Department of Physiology, Ajou University School of Medicine, Suwon, Republic of Korea; Chronic Inflammatory Disease Research Center, Ajou University School of Medicine, Suwon, Republic of Korea.
Exp Neurol. 2013 Nov;249:95-103. doi: 10.1016/j.expneurol.2013.08.014. Epub 2013 Sep 1.
The immature brain is prone to seizure; however, the mechanism underlying this vulnerability has not been clarified. Febrile seizure is common in young children, and the use of non-steroidal anti-inflammatory drugs for febrile seizure is not recommended. In previous studies, we established that prostaglandin (PG) F2α, a product of cyclooxygenase (COX), acts as an endogenous anticonvulsant in the adult mouse. Therefore, we assumed that COX-2 activity was involved with seizure susceptibility in early life. In the present study, immature mice (postnatal day 9) were far more prone to kainic acid (KA)-induced seizures than mature mice (after postnatal day 35). Seizure activity began later in immature mice, but was more severe and was unaffected by a potent COX inhibitor, indomethacin; in contrast, indomethacin aggravated seizure activity in mature mice. Immature mouse brains exhibited little basal COX-2 expression and little KA-induced COX-2 induction, while KA-induced COX-2 expression and PGF2α release were prominent in mature brains. During brain development, COX expression was increased and glycosylated in an age-dependent manner, which was necessary for COX enzyme activity. Intracisternal PGF2α administration also reduced KA-induced seizure activity and mortality. Taken together, low COX activity and the resulting deficiency of PGF2α may be an essential cause of increased seizure susceptibility in the immature brain.
不成熟的大脑容易发生癫痫发作;然而,这种脆弱性的机制尚未阐明。热性惊厥在幼儿中很常见,不建议使用非甾体抗炎药治疗热性惊厥。在之前的研究中,我们发现前列腺素(PG)F2α是环氧化酶(COX)的产物,在成年小鼠中作为内源性抗惊厥剂发挥作用。因此,我们假设 COX-2 活性与生命早期的癫痫易感性有关。在本研究中,与成熟小鼠(出生后第 35 天以后)相比,不成熟小鼠(出生后第 9 天)更容易发生海人酸(KA)诱导的癫痫发作。不成熟小鼠的癫痫发作活动开始较晚,但更为严重,且不受强效 COX 抑制剂吲哚美辛的影响;相比之下,吲哚美辛加重了成熟小鼠的癫痫发作活动。不成熟小鼠大脑中的基础 COX-2 表达和 KA 诱导的 COX-2 诱导较少,而成熟大脑中则存在明显的 KA 诱导的 COX-2 表达和 PGF2α 释放。在脑发育过程中,COX 表达以年龄依赖的方式增加和糖基化,这对于 COX 酶活性是必要的。脑室内给予 PGF2α 也可降低 KA 诱导的癫痫发作活动和死亡率。总之,低 COX 活性和由此导致的 PGF2α 缺乏可能是不成熟大脑中癫痫易感性增加的一个重要原因。