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抗癫痫药物使用期间神经毒性的分子和遗传机制

Molecular and Genetic Mechanisms of Neurotoxicity During Anti-seizure Medications Use.

作者信息

Rubio Carmen, Gatica Fernando, Uribe Eric, Ochoa Ernesto, Campos Victoria, Rubio-Osornio Moisés

机构信息

Department of Neurophisiology, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico.

Department of Neurodegenerative Diseases Laboratory, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico.

出版信息

Rev Invest Clin. 2023;75(1):1-12. doi: 10.24875/RIC.22000260.

Abstract

Epilepsy is a multifactorial pathology that has allowed the development of various drugs aiming to combat it. This effort was formally initiated in the 1940s when phenytoin began to be used. It eventually turned out to be a drug with great anticonvulsant efficacy. At present, several potentially good new generation anti-seizure medications (ASMs) have been developed. Most of them present more tolerability and less toxic effects. However, they continue to have adverse effects at different levels. In addition, some seizures are difficult to treat with ASMs, representing 30% of the total cases of people who suffer from epilepsy. This review aims to explore the genetic and molecular mechanisms of ASMs neurotoxicity, proposing the study of damage caused by epileptic seizures, in addition to the deterioration generated by anti-seizure drug administration within the central nervous system. It is beyond question that there is a need to develop drugs that lower the lower the risk of secondary and toxic effects of ASMs. Simultaneously, we must find strategies that produce fewer harmful interactions and more health benefits when taking anti-seizure drugs.

摘要

癫痫是一种多因素病理状况,促使了旨在对抗它的各种药物的研发。这项工作正式始于20世纪40年代苯妥英开始被使用之时。它最终被证明是一种具有强大抗惊厥功效的药物。目前,已经研发出了几种潜在的新一代抗癫痫药物(ASMs)。它们中的大多数具有更高的耐受性和更低的毒性作用。然而,它们在不同程度上仍然存在不良反应。此外,一些癫痫发作难以用抗癫痫药物治疗,占癫痫患者总数的30%。本综述旨在探讨抗癫痫药物神经毒性的遗传和分子机制,除了研究癫痫发作所造成的损害外,还研究抗癫痫药物在中枢神经系统内给药所产生的恶化情况。毫无疑问,有必要研发降低抗癫痫药物继发性和毒性作用风险的药物。同时,我们必须找到在服用抗癫痫药物时产生更少有害相互作用且带来更多健康益处的策略。

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