Epilepsy Therapy Screening Program (ETSP) Contract Site, University of Utah, Salt Lake City, UT, USA.
Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA.
Epilepsia. 2021 Jul;62(7):1665-1676. doi: 10.1111/epi.16925. Epub 2021 May 17.
Dravet syndrome (DS) is a rare but catastrophic genetic epilepsy, with 80% of patients carrying a mutation in the SCN1A gene. Currently, no antiseizure drug (ASD) exists that adequately controls seizures. In the clinic, individuals with DS often present first with a febrile seizure and, subsequently, generalized tonic-clonic seizures that can continue throughout life. To facilitate the development of ASDs for DS, the contract site of the National Institute of Neurological Disorders and Stroke (NINDS) Epilepsy Therapy Screening Program (ETSP) has evaluated a mouse model of DS using the conditional knock-in Scn1a mouse.
Survival rates and temperature thresholds for Scn1a were determined. Prototype ASDs were administered via intraperitoneal injections at the time-to-peak effect, which was previously determined, prior to the induction of hyperthermia-induced seizures. ASDs were considered effective if they significantly increased the temperature at which Scn1a mice had seizures.
Approximately 50% of Scn1a survive to adulthood and all have hyperthermia-induced seizures. The results suggest that hyperthermia-induced seizures in this model of DS are highly refractory to a battery of ASDs. Exceptions were clobazam, tiagabine, levetiracetam, and the combination of clobazam and valproic acid with add-on stiripentol, which elevated seizure thresholds.
Overall, the data demonstrate that the proposed model for DS is suitable for screening novel compounds for the ability to block hyperthermia-induced seizures and that heterozygous mice can be evaluated repeatedly over the course of several weeks, allowing for higher throughput screening.
Dravet 综合征(DS)是一种罕见但严重的遗传性癫痫,80%的患者携带 SCN1A 基因突变。目前,尚无抗癫痫药物(ASD)能充分控制癫痫发作。临床上,DS 患者常首先表现为热性惊厥,随后出现全身性强直阵挛性发作,且可能持续终生。为了促进 DS 抗癫痫药物的研发,美国国立神经病学与卒中研究所(NINDS)癫痫治疗筛选计划(ETSP)的合同机构使用条件性 Scn1a 敲入小鼠对 DS 的小鼠模型进行了评估。
确定 Scn1a 的存活率和体温阈值。在诱导发热性癫痫发作之前,根据达到峰值效应的时间,通过腹腔注射给予原型 ASD。如果 ASD 能显著提高 Scn1a 小鼠癫痫发作的体温,则认为其有效。
约 50%的 Scn1a 存活至成年,且均发生发热性癫痫发作。结果表明,该 DS 模型中的发热性癫痫发作对一系列 ASD 高度耐药。例外的是氯巴占、噻加宾、左乙拉西坦以及氯巴占和丙戊酸联合添加 stiripentol,这些药物提高了癫痫发作阈值。
总体而言,数据表明,拟议的 DS 模型适合筛选具有阻断发热性癫痫发作能力的新型化合物,并且杂合子小鼠可以在数周内重复评估,从而实现更高的高通量筛选。