Departamento de Fisiologia, Laboratório de Neurofisiologia, Universidade Federal de São Paulo - UNIFESP, Brazil.
Departamento de Psiquiatria e Psicologia Médica, Universidade Federal de São Paulo - UNIFESP, Brazil.
Epilepsy Behav. 2022 Apr;129:108615. doi: 10.1016/j.yebeh.2022.108615. Epub 2022 Feb 23.
Approximately 70% of women with epilepsy experience additional challenges in seizure exacerbation due to hormonal changes, particularly during fluctuations of estrogen-progesterone levels in the menstrual cycle, which is known as catamenial epilepsy. In animal models of epilepsy, a sustained increase in seizure frequency has been observed in female rats during the proestrus-estrus transition when estrogen levels are high and progesterone levels are low resembling catamenial epilepsy. Cannabidiol (CBD) has been proposed to have anticonvulsant and anti-inflammatory effects, able to decrease seizure duration and increase seizure threshold in rats with epilepsy. However, most studies have used males to investigate the pharmacological effects of CBD on seizures, and the neuroprotective effects of CBD against seizures exacerbated by hormonal fluctuations in females are still little explored. Given this scenario, the aim of the present study was to investigate whether CBD would protect against acute seizures induced by pentylenetetrazole (PTZ) in female rats during a pro-convulsant hormonal phase. Therefore, CBD (50 mg/kg) or saline was administered during the proestrus-estrus transition phase, 1 h prior to induction of seizures with PTZ (60 mg/kg), and the following parameters were recorded: duration, latency to first seizure, as well as percentage of convulsing animals (incidence), mortality, and severity of seizures. Brains were processed for immunohistochemistry for microglial cells (Iba-1), and blood was collected for the analysis of cytokines (IL-1β, IL-6, IL-10, and TNF-α). Cannabidiol pre-treated rats showed a significant reduction in duration and severity of seizures, and IL-1β levels, although the latency, incidence of seizures, and mortality rate remained unchanged as well the quantification of microglia in the selected areas. Therefore, acute administration of CBD in a single dose prior to seizure induction showed a partial neuroprotective effect against seizure severity and inflammation, suggesting that female rats in the proconvulsant phase of proestrus-estrus have a low seizure threshold and are more resistant to the anticonvulsant effects of CBD. It appears that other doses or administration windows of CBD may be required to achieve a full protective effect against seizures, suggesting that CBD could be used as an adjunctive therapy during fluctuations of estrogen-progesterone levels. In this sense, considering the hormonal fluctuation as a seizure-potentiating factor, our study contributes to understand the anticonvulsant activity of CBD in females in a pro-convulsant hormonal phase, similar to catamenial seizures in humans.
大约 70%的女性癫痫患者由于激素变化而导致癫痫发作加剧,尤其是在月经周期中雌激素-孕激素水平波动期间,这种情况被称为月经性癫痫。在癫痫动物模型中,当雌激素水平高而孕激素水平低时,雌性大鼠在发情前期-发情期过渡期间观察到癫痫发作频率持续增加,类似于月经性癫痫。大麻二酚 (CBD) 具有抗惊厥和抗炎作用,能够减少癫痫大鼠的癫痫发作持续时间并增加癫痫发作阈值。然而,大多数研究都使用雄性大鼠来研究 CBD 对癫痫发作的药理学作用,而 CBD 对女性激素波动引起的癫痫发作加剧的神经保护作用仍未得到充分探索。鉴于这种情况,本研究旨在探讨 CBD 是否会在发情前期-发情期过渡期间的促惊厥激素阶段保护雌性大鼠免受戊四氮 (PTZ) 诱导的急性癫痫发作。因此,在 PTZ(60mg/kg)诱导癫痫发作前 1 小时,给予 CBD(50mg/kg)或生理盐水,记录以下参数:发作持续时间、首次发作潜伏期以及抽搐动物的百分比(发生率)、死亡率和癫痫发作严重程度。对大脑进行小胶质细胞(Iba-1)免疫组织化学处理,并采集血液用于分析细胞因子(IL-1β、IL-6、IL-10 和 TNF-α)。预先用 CBD 治疗的大鼠发作持续时间和严重程度显著降低,IL-1β 水平降低,尽管潜伏期、癫痫发作发生率和死亡率以及所选区域的小胶质细胞数量仍保持不变。因此,在诱导癫痫发作前单次给予 CBD 具有部分神经保护作用,可减轻癫痫发作严重程度和炎症,这表明发情前期-发情期促惊厥阶段的雌性大鼠癫痫发作阈值较低,对 CBD 的抗惊厥作用更具抵抗力。似乎需要其他剂量或 CBD 给药窗口才能实现对癫痫发作的完全保护作用,这表明 CBD 可在雌激素-孕激素水平波动期间作为辅助治疗。从这个意义上说,考虑到激素波动是癫痫发作的增强因素,我们的研究有助于理解 CBD 在促惊厥激素阶段的女性中的抗惊厥活性,类似于人类的月经性癫痫。