Department of Neurology, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, 210029, Nanjing, China.
Curr Neuropharmacol. 2020;18(7):624-635. doi: 10.2174/1570159X18666200128124338.
Although over 25 antiepileptic drugs (AEDs) have become currently available for clinical use, the incidence of epilepsy worldwide and the proportions of drug-resistant epilepsy among them are not significantly reduced during the past decades. Traditional screens for AEDs have been mainly focused on their anti-ictogenic roles, and their efficacies primarily depend on suppressing neuronal excitability or enhancing inhibitory neuronal activity, almost without the influence on the epileptogenesis or with inconsistent results from different studies. Epileptogenesis refers to the pathological process of a brain from its normal status to the alterations with the continuous prone of unprovoked spontaneous seizures after brain insults, such as stroke, traumatic brain injury, CNS infectious, and autoimmune disorders, and even some specific inherited conditions. Recently growing experimental and clinical studies have discovered the underlying mechanisms for epileptogenesis, which are multi-aspect and multistep. These findings provide us a number of interesting sites for antiepileptogenic drugs (AEGDs). AEGDs have been evidenced as significantly roles of postponing or completely blocking the development of epilepsy in experimental models. The present review will introduce potential novel candidate drug-targets for AEGDs based on the published studies.
尽管目前已有超过 25 种抗癫痫药物(AEDs)可用于临床,但在过去几十年中,全球癫痫的发病率和其中耐药性癫痫的比例并没有显著降低。传统的 AED 筛选主要集中在它们的抗惊厥作用上,其疗效主要取决于抑制神经元兴奋性或增强抑制性神经元活动,几乎没有对癫痫发生的影响,或者不同研究的结果不一致。癫痫发生是指大脑从正常状态到脑损伤后持续易发生自发性无诱因癫痫发作的改变的病理过程,如中风、创伤性脑损伤、中枢神经系统感染和自身免疫性疾病,甚至一些特定的遗传性疾病。最近越来越多的实验和临床研究发现了癫痫发生的潜在机制,这些机制具有多方面和多步骤的特点。这些发现为我们提供了一些有趣的抗癫痫发生药物(AEGDs)的作用靶点。在实验模型中,AEGDs 已被证明具有推迟或完全阻止癫痫发展的显著作用。本综述将根据已发表的研究,介绍 AEGDs 的潜在新型候选药物靶点。