Gözüaçık Neriman, Türkmen Aslı Zengin, Nurten Asiye, Enginar Nurhan
Department of Medical Pharmacology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Department of Physiology, Faculty of Medicine, Istanbul Yeni Yuzyil University, Istanbul, Turkey.
Iran J Basic Med Sci. 2019 Mar;22(3):310-314. doi: 10.22038/ijbms.2019.33890.8062.
Fasted rodents treated with antimuscarinics develop convulsions after refeeding. Food deprivation for 48 hr produces changes in [3H]glutamate binding suggesting glutamatergic contribution to the underlying mechanism of the seizures that are somewhat unresponsive to antiepileptics. Studies in animals and epileptic patients yielded considerable information regarding the anticonvulsant effect of the noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist ketamine. Thus, this study evaluated the efficacy of ketamine and its combinations with valproate and carbamazepine on convulsions in fasted animals.
Following 24 hr of fasting, mice were given saline, 5 or 10 mg/kg ketamine, 250 mg/kg sodium valproate, 24 mg/kg carbamazepine, 5 mg/kg ketamine+sodium valproate, or 5 mg/kg ketamine+carbamazepine and then were treated with saline or 2.4 mg/kg atropine (5-9 mice per group). The animals were observed for the occurrence of convulsions after being allowed to eat
Ketamine, valproate and carbamazepine pretreatments were ineffective in preventing the convulsions developed after atropine treatment and food intake in fasted animals. The incidence of convulsions was significantly higher in 5 and 10 mg/kg ketamine, carbamazepine, and carbamazepine+ketamine groups, but not in the valproate and valproate+ketamine treated animals.
In contrast to previous findings obtained with the NMDA antagonist dizocilpine (MK-801), ketamine lacks activity against convulsions developed after fasting. The drug does not enhance the efficacy of valproate and carbamazepine either. Using different doses of ketamine or other NMDA antagonists, further studies may better clarify the anticonvulsant effect of ketamine and/or role of glutamate in these seizures.
用抗毒蕈碱药治疗的禁食啮齿动物在重新进食后会发生惊厥。禁食48小时会导致[3H]谷氨酸结合发生变化,提示谷氨酸能在癫痫发作的潜在机制中起作用,而癫痫发作对抗癫痫药有些无反应。对动物和癫痫患者的研究产生了大量关于非竞争性N-甲基-D-天冬氨酸(NMDA)受体拮抗剂氯胺酮抗惊厥作用的信息。因此,本研究评估了氯胺酮及其与丙戊酸盐和卡马西平联合使用对禁食动物惊厥的疗效。
禁食24小时后,给小鼠注射生理盐水、5或10mg/kg氯胺酮、250mg/kg丙戊酸钠、24mg/kg卡马西平、5mg/kg氯胺酮+丙戊酸钠或5mg/kg氯胺酮+卡马西平,然后用生理盐水或2.4mg/kg阿托品治疗(每组5-9只小鼠)。让动物进食后观察惊厥的发生情况。
氯胺酮、丙戊酸盐和卡马西平预处理在预防禁食动物阿托品治疗和进食后发生的惊厥方面无效。5和10mg/kg氯胺酮、卡马西平以及卡马西平+氯胺酮组惊厥发生率显著更高,但丙戊酸盐和丙戊酸盐+氯胺酮治疗的动物中未出现这种情况。
与之前使用NMDA拮抗剂地佐环平(MK-801)获得的结果相反,氯胺酮对禁食后发生的惊厥缺乏活性。该药物也不会增强丙戊酸盐和卡马西平的疗效。使用不同剂量的氯胺酮或其他NMDA拮抗剂,进一步的研究可能会更好地阐明氯胺酮的抗惊厥作用和/或谷氨酸在这些癫痫发作中的作用。