Laboratory for Neurotherapeutics, Department of Neurology, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea.
PLoS One. 2014 Jan 15;9(1):e85617. doi: 10.1371/journal.pone.0085617. eCollection 2014.
Pharmacoresistance is a major issue in the treatment of epilepsy. However, the mechanism underlying pharmacoresistance to antiepileptic drugs (AEDs) is still unclear, and few animal models have been established for studying drug resistant epilepsy (DRE). In our study, spontaneous recurrent seizures (SRSs) were investigated by video-EEG monitoring during the entire procedure.
METHODS/PRINCIPAL FINDINGS: In the mouse pilocarpine-induced epilepsy model, we administered levetiracetam (LEV) and valproate (VPA) in sequence. AED-responsive and AED-resistant mice were naturally selected after 7-day treatment of LEV and VPA. Behavioral tests (open field, object exploration, elevated plus maze, and light-dark transition test) and a microRNA microarray test were performed. Among the 37 epileptic mice with SRS, 23 showed significantly fewer SRSs during administration of LEV (n = 16, LEV sensitive (LS) group) or VPA (n = 7, LEV resistant/VPA sensitive (LRVS) group), while 7 epileptic mice did not show any amelioration with either of the AEDs (n = 7, multidrug resistant (MDR) group). On the behavioral assessment, MDR mice displayed distinctive behaviors in the object exploration and elevated plus maze tests, which were not observed in the LS group. Expression of miRNA was altered in LS and MDR groups, and we identified 4 miRNAs (miR-206, miR-374, miR-468, and miR-142-5p), which were differently modulated in the MDR group versus both control and LS groups.
This is the first study to identify a pharmacoresistant subgroup, resistant to 2 AEDs, in the pilocarpine-induced epilepsy model. We hypothesize that modulation of the identified miRNAs may play a key role in developing pharmacoresistance and behavioral alterations in the MDR group.
抗药性是癫痫治疗中的一个主要问题。然而,抗癫痫药物(AEDs)耐药的机制仍不清楚,并且很少有动物模型被建立来研究耐药性癫痫(DRE)。在我们的研究中,通过视频-EEG 监测在整个过程中研究了自发性复发发作(SRS)。
方法/主要发现:在小鼠匹鲁卡品诱导的癫痫模型中,我们先后给予左乙拉西坦(LEV)和丙戊酸(VPA)。在 LEV 和 VPA 治疗 7 天后,自然选择出 AED 反应性和 AED 耐药性的小鼠。进行了行为测试(旷场、物体探索、高架十字迷宫和明暗过渡测试)和 microRNA 微阵列测试。在 37 只有 SRS 的癫痫小鼠中,23 只在 LEV(n=16,LEV 敏感(LS)组)或 VPA(n=7,LEV 耐药/丙戊酸敏感(LRVS)组)治疗期间 SRS 明显减少,而 7 只癫痫小鼠对任何一种 AED 都没有改善(n=7,多药耐药(MDR)组)。在行为评估中,MDR 小鼠在物体探索和高架十字迷宫测试中表现出独特的行为,而 LS 组则没有观察到这些行为。LS 和 MDR 组的 miRNA 表达发生改变,我们发现了 4 种 miRNA(miR-206、miR-374、miR-468 和 miR-142-5p),它们在 MDR 组与对照组和 LS 组的差异表达。
这是首次在匹鲁卡品诱导的癫痫模型中鉴定出一种对 2 种 AED 耐药的耐药亚组。我们假设,鉴定出的 miRNA 的调节可能在 MDR 组的耐药性和行为改变中发挥关键作用。