Department of Pharmaceutical Sciences, College of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, United States.
Pharmacol Ther. 2023 Apr;244:108384. doi: 10.1016/j.pharmthera.2023.108384. Epub 2023 Mar 16.
As one of the most prevalent and disabling brain disorders, epilepsy is characterized by spontaneous seizures that result from aberrant, excessive hyperactivity of a group of highly synchronized brain neurons. Remarkable progress in epilepsy research and treatment over the first two decades of this century led to a dramatical expansion in the third-generation antiseizure drugs (ASDs). However, there are still over 30% of patients suffering from seizures resistant to the current medications, and the broad unbearable adversative effects of ASDs significantly impair the quality of life in about 40% of individuals affected by the disease. Prevention of epilepsy in those who are at high risks is another major unmet medical need, given that up to 40% of epilepsy patients are believed to have acquired causes. Therefore, it is important to identify novel drug targets that can facilitate the discovery and development of new therapies engaging unprecedented mechanisms of action that might overcome these significant limitations. Also over the last two decades, calcium signaling has been increasingly recognized as a key contributory factor in epileptogenesis of many aspects. The intracellular calcium homeostasis involves a variety of calcium-permeable cation channels, the most important of which perhaps are the transient receptor potential (TRP) ion channels. This review focuses on recent exciting advances in understanding of TRP channels in preclinical models of seizure disorders. We also provide emerging insights into the molecular and cellular mechanisms of TRP channels-engaged epileptogenesis that might lead to new antiseizure therapies, epilepsy prevention and modification, and even a cure.
作为最常见和致残的脑部疾病之一,癫痫的特征是自发性癫痫发作,这是由于一群高度同步的脑神经元异常、过度活跃引起的。本世纪头二十年,癫痫研究和治疗取得了显著进展,第三代抗癫痫药物(ASD)得到了极大的扩展。然而,仍有超过 30%的患者对现有药物有耐药性,ASD 的广泛不可忍受的不良反应显著降低了大约 40%受该疾病影响的个体的生活质量。鉴于高达 40%的癫痫患者被认为具有获得性病因,预防高危人群的癫痫发作是另一个主要的未满足的医疗需求。因此,确定新的药物靶点对于发现和开发新的治疗方法非常重要,这些方法可以利用前所未有的作用机制来克服这些重大局限性。在过去的二十年中,钙信号也越来越被认为是许多方面癫痫发生的关键促成因素。细胞内钙稳态涉及多种钙通透性阳离子通道,其中最重要的可能是瞬时受体电位(TRP)离子通道。本综述重点介绍了近年来在理解癫痫发作疾病的临床前模型中 TRP 通道方面令人兴奋的进展。我们还提供了关于 TRP 通道参与癫痫发生的分子和细胞机制的新见解,这可能导致新的抗癫痫治疗、癫痫预防和修饰,甚至治愈。