在小鼠内侧颞叶癫痫的海马内红藻氨酸模型中,P-糖蛋白基因敲除不会改变抗癫痫药物的疗效。
Knockout of P-glycoprotein does not alter antiepileptic drug efficacy in the intrahippocampal kainate model of mesial temporal lobe epilepsy in mice.
作者信息
Bankstahl Marion, Klein Sabine, Römermann Kerstin, Löscher Wolfgang
机构信息
Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine Hannover, Germany; Center for Systems Neuroscience, Hannover, Germany.
Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine Hannover, Germany; Center for Systems Neuroscience, Hannover, Germany.
出版信息
Neuropharmacology. 2016 Oct;109:183-195. doi: 10.1016/j.neuropharm.2016.06.007. Epub 2016 Jun 7.
Pharmacoresistance to antiepileptic drugs (AEDs) is a major challenge in epilepsy therapy, affecting at least 30% of patients. Thus, there is considerable interest in the mechanisms responsible for such pharmacoresistance, with particular attention on the specific cellular and molecular factors that lead to reduced drug sensitivity. Current hypotheses of refractory epilepsy include the multidrug transporter hypothesis, which posits that increased expression or function of drug efflux transporters, such as P-glycoprotein (Pgp), in brain capillaries reduces the local concentration of AEDs in epileptic brain regions to subtherapeutic levels. In the present study, this hypothesis was addressed by evaluating the efficacy of six AEDs in wildtype and Pgp deficient Mdr1a/b(-/-) mice in the intrahippocampal kainate model of mesial temporal lobe epilepsy. In this model, frequent focal electrographic seizures develop after an initial kainate-induced status epilepticus. These seizures are resistant to major AEDs, but the mechanisms of this resistance are unknown. In the present experiments, the focal nonconvulsive seizures were resistant to carbamazepine and phenytoin, whereas high doses of valproate and levetiracetam exerted moderate and phenobarbital and diazepam marked anti-seizure effects. All AEDs suppressed generalized convulsive seizures. No significant differences between wildtype and Pgp-deficient mice were observed in anti-seizure drug efficacies. Also, the individual responder and nonresponder rates in each experiment did not differ between mouse genotypes. This does not argue against the multidrug transporter hypothesis in general, but indicates that Pgp is not involved in the mechanisms explaining that focal electrographic seizures are resistant to some AEDs in the intrahippocampal mouse model of partial epilepsy. This was substantiated by the finding that epileptic wildtype mice do not exhibit increased Pgp expression in this model.
对抗癫痫药物(AEDs)产生耐药性是癫痫治疗中的一项重大挑战,至少影响30%的患者。因此,人们对导致这种耐药性的机制极为关注,尤其关注导致药物敏感性降低的特定细胞和分子因素。难治性癫痫的当前假说包括多药转运体假说,该假说认为脑毛细血管中药物外排转运体(如P-糖蛋白(Pgp))的表达或功能增加会将癫痫脑区中AEDs的局部浓度降低至亚治疗水平。在本研究中,通过评估六种AEDs在野生型和Pgp缺陷型Mdr1a/b(-/-)小鼠的海马内红藻氨酸颞叶内侧癫痫模型中的疗效来探讨这一假说。在该模型中,最初由红藻氨酸诱导的癫痫持续状态后会频繁出现局灶性脑电图癫痫发作。这些发作对主要的AEDs具有抗性,但其抗性机制尚不清楚。在本实验中,局灶性非惊厥性癫痫发作对卡马西平和苯妥英耐药,而高剂量丙戊酸和左乙拉西坦有中度抗癫痫作用,苯巴比妥和地西泮有显著抗癫痫作用。所有AEDs均能抑制全身性惊厥性癫痫发作。在抗癫痫药物疗效方面,未观察到野生型和Pgp缺陷型小鼠之间存在显著差异。此外,每个实验中个体的反应者和无反应者比率在小鼠基因型之间也没有差异。这总体上并不反对多药转运体假说,但表明在海马内部分癫痫小鼠模型中,Pgp不参与解释局灶性脑电图癫痫发作对某些AEDs耐药的机制。癫痫野生型小鼠在该模型中未表现出Pgp表达增加这一发现证实了这一点。