Jonathan I Silverberg
- Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, Ill; Department of Preventive Medicine, Feinberg School of Medicine at Northwestern University, Chicago, Ill; Department of Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Ill; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Ill.
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30
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Bennani-Baiti B, Toegel S, Viernstein H, Urban E, Noe CR, Bennani-Baiti IM. Inflammation Modulates RLIP76/RALBP1 Electrophile-Glutathione Conjugate Transporter and Housekeeping Genes in Human Blood-Brain Barrier Endothelial Cells. PLoS One 2015; 10:e0139101. [PMID: 26406496 PMCID: PMC4583384 DOI: 10.1371/journal.pone.0139101] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 09/09/2015] [Indexed: 12/22/2022] Open
Abstract
Endothelial cells are often present at inflammation sites. This is the case of endothelial cells of the blood-brain barrier (BBB) of patients afflicted with neurodegenerative disorders such as Alzheimer's, Parkinson's, or multiple sclerosis, as well as in cases of bacterial meningitis, trauma, or tumor-associated ischemia. Inflammation is a known modulator of gene expression through the activation of transcription factors, mostly NF-κB. RLIP76 (a.k.a. RALBP1), an ATP-dependent transporter of electrophile-glutathione conjugates, modulates BBB permeability through the regulation of tight junction function, cell adhesion, and exocytosis. Genes and pathways regulated by RLIP76 are transcriptional targets of tumor necrosis factor alpha (TNF-α) pro-inflammatory molecule, suggesting that RLIP76 may also be an inflammation target. To assess the effects of TNF-α on RLIP76, we faced the problem of choosing reference genes impervious to TNF-α. Since such genes were not known in human BBB endothelial cells, we subjected these to TNF-α, and measured by quantitative RT-PCR the expression of housekeeping genes commonly used as reference genes. We find most to be modulated, and analysis of several inflammation datasets as well as a metaanalysis of more than 5000 human tissue samples encompassing more than 300 cell types and diseases show that no single housekeeping gene may be used as a reference gene. Using three different algorithms, however, we uncovered a reference geneset impervious to TNF-α, and show for the first time that RLIP76 expression is induced by TNF-α and follows the induction kinetics of inflammation markers, suggesting that inflammation can influence RLIP76 expression at the BBB. We also show that MRP1 (a.k.a. ABCC1), another electrophile-glutathione transporter, is not modulated in the same cells and conditions, indicating that RLIP76 regulation by TNF-α is not a general property of glutathione transporters. The reference geneset uncovered herein should aid in future gene expression studies in inflammatory conditions of the BBB.
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Affiliation(s)
- Barbara Bennani-Baiti
- Department for Medicinal Chemistry, Institute of Pharmaceutical Chemistry, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
- Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital (AKH), Medical University of Vienna, Waehringer-Guertel 18–20, 1090 Vienna, Austria
| | - Stefan Toegel
- Karl Chiari Lab for Orthopaedic Biology, Department of Orthopaedics, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Helmut Viernstein
- Department of Pharmaceutical Technology and Biopharmaceutics, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
| | - Ernst Urban
- Department for Medicinal Chemistry, Institute of Pharmaceutical Chemistry, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
| | - Christian R. Noe
- Department for Medicinal Chemistry, Institute of Pharmaceutical Chemistry, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
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Chang KH, Hsu YC, Chang MY, Lin CL, Wu TN, Hwang BF, Chen CY, Liu HC, Kao CH. A Large-Scale Study Indicates Increase in the Risk of Epilepsy in Patients With Different Risk Factors, Including Rheumatoid Arthritis. Medicine (Baltimore) 2015; 94:e1485. [PMID: 26356713 PMCID: PMC4616629 DOI: 10.1097/md.0000000000001485] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Peripheral neuropathy and inflammatory reactions of the central nervous system may accompany rheumatoid arthritis (RA). Inflammatory processes play a critical role in epilepsy. Therefore, we conducted this study to determine the risk of epilepsy in patients with RA.The RA cohort comprised patients ages 20 years and older who were newly diagnosed with RA between 2000 and 2011, with data obtained from the Registry of Catastrophic Illnesses Patient Database. Patients without RA were frequency matched with an RA cohort at a 1:1 ratio according to age, sex, and year of RA diagnosis.The overall crude hazard ratio (HR) for epilepsy was 1.27-fold higher in the RA cohort compared with that in the controls. After adjustment for age, sex, comorbidities, and medications, the patients with RA were associated with an increased risk of epilepsy compared with those without RA (adjusted HR [aHR] = 1.52, 95% confidence interval [CI] = 1.12-2.07). Compared with the RA patients with ≤ 560 days of nonsteroidal anti-inflammatory drug (NSAID) use, the RA patients with 1181 to 2145 and >2145 days of NSAID use had a significantly lower risk of epilepsy (aHR = 0.35, 95% CI = 0.24-0.52 and aHR = 0.15, 95% CI = 0.09-0.24, respectively).This study provides compelling evidence of an increased risk of epilepsy in patients with RA. The period of NSAID treatment is negatively associated with the risk of epilepsy in RA patients.
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Affiliation(s)
- Kuang-Hsi Chang
- From the Department of Public Health, China Medical University, Taichung, Taiwan (K-HC, C-YC); Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (K-HC); Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan (K-HC), Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan (Y-CH); Department of Medical Laboratory Science and Biotechnology, School of Medical and Health Sciences, Fooyin University, Kaohsiung, Taiwan (M-YC); Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan (C-LL); College of Medicine, China Medical University, Taichung, Taiwan (C-LL); Department of Nursing, Hung Kuang University, Taichung, Taiwan (T-NW); Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan (B-FH); Respiratory Therapy Intensive Care Unit, Veterans General Hospital, Taichung, Taiwan (H-CL); Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan (C-HK); Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK)
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Eun BL, Abraham J, Mlsna L, Kim MJ, Koh S. Lipopolysaccharide potentiates hyperthermia-induced seizures. Brain Behav 2015; 5:e00348. [PMID: 26357586 PMCID: PMC4559014 DOI: 10.1002/brb3.348] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/25/2015] [Accepted: 04/05/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Prolonged febrile seizures (FS) have both acute and long-lasting effects on the developing brain. Because FS are often associated with peripheral infection, we aimed to develop a preclinical model of FS that simulates fever and immune activation in order to facilitate the implementation of targeted therapy after prolonged FS in young children. METHODS The innate immune activator lipopolysaccharide (LPS) was administered to postnatal day 14 rat (200 μg/kg) and mouse (100 μg/kg) pups 2-2.5 h prior to hyperthermic seizures (HT) induced by hair dryer or heat lamp. To determine whether simulation of infection enhances neuronal excitability, latency to seizure onset, threshold temperature and total number of seizures were quantified. Behavioral seizures were correlated with electroencephalographic changes in rat pups. Seizure-induced proinflammatory cytokine production was assessed in blood samples at various time points after HT. Seizure-induced microglia activation in the hippocampus was quantified using Cx3cr1(GFP/+) mice. RESULTS Lipopolysaccharide priming increased susceptibility of rats and mice to hyperthemic seizures and enhanced seizure-induced proinflammatory cytokine production and microglial activation. CONCLUSIONS Peripheral inflammation appears to work synergistically with hyperthermia to potentiate seizures and to exacerbate seizure-induced immune responses. By simulating fever, a regulated increase in body temperature from an immune challenge, we developed a more clinically relevant animal model of prolonged FS.
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Affiliation(s)
- Baik-Lin Eun
- Department of Pediatrics, Korea University College of Medicine Seoul, Korea
| | - Jayne Abraham
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago Stanley Manne Children's Research Institute, Northwestern University Feinberg School of Medicine Chicago, Illinois
| | - Lauren Mlsna
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago Stanley Manne Children's Research Institute, Northwestern University Feinberg School of Medicine Chicago, Illinois
| | - Min Jung Kim
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago Stanley Manne Children's Research Institute, Northwestern University Feinberg School of Medicine Chicago, Illinois
| | - Sookyong Koh
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago Stanley Manne Children's Research Institute, Northwestern University Feinberg School of Medicine Chicago, Illinois
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Dupuis N, Curatolo N, Benoist JF, Auvin S. Ketogenic diet exhibits anti-inflammatory properties. Epilepsia 2015; 56:e95-8. [DOI: 10.1111/epi.13038] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 12/16/2022]
Affiliation(s)
- Nina Dupuis
- INSERM, U1141; Paris France
- INSERM UMR1141; Paris Diderot University; Paris France
| | | | - Jean-François Benoist
- INSERM, U1141; Paris France
- AP-HP; Biochemistery Department; Robert Debre Univeristy Hospital; Paris France
| | - Stéphane Auvin
- INSERM, U1141; Paris France
- INSERM UMR1141; Paris Diderot University; Paris France
- AP-HP; Pediatric Neurology Department; Robert Debre University Hospital; Paris France
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Hypobromous acid, a powerful endogenous electrophile: Experimental and theoretical studies. J Inorg Biochem 2015; 146:61-8. [PMID: 25771434 DOI: 10.1016/j.jinorgbio.2015.02.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 02/20/2015] [Accepted: 02/20/2015] [Indexed: 12/26/2022]
Abstract
Hypobromous acid (HOBr) is an inorganic acid produced by the oxidation of the bromide anion (Br(-)). The blood plasma level of Br(-) is more than 1,000-fold lower than that of chloride anion (Cl(-)). Consequently, the endogenous production of HOBr is also lower compared to hypochlorous acid (HOCl). Nevertheless, there is much evidence of the deleterious effects of HOBr. From these data, we hypothesized that the reactivity of HOBr could be better associated with its electrophilic strength. Our hypothesis was confirmed, since HOBr was significantly more reactive than HOCl when the oxidability of the studied compounds was not relevant. For instance: anisole (HOBr, k2=2.3×10(2)M(-1)s(-1), HOCl non-reactive); dansylglycine (HOBr, k2=7.3×10(6)M(-1)s(-1), HOCl, 5.2×10(2)M(-1)s(-1)); salicylic acid (HOBr, k2=4.0×10(4)M(-1)s(-1), non-reactive); 3-hydroxybenzoic acid (HOBr, k2=5.9×10(4)M(-1)s(-1), HOCl, k2=1.1×10(1)M(-1)s(-1)); uridine (HOBr, k2=1.3×10(3)M(-1)s(-1), HOCl non-reactive). The compounds 4-bromoanisole and 5-bromouridine were identified as the products of the reactions between HOBr and anisole or uridine, respectively, i.e. typical products of electrophilic substitutions. Together, these results show that, rather than an oxidant, HOBr is a powerful electrophilic reactant. This chemical property was theoretically confirmed by measuring the positive Mulliken and ChelpG charges upon bromine and chlorine. In conclusion, the high electrophilicity of HOBr could be behind its well-established deleterious effects. We propose that HOBr is the most powerful endogenous electrophile.
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