Aronica Eleonora, Bauer Sebastian, Bozzi Yuri, Caleo Matteo, Dingledine Raymond, Gorter Jan A, Henshall David C, Kaufer Daniela, Koh Sookyong, Löscher Wolfgang, Louboutin Jean-Pierre, Mishto Michele, Norwood Braxton A, Palma Eleonora, Poulter Michael O, Terrone Gaetano, Vezzani Annamaria, Kaminski Rafal M
Department of (Neuro)Pathology, Academic Medical Center, Amsterdam, The Netherlands.
Swammerdam Institute for Life Sciences, Center for Neuroscience University of Amsterdam, Amsterdam, The Netherlands.
Epilepsia. 2017 Jul;58 Suppl 3(Suppl 3):27-38. doi: 10.1111/epi.13783.
A large body of evidence that has accumulated over the past decade strongly supports the role of inflammation in the pathophysiology of human epilepsy. Specific inflammatory molecules and pathways have been identified that influence various pathologic outcomes in different experimental models of epilepsy. Most importantly, the same inflammatory pathways have also been found in surgically resected brain tissue from patients with treatment-resistant epilepsy. New antiseizure therapies may be derived from these novel potential targets. An essential and crucial question is whether targeting these molecules and pathways may result in anti-ictogenesis, antiepileptogenesis, and/or disease-modification effects. Therefore, preclinical testing in models mimicking relevant aspects of epileptogenesis is needed to guide integrated experimental and clinical trial designs. We discuss the most recent preclinical proof-of-concept studies validating a number of therapeutic approaches against inflammatory mechanisms in animal models that could represent novel avenues for drug development in epilepsy. Finally, we suggest future directions to accelerate preclinical to clinical translation of these recent discoveries.
在过去十年中积累的大量证据有力地支持了炎症在人类癫痫病理生理学中的作用。已确定了特定的炎症分子和途径,它们在不同的癫痫实验模型中影响各种病理结果。最重要的是,在耐药性癫痫患者手术切除的脑组织中也发现了相同的炎症途径。新的抗癫痫疗法可能源于这些新的潜在靶点。一个至关重要的问题是,针对这些分子和途径是否可能产生抗癫痫发生、抗癫痫发作和/或疾病修饰作用。因此,需要在模拟癫痫发生相关方面的模型中进行临床前测试,以指导综合实验和临床试验设计。我们讨论了最近的临床前概念验证研究,这些研究验证了在动物模型中针对炎症机制的多种治疗方法,这些方法可能代表癫痫药物开发的新途径。最后,我们提出了加速这些最新发现从临床前向临床转化的未来方向。