Aujla Paven K, Fetell Michael R, Jensen Frances E
Department of Neurology, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
Epilepsia. 2009 Apr;50(4):694-701. doi: 10.1111/j.1528-1167.2008.01947.x. Epub 2009 Feb 12.
To test the efficacy of the novel candidate anticonvulsant talampanel (GYKI 53773) in a rodent model of hypoxic neonatal seizures. Talampanel is a noncompetitive antagonist of the alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid subtype of the glutamate receptor (AMPAR). We have previously shown that AMPARs play a critical role in the generation of acute seizures and later-life seizure susceptibility in this model of neonatal seizures.
Seizures were induced in postnatal day (P) 10 Long-Evans rat pups by a 15 min exposure to global hypoxia. Acute seizure activity at P10 and subsequent susceptibility to seizure-induced neuronal injury with a "second-hit" kainate-induced seizure at P30-31 were compared between animals receiving talampanel (1, 5, 7.5, or 10 mg/kg) intraperitoneally (i.p.) versus saline vehicle treatment.
Talampanel treatment suppressed seizures in a dose-dependent manner, with maximal effect at 7.5 and 10 mg/kg. In addition, talampanel treatment 30 min before hypoxia prevented later-life increases in seizure-induced neuronal injury as assessed by in situ DNA nick end-labeling (ISEL).
We have previously demonstrated efficacy of other AMPAR antagonists such as NBQX and topiramate in this model. The present finding shows that the novel agent talampanel, under evaluation as an antiepileptic drug in children and adults, may have clinical potential in the treatment of neonatal seizures, particularly those occurring in the context of hypoxic encephalopathy.
在新生大鼠缺氧性癫痫发作的啮齿动物模型中测试新型候选抗惊厥药物他拉喷酯(GYKI 53773)的疗效。他拉喷酯是谷氨酸受体(AMPAR)的α-氨基-3-羟基-5-甲基-4-异恶唑丙酸亚型的非竞争性拮抗剂。我们之前已经表明,在这种新生儿癫痫发作模型中,AMPAR在急性癫痫发作的发生以及后期癫痫易感性方面起着关键作用。
通过15分钟的全身性缺氧诱导出生后第10天(P10)的Long-Evans大鼠幼崽发生癫痫发作。比较腹腔注射(i.p.)他拉喷酯(1、5、7.5或10mg/kg)与生理盐水对照处理的动物在P10时的急性癫痫发作活动,以及随后在P30 - 31时对“二次打击”即由海藻酸诱导的癫痫发作所导致的神经元损伤的易感性。
他拉喷酯治疗以剂量依赖性方式抑制癫痫发作,在7.5和10mg/kg时效果最佳。此外,在缺氧前30分钟进行他拉喷酯治疗可预防后期癫痫发作诱导的神经元损伤增加,这通过原位DNA缺口末端标记(ISEL)进行评估。
我们之前已经证明其他AMPAR拮抗剂如NBQX和托吡酯在该模型中的疗效。目前的研究结果表明,正在作为儿童和成人抗癫痫药物进行评估的新型药物他拉喷酯,在治疗新生儿癫痫发作,特别是在缺氧性脑病背景下发生的癫痫发作方面可能具有临床潜力。