Advances in understanding the pathogenesis of post-traumatic epilepsy: a literature review

Targeted Pyroptosis with Resveratrol Nanoparticles to Reduce Secondary Brain Injury and Post-Traumatic Epilepsy

Traumatic brain injury (TBI) is associated with high mortality and disability rates globally, leading to significant sequelae, particularly post-traumatic epilepsy (PTE), which severely impacts physical health and quality of life. TBI involves primary and secondary damage, with the latter exacerbating the initial injury through neuroinflammation, influencing the overall outcome. Recent studies highlight pyroptosis as a crucial factor in the spread of secondary brain damage and the development of epilepsy, making it a vital therapeutic target. While current TBI treatments focus on surgical and medical interventions to reduce intracranial pressure, addressing secondary damage has limited clinical translation, largely due to the blood-brain barrier (BBB) hindering drug accumulation in the affected area. Resveratrol (RV) shows promise as a therapeutic agent due to its anti-inflammatory properties. This study presents a nanoliposome (C-Lips/RV) engineered with cysteine-alanine-glutamine-lysine peptides to enhance RV delivery to the brain, mitigate pyroptosis, and reduce inflammation. In TBI rats, C-Lips/RV demonstrates a longer half-life and effective targeting of brain injury, leading to reduced pyroptosis and PTE, slowed secondary damage progression, and improved functional recovery. This work offers insights into managing secondary brain damage and PTE.

Inflammasomes at the crossroads of traumatic brain injury and post-traumatic epilepsy

Post-traumatic epilepsy (PTE) is one of the most debilitating consequences of traumatic brain injury (TBI) and is one of the most drug-resistant forms of epilepsy. Novel therapeutic treatment options are an urgent unmet clinical need. The current focus in healthcare has been shifting to disease prevention, rather than treatment, though, not much progress has been made due to a limited understanding of the disease pathogenesis. Neuroinflammation has been implicated in the pathophysiology of traumatic brain injury and may impact neurological sequelae following TBI including functional behavior and post-traumatic epilepsy development. Inflammasome signaling is one of the major components of the neuroinflammatory response, which is increasingly being explored for its contribution to the epileptogenic mechanisms and a novel therapeutic target against epilepsy. This review discusses the role of inflammasomes as a possible connecting link between TBI and PTE with a particular focus on clinical and preclinical evidence of therapeutic inflammasome targeting and its downstream effector molecules for their contribution to epileptogenesis. Finally, we also discuss emerging evidence indicating the potential of evaluating inflammasome proteins in biofluids and the brain by non-invasive neuroimaging, as potential biomarkers for predicting PTE development.

Mechanisms of 3-Hydroxyl 3-Methylglutaryl CoA Reductase in Alzheimer's Disease

Alzheimer's disease (AD) is the most common neurodegenerative disease worldwide and has a high incidence in the elderly. Unfortunately, there is no effective therapy for AD owing to its complicated pathogenesis. However, the development of lipid-lowering anti-inflammatory drugs has heralded a new era in the treatment of Alzheimer's disease. Several studies in recent years have shown that lipid metabolic dysregulation and neuroinflammation are associated with the pathogenesis of AD. 3-Hydroxyl 3-methylglutaryl CoA reductase (HMGCR) is a rate-limiting enzyme in cholesterol synthesis that plays a key role in cholesterol metabolism. HMGCR inhibitors, known as statins, have changed from being solely lipid-lowering agents to neuroprotective compounds because of their effects on lipid levels and inflammation. In this review, we first summarize the main regulatory mechanism of HMGCR affecting cholesterol biosynthesis. We also discuss the pathogenesis of AD induced by HMGCR, including disordered lipid metabolism, oxidative stress, inflammation, microglial proliferation, and amyloid-β (Aβ) deposition. Subsequently, we explain the possibility of HMGCR as a potential target for AD treatment. Statins-based AD treatment is an ascent field and currently quite controversial; therefore, we also elaborate on the current application prospects and limitations of statins in AD treatment.