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Serrano-Castro PJ, Rodríguez-Uranga JJ, Cabezudo-García P, García-Martín G, Romero-Godoy J, Estivill-Torrús G, Ciano-Petersen NL, Oliver B, Ortega-Pinazo J, López-Moreno Y, Aguilar-Castillo MJ, Gutierrez-Cardo AL, Ramírez-García T, Sanchez-Godoy L, Carreño M. Cenobamate and Clobazam Combination as Personalized Medicine in Autoimmune-Associated Epilepsy With Anti-Gad65 Antibodies. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2023; 10:e200151. [PMID: 37607753 PMCID: PMC10443460 DOI: 10.1212/nxi.0000000000200151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/09/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Autoimmune-associated epilepsy (AAE) with antiglutamic acid decarboxylase 65 (GAD65) antibodies is considered a T-cell-mediated encephalitis that evolves to drug-resistant epilepsy. We do not have an effective therapeutic strategy for these patients. Because the GAD enzyme is primarily responsible for the conversion of glutamate to GABA, the mechanism of epileptogenesis in this condition predicts decreased levels of GABA content in synaptic vesicles. Cenobamate (CNB) acts as a positive allosteric modulator at synaptic and extra synaptic GABAA receptors, producing increased inhibitory neurotransmission in the brain. This mechanism could be especially beneficial in AAE with anti-GAD65 antibodies because it would be able to correct the imbalance due to the GABAergic stimulation deficit in postsynaptic neurons. METHODS We recruit a retrospective multicentric consecutive case series of AAE with anti-GAD65 antibodies from 5 epilepsy units in Spain who have received treatment with CNB. RESULTS A total of 8 patients were recruited. This cohort of highly refractory patients have failed a mean of 9.50 (SD = 3.20) ASM without control of seizures for sustained periods of time. The average number of seizures per month during the previous 3 months before CNB treatment was 19.63 (SD = 17.03). After the introduction of CNB improvement was achieved in all our patients, with a median reduction in the number of seizures of 92.22% (interquartile range [IQR]: 57.25-98.75). The mean follow-up was 156.75 days (SD = 68.23). In patients with concomitant treatment with clobazam (CLB), the median percentage of seizure reduction was higher than those not taking CLB: 94.72% (IQR: 87.25-100) vs 41.50% (p = 0.044) and also higher than the control group of patients with refractory epilepsy not related to anti-GAD65 treated with the same combination: 94.72% (IQR: 87.25-100) vs 45.00% (IQR: 25.00-87.00) (p = 0.019). DISCUSSION Treatment with the combination CNB + CLB could be a type of personalized medicine in patients with AAE with anti-GAD65. Our preliminary data will need to be endorsed with new prospective and controlled studies.
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Affiliation(s)
- Pedro J Serrano-Castro
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain.
| | - Juan J Rodríguez-Uranga
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Pablo Cabezudo-García
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain.
| | - Guillermina García-Martín
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Jorge Romero-Godoy
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Guillermo Estivill-Torrús
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Nicolás Lundahl Ciano-Petersen
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Begoña Oliver
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Jesús Ortega-Pinazo
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Yolanda López-Moreno
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Maria J Aguilar-Castillo
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Antonio L Gutierrez-Cardo
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Teresa Ramírez-García
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Lorenzo Sanchez-Godoy
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
| | - Mar Carreño
- From the Epilepsy Unit, Regional University Hospital of Málaga (P.J.S.-C., P.C.-G., G.G.-M., Y.L.-M); Institute for Biomedical Research of Málaga (IBIMA-Plataforma Bionand), Málaga (P.J.S.-C., P.C.-G., G.G.-M., N.L.C.-P., B.O., G.E.-T., J.O.-P., T.R.-G., L.S.-G.); Andalusian Network for Clinical and Translational Research in Neurology (Neuro-RECA), Spain (P.J.S.-C., J.J.R.-U., P.C.-G., G.G.-M., B.O.) University of Málaga (P.J.S.-C., B.O.); Vithas Hospital of Málaga, Spain (P.J.S.-C., P.C.-G.); Epilepsy Unit, Center for Avanced Neurology of Seville (J.J.R.-U.); Epilepsy Unit, Virgen de la Victoria University Hospital of Málaga (J.R.-G.), Biotechnology Unit, Regional University Hospital of Málaga (M.J.A.-C., L.S.-G.); Nuclear Medicina Unit, Regional University Hospital of Málaga (A.L.G.-C.); Epilepsy Unit, Clinic Hospital of Barcelona (M.C.), August Pi i Sunyer Biomedical Research Institute, Barcelona (M.C.), European Reference Network for Rare and Complex Epilepsies (EPICARE) (M.C.), Spain
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Scalise S, Zannino C, Lucchino V, Lo Conte M, Scaramuzzino L, Cifelli P, D’Andrea T, Martinello K, Fucile S, Palma E, Gambardella A, Ruffolo G, Cuda G, Parrotta EI. Human iPSC Modeling of Genetic Febrile Seizure Reveals Aberrant Molecular and Physiological Features Underlying an Impaired Neuronal Activity. Biomedicines 2022; 10:biomedicines10051075. [PMID: 35625812 PMCID: PMC9138645 DOI: 10.3390/biomedicines10051075] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 02/01/2023] Open
Abstract
Mutations in SCN1A gene, encoding the voltage-gated sodium channel (VGSC) NaV1.1, are widely recognized as a leading cause of genetic febrile seizures (FS), due to the decrease in the Na+ current density, mainly affecting the inhibitory neuronal transmission. Here, we generated induced pluripotent stem cells (iPSCs)-derived neurons (idNs) from a patient belonging to a genetically well-characterized Italian family, carrying the c.434T > C mutation in SCN1A gene (hereafter SCN1AM145T). A side-by-side comparison of diseased and healthy idNs revealed an overall maturation delay of SCN1AM145T cells. Membranes isolated from both diseased and control idNs were injected into Xenopus oocytes and both GABA and AMPA currents were successfully recorded. Patch-clamp measurements on idNs revealed depolarized action potential for SCN1AM145T, suggesting a reduced excitability. Expression analyses of VGSCs and chloride co-transporters NKCC1 and KCC2 showed a cellular “dysmaturity” of mutated idNs, strengthened by the high expression of SCN3A, a more fetal-like VGSC isoform, and a high NKCC1/KCC2 ratio, in mutated cells. Overall, we provide strong evidence for an intrinsic cellular immaturity, underscoring the role of mutant NaV1.1 in the development of FS. Furthermore, our data are strengthening previous findings obtained using transfected cells and recordings on human slices, demonstrating that diseased idNs represent a powerful tool for personalized therapy and ex vivo drug screening for human epileptic disorders.
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Affiliation(s)
- Stefania Scalise
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.S.); (C.Z.); (V.L.); (M.L.C.); (L.S.)
| | - Clara Zannino
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.S.); (C.Z.); (V.L.); (M.L.C.); (L.S.)
| | - Valeria Lucchino
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.S.); (C.Z.); (V.L.); (M.L.C.); (L.S.)
| | - Michela Lo Conte
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.S.); (C.Z.); (V.L.); (M.L.C.); (L.S.)
| | - Luana Scaramuzzino
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.S.); (C.Z.); (V.L.); (M.L.C.); (L.S.)
| | - Pierangelo Cifelli
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of Aquila, 67100 Aquila, Italy;
| | - Tiziano D’Andrea
- Department of Physiology and Pharmacology, University of Rome, Sapienza, P.le Aldo Moro, 5, 00185 Rome, Italy; (T.D.); (S.F.); (E.P.)
| | | | - Sergio Fucile
- Department of Physiology and Pharmacology, University of Rome, Sapienza, P.le Aldo Moro, 5, 00185 Rome, Italy; (T.D.); (S.F.); (E.P.)
- IRCCS Neuromed, Via Atinense, 86077 Pozzilli, Italy;
| | - Eleonora Palma
- Department of Physiology and Pharmacology, University of Rome, Sapienza, P.le Aldo Moro, 5, 00185 Rome, Italy; (T.D.); (S.F.); (E.P.)
| | - Antonio Gambardella
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (A.G.); (E.I.P.)
| | - Gabriele Ruffolo
- Department of Physiology and Pharmacology, University of Rome, Sapienza, P.le Aldo Moro, 5, 00185 Rome, Italy; (T.D.); (S.F.); (E.P.)
- IRCCS San Raffaele Roma, Via della Pisana, 00163 Rome, Italy
- Correspondence: (G.R.); (G.C.)
| | - Giovanni Cuda
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (S.S.); (C.Z.); (V.L.); (M.L.C.); (L.S.)
- Correspondence: (G.R.); (G.C.)
| | - Elvira Immacolata Parrotta
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100 Catanzaro, Italy; (A.G.); (E.I.P.)
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