Aguilar-Castillo María José, Cabezudo-García Pablo, Ciano-Petersen Nicolas Lundahl, García-Martin Guillermina, Marín-Gracia Marta, Estivill-Torrús Guillermo, Serrano-Castro Pedro Jesús
Epilepsy Unit, Regional University Hospital of Málaga, 29010 Málaga, Spain.
Biotechnology Service, Regional University Hospital of Málaga, 29010 Málaga, Spain.
Biomedicines. 2022 Mar 19;10(3):716. doi: 10.3390/biomedicines10030716.
Immunologic and neuroinflammatory pathways have been found to play a major role in the pathogenesis of many neurological disorders such as epilepsy, proposing the use of novel therapeutic strategies. In the era of personalized medicine and in the face of the exhaustion of anti-seizure therapeutic resources, it is worth looking at the current or future possibilities that neuroimmunomodulator or anti-inflammatory therapy can offer us in the management of patients with epilepsy. For this reason, we performed a narrative review on the recent advances on the basic epileptogenic mechanisms related to the activation of immunity or neuroinflammation with special attention to current and future opportunities for novel treatments in epilepsy. Neuroinflammation can be considered a universal phenomenon and occurs in structural, infectious, post-traumatic, autoimmune, or even genetically based epilepsies. The emerging research developed in recent years has allowed us to identify the main molecular pathways involved in these processes. These molecular pathways could constitute future therapeutic targets for epilepsy. Different drugs current or in development have demonstrated their capacity to inhibit or modulate molecular pathways involved in the immunologic or neuroinflammatory mechanisms described in epilepsy. Some of them should be tested in the future as possible antiepileptic drugs.
免疫和神经炎症通路在许多神经系统疾病(如癫痫)的发病机制中起着重要作用,这促使人们采用新的治疗策略。在个性化医疗时代,面对抗癫痫治疗资源的枯竭,值得探讨神经免疫调节剂或抗炎治疗在癫痫患者管理中为我们提供的当前或未来可能性。因此,我们对与免疫激活或神经炎症相关的基本致痫机制的最新进展进行了叙述性综述,特别关注癫痫新治疗方法的当前和未来机会。神经炎症可被视为一种普遍现象,发生在结构性、感染性、创伤后、自身免疫性甚至基于遗传的癫痫中。近年来开展的新兴研究使我们能够确定这些过程中涉及的主要分子途径。这些分子途径可能构成癫痫未来的治疗靶点。目前或正在研发的不同药物已证明它们能够抑制或调节癫痫中描述的免疫或神经炎症机制所涉及的分子途径。其中一些药物未来应作为可能的抗癫痫药物进行测试。