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Sonawane S, Všianský V, Brázdil M. MicroRNA-mediated regulation of neurotransmitter receptors in epilepsy: A systematic review. Epilepsy Behav 2024; 158:109912. [PMID: 38924965 DOI: 10.1016/j.yebeh.2024.109912] [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: 02/22/2024] [Revised: 05/21/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Pathogenesis of epilepsy involves dysregulation of the neurotransmitter system contributing to hyper-excitability of neuronal cells. MicroRNA (miRNAs) are small non-coding RNAs known to play a crucial role in post-transcriptional regulation of gene expression. METHODS The present review was prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, employing a comprehensive search strategy to identify and extract data from published research articles. Keywords suchas epilepsy, micro RNA (micro RNAs, miRNA, miRNAs, miR), neurotransmitters (specific names), and neurotransmitter receptors (specific names) were used to construct the query. RESULTS A total of 724 articles were identified using the keywords epilepsy, microRNA along with select neurotransmitter and neurotransmitter receptor names. After exclusions, the final selection consisted of 17 studies, most of which centered on glutamate and gamma-aminobutyric acid (GABA) receptors. Singular studies also investigated miRNAs affecting cholinergic, purinergic, and glycine receptors. CONCLUSION This review offers a concise overview of the current knowledge on miRNA-mediated regulation of neurotransmitter receptors in epilepsy and highlights their potential for future clinical application.
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Affiliation(s)
- Shivani Sonawane
- Brno Epilepsy Center, 1st Department of Neurology, Faculty of Medicine, Masaryk University and St. Annés University Hospital, Brno, Czech Republic; Behavioural and Social Neuroscience Research Group, CEITEC - Central European Institute of Technology Masaryk University, Brno, Czech Republic
| | - Vít Všianský
- Brno Epilepsy Center, Department of Neurology, St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Member of the ERN EpiCARE, Brno, Czech Republic
| | - Milan Brázdil
- Brno Epilepsy Center, 1st Department of Neurology, Faculty of Medicine, Masaryk University and St. Annés University Hospital, Brno, Czech Republic; Behavioural and Social Neuroscience Research Group, CEITEC - Central European Institute of Technology Masaryk University, Brno, Czech Republic.
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Youn SE, Kang HC, Lee JS, Kim HD, Kim SH. Long-term efficacy and safety of adjunctive perampanel in pediatric patients aged 4-19 years with epilepsy: a real-world study. Sci Rep 2023; 13:14369. [PMID: 37658098 PMCID: PMC10474112 DOI: 10.1038/s41598-023-40594-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 08/14/2023] [Indexed: 09/03/2023] Open
Abstract
This study determined the 24-month outcomes of perampanel treatment in children and adolescents with epilepsy. The percentage of ≥ 50% responders was 47.3% (139/294) at 12 months and 49.0% (144/294) at 24 months. A 100% reduction in seizures for more than 12 months was observed in 12.2% (36/294). Discontinuation occurred in 39.8% (117/294). The most common reason for discontinuation was adverse events (29.1%, 34/117). Baseline seizure frequency was higher in children aged < 12 years than in patients aged ≥ 12 years; however, the percentage of seizure reduction and ≥ 50% responders did not significantly differ between the two groups. The rate of early discontinuation was higher (p < 0.001) and the duration of perampanel treatment was shorter in children aged < 12 years (p = 0.001). Most children aged < 12 years discontinued PER due to inadequate effectiveness, while adverse event was the most common reason in patients aged ≥ 12 years (p = 0.045). Only slow titration was significantly associated with ≥ 50% of responders. In conclusion, this study showed that perampanel can be utilized effectively and safely for a prolonged period in pediatric patients aged 4 to < 12 years, as well as in patients aged 12 years and older.
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Affiliation(s)
- Song Ee Youn
- Department of Pediatrics, Yonsei University College of Medicine, Division of Pediatric Neurology, Severance Children's Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150 Seongan-ro, Gangdong-gu, Seoul, 05355, Republic of Korea
| | - Hoon-Chul Kang
- Department of Pediatrics, Yonsei University College of Medicine, Division of Pediatric Neurology, Severance Children's Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Joon Soo Lee
- Department of Pediatrics, Yonsei University College of Medicine, Division of Pediatric Neurology, Severance Children's Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Heung Dong Kim
- Department of Pediatrics, Yonsei University College of Medicine, Division of Pediatric Neurology, Severance Children's Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Se Hee Kim
- Department of Pediatrics, Yonsei University College of Medicine, Division of Pediatric Neurology, Severance Children's Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Maeda A, Neshige S, Katsumata R, Nonaka M, Ishibashi H, Maruyama H. Exacerbation of Repetitive Falls Due to Atonic Seizures Following Perampanel Administration. Cureus 2023; 15:e40818. [PMID: 37485229 PMCID: PMC10362973 DOI: 10.7759/cureus.40818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
A 47-year-old man presented with tonic-clonic seizures characterized by convulsions. He repeatedly exhibited seizures despite treatment with four anti-seizure medications. During the titration process of perampanel (PER), the seizures paradoxically increased in intensity and frequency, resulting in trauma. Video electroencephalogram monitoring revealed interictal rapid rhythms and generalized spikes and documented atonic seizures. Thus, the patient was diagnosed with Lennox-Gastaut syndrome. Upon discontinuation of PER, the patient's atonic seizures with falls improved, probably suggesting a paradoxical effect of PER. A non-competitive antagonist selective for AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptors may have caused the weakness and delayed recovery from prolonged atonia that caused injuries.
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Affiliation(s)
- Akiko Maeda
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, JPN
| | - Shuichiro Neshige
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, JPN
| | - Riho Katsumata
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, JPN
| | - Megumi Nonaka
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, JPN
| | - Haruka Ishibashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, JPN
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, JPN
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4
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Chen R, Xue G, Hölscher C. The role of the TNFα-mediated astrocyte signaling pathway in epilepsy. ACTA EPILEPTOLOGICA 2021. [DOI: 10.1186/s42494-021-00059-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractEpilepsy is a common disease in the central nervous system. There is growing evidence that epilepsy is associated with glial cells, including astrocytes. Tumor necrosis factor α (TNFα) is a “master regulator” of proinflammatory cytokine production and is secreted by microglia and astrocytes. TNFα secreted by microglia can activate astrocytes. Additionally, TNFα can regulate neuron activity and induce epilepsy by increasing the glutamate release, reducing the expression of γ-aminobutyric acid, inducing neuroinflammation and affecting the synaptic function in astrocytes. This review summarizes the signaling pathways and receptors of TNFα acting on astrocytes that are related to epilepsy and provides insights into the potential therapeutic strategies of epilepsy for clinical practice.
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Zhang R, Qiao S, Fang X, Wang K, Shi Y, Du Q, Yang T, Liu X. Efficacy and Tolerability of Perampanel as Adjunctive Therapy in Chinese Patients With Focal-Onset Seizures: An Observational, Prospective Study. Front Neurol 2021; 12:731566. [PMID: 34526963 PMCID: PMC8435584 DOI: 10.3389/fneur.2021.731566] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To evaluate the efficacy and tolerability of adjunctive perampanel (PER) in Chinese patients with focal-onset seizures, with or without secondarily generalized tonic-clonic seizures. Methods: Fifty-six patients aged 14-72 years were recruited consecutively in this single-center prospective observational study. All patients received PER as add-on treatment on the basis of clinical judgment. Seizure frequency, adverse events (AEs), and retention rates were obtained at 3 and 6 months after PER introduction. Results: The overall response rates were 60 and 71.1% after 3 and 6 months, respectively, and the freedom of seizures at the same points were reached in 8 and 15.8%. The retention rates were 89.3% at the 3-month follow-up and 67.9% at the 6-month follow-up. The overall incidence of adverse events was 55.4%. The leading reported AEs were dizziness (39.3%) and somnolence (25%). Conclusions: Our study confirmed the efficacy and tolerability of adjunctive PER in Chinese patients in real-life conditions. Based on our treatment experience, a lower maintenance dose of PER would be needed in Chinese patients.
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Affiliation(s)
- Ranran Zhang
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shan Qiao
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Xiqin Fang
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Kemo Wang
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yanting Shi
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qianwen Du
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tingting Yang
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xuewu Liu
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Institute of Epilepsy, Shandong University, Jinan, China
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Lattanzi S, Striano P. The impact of perampanel and targeting AMPA transmission on anti-seizure drug discovery. Expert Opin Drug Discov 2019; 14:195-197. [DOI: 10.1080/17460441.2019.1566318] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Simona Lattanzi
- Department of Experimental and Clinical Medicine, Neurological Clinic, Marche Polytechnic University, Ancona, Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, “G. Gaslini” Institute, Genova, Italy
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7
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Zhang Y, Gao B, Zheng F, Lu S, Li Y, Xiong Y, Yang Q, Yang Y, Fu P, Xiao F, Wang X. The Phosphodiesterase 10A Inhibitor PF-2545920 Enhances Hippocampal Excitability and Seizure Activity Involving the Upregulation of GluA1 and NR2A in Post-synaptic Densities. Front Mol Neurosci 2017; 10:100. [PMID: 28439226 PMCID: PMC5383654 DOI: 10.3389/fnmol.2017.00100] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/23/2017] [Indexed: 12/16/2022] Open
Abstract
Phosphodiesterase regulates the homeostasis of cAMP and cGMP, which increase the strength of excitatory neural circuits and/or decrease inhibitory synaptic plasticity. Abnormally, synchronized synaptic transmission in the brain leads to seizures. A phosphodiesterase 10A (PDE10A) inhibitor PF-2545920 has recently attracted attention as a potential therapy for neurological and psychiatric disorders. We hypothesized that PF-2545920 plays an important role in status epilepticus (SE) and investigated the underlying mechanisms. PDE10A was primarily located in neurons, and PDE10A expression increased significantly in patients with temporal lobe epilepsy. PF-2545920 enhanced the hyperexcitability of pyramidal neurons in rat CA1, as measured by the frequency of action potentials and miniature excitatory post-synaptic current. GluA1 and NR2A expression also increased significantly in post-synaptic densities, with or without SE in rats treated with PF-2545920. The ratio of p-GluA1/GluA1 increased in the presence of PF-2545920 in groups with SE. Our results suggest that PF-2545920 facilitates seizure activity via the intracellular redistribution of GluA1 and NR2A in the hippocampus. The upregulation of p-GluA1 may play an important role in trafficking GluA1 to post-synaptic densities. The data suggest it would be detrimental to use the drug in seizure patients and might cause neuronal hyperexcitability in non-epileptic individuals.
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Affiliation(s)
- Yanke Zhang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
| | - Baobing Gao
- Department of Neurology, Chongqing General HospitalChongqing, China
| | - Fangshuo Zheng
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
| | - Shanshan Lu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
| | - Yun Li
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
| | - Yan Xiong
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
| | - Qin Yang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
| | - Yong Yang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
| | - Pengfei Fu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
| | - Fei Xiao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
| | - Xuefeng Wang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China.,Center of Epilepsy, Beijing Institute for Brain DisordersBeijing, China.,Chongqing Key Laboratory of NeurologyChongqing, China
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8
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Lykens NM, Coughlin DJ, Reddi JM, Lutz GJ, Tallent MK. AMPA GluA1-flip targeted oligonucleotide therapy reduces neonatal seizures and hyperexcitability. PLoS One 2017; 12:e0171538. [PMID: 28178321 PMCID: PMC5298276 DOI: 10.1371/journal.pone.0171538] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 01/23/2017] [Indexed: 12/24/2022] Open
Abstract
Glutamate-activated α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPA-Rs) mediate the majority of excitatory neurotransmission in brain and thus are major drug targets for diseases associated with hyperexcitability or neurotoxicity. Due to the critical nature of AMPA-Rs in normal brain function, typical AMPA-R antagonists have deleterious effects on cognition and motor function, highlighting the need for more precise modulators. A dramatic increase in the flip isoform of alternatively spliced AMPA-R GluA1 subunits occurs post-seizure in humans and animal models. GluA1-flip produces higher gain AMPA channels than GluA1-flop, increasing network excitability and seizure susceptibility. Splice modulating oligonucleotides (SMOs) bind to pre-mRNA to influence alternative splicing, a strategy that can be exploited to develop more selective drugs across therapeutic areas. We developed a novel SMO, GR1, which potently and specifically decreased GluA1-flip expression throughout the brain of neonatal mice lasting at least 60 days after single intracerebroventricular injection. GR1 treatment reduced AMPA-R mediated excitatory postsynaptic currents at hippocampal CA1 synapses, without affecting long-term potentiation or long-term depression, cellular models of memory, or impairing GluA1-dependent cognition or motor function in mice. Importantly, GR1 demonstrated anti-seizure properties and reduced post-seizure hyperexcitability in neonatal mice, highlighting its drug candidate potential for treating epilepsies and other neurological diseases involving network hyperexcitability.
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Affiliation(s)
- Nicole M. Lykens
- Graduate Program in Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- LifeSplice Pharma, Malvern, Pennsylvania, United States of America
| | - David J. Coughlin
- Department of Biology, Widener University, Chester, Pennsylvania, United States of America
| | - Jyoti M. Reddi
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Gordon J. Lutz
- LifeSplice Pharma, Malvern, Pennsylvania, United States of America
- Department of Biochemistry and Molecular Biology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Melanie K. Tallent
- LifeSplice Pharma, Malvern, Pennsylvania, United States of America
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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10
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Remen L, Bezençon O, Simons L, Gaston R, Downing D, Gatfield J, Roch C, Kessler M, Mosbacher J, Pfeifer T, Grisostomi C, Rey M, Ertel EA, Moon R. Preparation, Antiepileptic Activity, and Cardiovascular Safety of Dihydropyrazoles as Brain-Penetrant T-Type Calcium Channel Blockers. J Med Chem 2016; 59:8398-411. [DOI: 10.1021/acs.jmedchem.6b00756] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Lubos Remen
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Olivier Bezençon
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Lloyd Simons
- Kalexsyn, Inc., 4502 Campus Drive, Kalamazoo, Michigan 49008, United States
| | - Rick Gaston
- Kalexsyn, Inc., 4502 Campus Drive, Kalamazoo, Michigan 49008, United States
| | - Dennis Downing
- Kalexsyn, Inc., 4502 Campus Drive, Kalamazoo, Michigan 49008, United States
| | - John Gatfield
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Catherine Roch
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Melanie Kessler
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Johannes Mosbacher
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Thomas Pfeifer
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Corinna Grisostomi
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Markus Rey
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Eric A. Ertel
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
| | - Richard Moon
- Drug
Discovery Chemistry, Biology and Pharmacology, Actelion Pharmaceuticals Ltd., Gewerbestrasse 16, CH-4123 Allschwil, Switzerland
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Rudzinski LA, Vélez-Ruiz NJ, Gedzelman ER, Mauricio EA, Shih JJ, Karakis I. New antiepileptic drugs: focus on ezogabine, clobazam, and perampanel. J Investig Med 2016; 64:1087-101. [DOI: 10.1136/jim-2016-000151] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 12/17/2022]
Abstract
Ezogabine, clobazam, and perampanel are among the newest antiseizure drugs approved by the Food and Drug Administration between 2011 and 2012. Ezogabine and perampanel are approved for adjunctive treatment of partial epilepsy. Perampanel is also approved for adjunctive treatment of primary generalized tonic–clonic seizures. Ezogabine and perampanel have novel mechanisms of action. Ezogabine binds to voltage-gated potassium channels and increases the M-current thereby causing membrane hyperpolarization. Perampanel is a selective, non-competitive 2-amino-3-(3-hydroxy-5-methyl-isoxazol-4-yl)propanoic acid receptor antagonist, which reduces neuronal excitation. Clobazam has been used worldwide since the 1970s and is approved for adjunctive treatment of seizures associated with Lennox-Gastaut syndrome. Clobazam is the only 1,5-benzodiazepine currently in clinical use, which is less sedating than the commonly used 1,4-benzodiazepines. Phase III multicenter, randomized, double-blind, placebo-controlled trials demonstrated efficacy and good tolerability of these 3 new antiepileptic drugs. These drugs represent a welcome addition to the armamentarium of practitioners, but it remains to be seen how they will affect the landscape of pharmacoresistant epilepsy.
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12
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Do traditional anti-seizure drugs have a future? A review of potential anti-seizure drugs in clinical development. Pharmacol Res 2016; 104:38-48. [DOI: 10.1016/j.phrs.2015.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 12/08/2015] [Accepted: 12/08/2015] [Indexed: 12/11/2022]
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13
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Schulze-Bonhage A. Perampanel for epilepsy with partial-onset seizures: a pharmacokinetic and pharmacodynamic evaluation. Expert Opin Drug Metab Toxicol 2015; 11:1329-37. [DOI: 10.1517/17425255.2015.1061504] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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14
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Zwart R, Sher E, Ping X, Jin X, Sims JR, Chappell AS, Gleason SD, Hahn PJ, Gardinier K, Gernert DL, Hobbs J, Smith JL, Valli SN, Witkin JM. Perampanel, an antagonist of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors, for the treatment of epilepsy: studies in human epileptic brain and nonepileptic brain and in rodent models. J Pharmacol Exp Ther 2014; 351:124-33. [PMID: 25027316 DOI: 10.1124/jpet.114.212779] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Perampanel [Fycompa, 2-(2-oxo-1-phenyl-5-pyridin-2-yl-1,2-dihydropyridin-3-yl)benzonitrile hydrate 4:3; Eisai Inc., Woodcliff Lake, NJ] is an AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptor antagonist used as an adjunctive treatment of partial-onset seizures. We asked whether perampanel has AMPA receptor antagonist activity in both the cerebral cortex and hippocampus associated with antiepileptic efficacy and also in the cerebellum associated with motor side effects in rodent and human brains. We also asked whether epileptic or nonepileptic human cortex is similarly responsive to AMPA receptor antagonism by perampanel. In rodent models, perampanel decreased epileptic-like activity in multiple seizure models. However, doses of perampanel that had anticonvulsant effects were within the same range as those engendering motor side effects. Perampanel inhibited native rat and human AMPA receptors from the hippocampus as well as the cerebellum that were reconstituted into Xenopus oocytes. In addition, with the same technique, we found that perampanel inhibited AMPA receptors from hippocampal tissue that had been removed from a patient who underwent surgical resection for refractory epilepsy. Perampanel inhibited AMPA receptor-mediated ion currents from all the tissues investigated with similar potency (IC50 values ranging from 2.6 to 7.0 μM). Cortical slices from the left temporal lobe derived from the same patient were studied in a 60-microelectrode array. Large field potentials were evoked on at least 45 channels of the array, and 10 μM perampanel decreased their amplitude and firing rate. Perampanel also produced a 33% reduction in the branching parameter, demonstrating the effects of perampanel at the network level. These data suggest that perampanel blocks AMPA receptors globally across the brain to account for both its antiepileptic and side-effect profile in rodents and epileptic patients.
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Affiliation(s)
- R Zwart
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - E Sher
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - X Ping
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - X Jin
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - J R Sims
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - A S Chappell
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - S D Gleason
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - P J Hahn
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - K Gardinier
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - D L Gernert
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - J Hobbs
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - J L Smith
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - S N Valli
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
| | - J M Witkin
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (J.R.S., A.S.C., S.D.G., P.J.H., K.G., D.L.G., S.N.V., J.M.W.); Lilly Research Laboratories, Eli Lilly and Company, Windlesham, Surrey, United Kingdom (R.Z., E.S.); and Indiana University/Purdue University, Riley Hospital, Indianapolis, Indiana (X.P., X.J., J.H., J.L.S.)
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Miziak B, Chrościńska-Krawczyk M, Błaszczyk B, Radzik I, Czuczwar SJ. Novel approaches to anticonvulsant drug discovery. Expert Opin Drug Discov 2013; 8:1415-27. [DOI: 10.1517/17460441.2013.837047] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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