French Jacqueline A, Koepp Matthias, Naegelin Yvonne, Vigevano Federico, Auvin Stéphane, Rho Jong M, Rosenberg Evan, Devinsky Orrin, Olofsson Peder S, Dichter Marc A
Comprehensive Epilepsy Center, NYU Langone School of Medicine, New York City, New York, U.S.A.
Institute of Neurology, University College London, London, United Kingdom.
Epilepsia. 2017 Jul;58 Suppl 3(Suppl 3):69-82. doi: 10.1111/epi.13779.
In this exciting era, we are coming closer and closer to bringing an anti-inflammatory therapy to the clinic for the purpose of seizure prevention, modification, and/or suppression. At present, it is unclear what this approach might entail, and what form it will take. Irrespective of the therapy that ultimately reaches the clinic, there will be some commonalities with regard to clinical trials. A number of animal models have now been used to identify inflammation as a major underlying mechanism of both chronic seizures and the epileptogenic process. These models have demonstrated that specific anti-inflammatory treatments can be effective at both suppressing chronic seizures and interfering with the process of epileptogenesis. Some of these have already been evaluated in early phase clinical trials. It can be expected that there will soon be more clinical trials of both "conventional, broad spectrum" anti-inflammatory agents and novel new approaches to utilizing specific anti-inflammatory therapies with drugs or other therapeutic interventions. A summary of some of those approaches appears below, as well as a discussion of the issues facing clinical trials in this new domain.
在这个激动人心的时代,我们距离将一种抗炎疗法应用于临床以预防、改善和/或抑制癫痫发作越来越近。目前,尚不清楚这种方法具体包括哪些内容,以及会采取何种形式。无论最终进入临床的是何种疗法,在临床试验方面都会有一些共性。现在已经有许多动物模型被用于确定炎症是慢性癫痫发作和癫痫发生过程的主要潜在机制。这些模型表明,特定的抗炎治疗在抑制慢性癫痫发作和干扰癫痫发生过程方面都可能有效。其中一些已经在早期临床试验中得到评估。可以预期,很快将会有更多关于“传统、广谱”抗炎药物以及利用特定抗炎疗法与药物或其他治疗干预措施的新方法的临床试验。以下是其中一些方法的总结,以及对这个新领域临床试验所面临问题的讨论。