Department of Neurology, Tainan Sin-Lau Hospital, Tainan 701002, Taiwan.
Department of Pediatrics, Chi-Mei Medical Center, Tainan 71004, Taiwan.
Int J Mol Sci. 2022 Jun 9;23(12):6446. doi: 10.3390/ijms23126446.
Epilepsy is a common chronic neurological disorder in modern society. One of the major unmet challenges is that current antiseizure medications are basically not disease-modifying. Among the multifaceted etiologies of epilepsy, the role of the immune system has attracted considerable attention in recent years. It is known that both innate and adaptive immunity can be activated in response to insults to the central nervous system, leading to seizures. Moreover, the interaction between ion channels, which have a well-established role in epileptogenesis and epilepsy, and the immune system is complex and is being actively investigated. Some examples, including the interaction between ion channels and mTOR pathways, will be discussed in this paper. Furthermore, there has been substantial progress in our understanding of the pathophysiology of epilepsy associated with autoimmune encephalitis, and numerous neural-specific autoantibodies have been found and documented. Early recognition of immune-mediated epilepsy is important, especially in cases of pharmacoresistant epilepsy and in the presence of signs of autoimmune encephalitis, as early intervention with immunotherapy shows promise.
癫痫是现代社会中一种常见的慢性神经障碍。目前尚未满足的主要挑战之一是，现有的抗癫痫药物基本上不能改变疾病进程。在癫痫的多因素病因中，免疫系统的作用近年来引起了相当大的关注。已知先天和适应性免疫都可以对中枢神经系统的损伤作出反应，从而导致癫痫发作。此外，离子通道与免疫系统之间的相互作用在癫痫发生和癫痫中具有明确的作用，其相互作用非常复杂，正在积极研究中。本文将讨论一些例子，包括离子通道与 mTOR 途径之间的相互作用。此外，我们对自身免疫性脑炎相关癫痫的病理生理学的理解已经取得了很大进展，并且已经发现并记录了许多神经特异性自身抗体。早期识别免疫介导的癫痫很重要，特别是在耐药性癫痫和存在自身免疫性脑炎迹象的情况下，因为免疫疗法的早期干预显示出希望。
