Drion Cato M, Borm Lars E, Kooijman Lieneke, Aronica Eleonora, Wadman Wytse J, Hartog Aloysius F, van Vliet Erwin A, Gorter Jan A
Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands.
Department (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Epilepsia. 2016 May;57(5):688-97. doi: 10.1111/epi.13345. Epub 2016 Feb 29.
Inhibition of the mammalian target of rapamycin (mTOR) pathway has been suggested as a possible antiepileptogenic strategy in temporal lobe epilepsy (TLE). Here we aim to elucidate whether mTOR inhibition has antiepileptogenic and/or antiseizure effects using different treatment strategies in the electrogenic post-status epilepticus (SE) rat model.
Effects of mTOR inhibitor rapamycin were tested using the following three treatment protocols: (1) "stop-treatment"-post-SE treatment (6 mg/kg/day) was discontinued after 3 weeks; rats were monitored for 5 more weeks thereafter, (2) "pretreatment"-rapamycin (3 mg/kg/day) was applied during 3 days preceding SE; and (3) "chronic phase-treatment"-5 days rapamycin treatment (3 mg/kg/day) in the chronic phase. We also tested curcumin, an alternative mTOR inhibitor with antiinflammatory and antioxidant effects, using chronic phase treatment. Seizures were continuously monitored using video-electroencephalography (EEG) recordings; mossy fiber sprouting, cell death, and inflammation were studied using immunohistochemistry. Blood was withdrawn regularly to assess rapamycin and curcumin levels with high performance liquid chromatography (HPLC).
Stop-treatment led to a strong reduction of seizures during the 3-week treatment and a gradual reappearance of seizures during the following 5 weeks. Three days pretreatment did not prevent seizure development, whereas 5-day rapamycin treatment in the chronic phase reduced seizure frequency. Washout of rapamycin was slow and associated with a gradual reappearance of seizures. Rapamycin treatment (both 3 and 6 mg/kg) led to body growth reduction. Curcumin treatment did not reduce seizure frequency or lead to a decrease in body weight.
The present study indicates that rapamycin cannot prevent epilepsy in the electrical stimulation post-SE rat model but has seizure-suppressing properties as long as rapamycin blood levels are sufficiently high. Oral curcumin treatment had no effect on chronic seizures, possibly because it did not reach the brain at adequate levels.
抑制雷帕霉素哺乳动物靶点(mTOR)通路被认为是颞叶癫痫(TLE)一种可能的抗癫痫发生策略。在此,我们旨在通过在电源性癫痫持续状态(SE)大鼠模型中采用不同治疗策略,阐明mTOR抑制是否具有抗癫痫发生和/或抗惊厥作用。
使用以下三种治疗方案测试mTOR抑制剂雷帕霉素的效果:(1)“停药治疗”——SE后治疗(6mg/kg/天)3周后停药;此后对大鼠再监测5周,(2)“预处理”——在SE前3天应用雷帕霉素(3mg/kg/天);以及(3)“慢性期治疗”——在慢性期进行5天雷帕霉素治疗(3mg/kg/天)。我们还使用慢性期治疗测试了姜黄素,一种具有抗炎和抗氧化作用的替代mTOR抑制剂。使用视频脑电图(EEG)记录持续监测癫痫发作;使用免疫组织化学研究苔藓纤维出芽、细胞死亡和炎症。定期采血,用高效液相色谱(HPLC)评估雷帕霉素和姜黄素水平。
停药治疗导致3周治疗期间癫痫发作明显减少,随后5周内癫痫发作逐渐再次出现。3天预处理未能预防癫痫发作的发生,而慢性期5天雷帕霉素治疗降低了癫痫发作频率。雷帕霉素的洗脱缓慢,且与癫痫发作逐渐再次出现相关。雷帕霉素治疗(3mg/kg和6mg/kg)均导致体重增长减少。姜黄素治疗未降低癫痫发作频率,也未导致体重下降。
本研究表明,雷帕霉素不能预防电刺激SE大鼠模型中的癫痫,但只要雷帕霉素血药水平足够高,就具有抑制癫痫发作的特性。口服姜黄素治疗对慢性癫痫发作无影响,可能是因为它未达到足够的脑内浓度。