Department of Neurology, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
Department of Pediatrics, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
Epilepsia. 2015 Sep;56(9):1355-65. doi: 10.1111/epi.13098. Epub 2015 Aug 6.
To determine if the activity-dependent trafficking of γ2 subunit-containing γ-aminobutyric acid type A receptors (GABAA Rs) that has been observed in older animals and posited to contribute to benzodiazepine pharmacoresistance during status epilepticus (SE) is age-dependent, and to evaluate whether blockade of protein phosphatases can inhibit or reverse the activity-dependent plasticity of these receptors.
The efficacy and potency of diazepam 0.2-10 mg/kg administered 3 or 60 min after the onset of a lithium/pilocarpine-induced seizure in postnatal day 15-16 rats was evaluated using video-electroencephalography (EEG) recordings. The surface expression of γ2 subunit-containing GABAA Rs was assessed using a biotinylation assay, and GABAA R-mediated miniature inhibitory postsynaptic currents (mIPSCs) were recorded using whole-cell patch-clamp recording techniques from dentate granule cells in hippocampal slices acutely obtained 60 min after seizure onset (SE-treated). The effect of the protein phosphatase inhibitors FK506 and okadaic acid (OA) on the surface expression of these receptors was determined in organotypic slice cultures exposed to high potassium and N-methyl-d-aspartate (NMDA) or in SE-treated slices.
Diazepam terminated seizures of 3 min but not 60 min duration, even at the highest dose. In the SE-treated slices, the surface expression of γ2 subunit-containing GABAA Rs was reduced and the amplitude of the mIPSCs was diminished. Inhibition of protein phosphatases prevented the activity-induced reduction of the γ2 subunit-containing GABAA Rs in organotypic slice cultures. Furthermore, treatment of SE-treated slices with FK506 or OA restored the surface expression of the γ2 subunit-containing GABAA Rs and the mIPSC amplitude.
This study demonstrates that the plasticity of γ2 subunit-containing GABAA Rs associated with the development of benzodiazepine resistance in young and adult animals is similar. The findings of this study suggest that the mechanisms regulating the activity-dependent trafficking of GABAA Rs during SE can be targeted to develop novel adjunctive therapy for the treatment of benzodiazepine-refractory SE.
确定在老年动物中观察到的 γ2 亚基 GABA A 型受体(GABAA Rs)的活性依赖性转运是否与癫痫持续状态(SE)期间苯二氮䓬类药物耐药性有关,并评估蛋白磷酸酶的阻断是否可以抑制或逆转这些受体的活性依赖性可塑性。
通过视频脑电图(EEG)记录评估在出生后 15-16 天的大鼠锂/匹罗卡品诱导的癫痫发作开始后 3 或 60 分钟给予地西泮 0.2-10mg/kg 的疗效和效力。使用生物素化测定法评估 γ2 亚基 GABA A Rs 的表面表达,并且使用全细胞膜片钳记录技术从海马切片中记录 GABAA R 介导的微小抑制性突触后电流(mIPSCs),该海马切片在癫痫发作开始后 60 分钟(SE 处理)急性获得。在暴露于高钾和 N-甲基-D-天冬氨酸(NMDA)或 SE 处理的切片中的器官型切片培养物中,确定蛋白磷酸酶抑制剂 FK506 和 okadaic 酸(OA)对这些受体的表面表达的影响。
地西泮终止了持续 3 分钟但不持续 60 分钟的发作,即使在最高剂量下也是如此。在 SE 处理的切片中,γ2 亚基 GABA A Rs 的表面表达减少,mIPSCs 的幅度减小。蛋白磷酸酶的抑制作用可防止活性诱导的器官型切片培养物中 γ2 亚基 GABA A Rs 的减少。此外,FK506 或 OA 处理 SE 处理的切片可恢复 γ2 亚基 GABA A Rs 的表面表达和 mIPSC 幅度。
本研究表明,与年轻和成年动物中苯二氮䓬类药物耐药性发展相关的 γ2 亚基 GABA A Rs 的可塑性相似。本研究的结果表明,可以针对 SE 期间 GABA A Rs 的活性依赖性转运的调节机制来开发新的辅助治疗苯二氮䓬难治性 SE 的方法。