Unidad de Cartografía Cerebral, Instituto Pluridisciplinar, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Unidad de Cartografía Cerebral, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
J Integr Neurosci. 2023 May 16;22(3):75. doi: 10.31083/j.jin2203075.
Epilepsy is one of the most common neurologic diseases, and around 30% of all epilepsies, particularly the temporal lobe epilepsy (TLE), are highly refractory to current pharmacological treatments. Abnormal synchronic neuronal activity, brain glucose metabolism alterations, neurodegeneration and neuroinflammation are features of epilepsy. Further, neuroinflammation has been shown to contribute to dysregulation of neuronal excitability and the progression of epileptogenesis. Flufenamic acid (FLU), a non-steroidal anti-inflammatory drug, is also characterized by its wide properties as a dose-dependent ion channel modulator. In this context, studies have shown that it abolishes seizure-like events in neocortical slices stimulated with a gamma-aminobutyric acid A (GABAA) receptor blocker. However, little is known about its effects in animal models. Thus, our goal was to assess the efficacy and safety of a relatively high dose of FLU in the lithium-pilocarpine rat model of status epilepticus (SE). This animal model reproduces many behavioral and neurobiological features of TLE such as short-term brain hypometabolism, severe hippocampal neurodegeneration and inflammation reflected by a marked reactive astrogliosis.
FLU (100 mg/kg, i.p.) was administered to adult male rats, 150 min before SE induced by pilocarpine. Three days after the SE, brain glucose metabolism was assessed by 2-deoxy-2-[18F]-fluoro-D-glucose ([18F]FDG) positron emission tomography (PET). Markers of hippocampal integrity, neurodegeneration and reactive astrogliosis were also evaluated.
FLU neither prevented the occurrence of the SE nor affected brain glucose hypometabolism as assessed by [18F]FDG PET. Regarding the neurohistochemical studies, FLU neither prevented neuronal damage nor hippocampal reactive astrogliosis. On the contrary, FLU increased the mortality rate and negatively affected body weight in the rats that survived the SE.
Our results do not support an acute anticonvulsant effect of a single dose of FLU. Besides, FLU did not show short-term neuroprotective or anti-inflammatory effects in the rat lithium-pilocarpine model of SE. Moreover, at the dose administered, FLU resulted in deleterious effects.
癫痫是最常见的神经系统疾病之一,约 30%的癫痫,特别是颞叶癫痫(TLE),对目前的药物治疗高度耐药。异常的同步神经元活动、脑葡萄糖代谢改变、神经退行性变和神经炎症是癫痫的特征。此外,神经炎症已被证明有助于神经元兴奋性的失调和癫痫发生的进展。氟芬那酸(FLU)是一种非甾体抗炎药,其特征还在于作为一种剂量依赖性离子通道调节剂的广泛特性。在这种情况下,研究表明它可以消除用γ-氨基丁酸 A(GABAA)受体阻滞剂刺激的新皮层切片中的惊厥样事件。然而,对于其在动物模型中的作用知之甚少。因此,我们的目标是评估相对高剂量 FLU 在锂-匹罗卡品大鼠癫痫持续状态(SE)模型中的疗效和安全性。这种动物模型再现了 TLE 的许多行为和神经生物学特征,例如短期脑低代谢、严重的海马神经退行性变和炎症,表现为明显的反应性星形胶质增生。
FLU(100mg/kg,ip)在匹罗卡品诱导 SE 前 150 分钟给予成年雄性大鼠。SE 后 3 天,通过 2-脱氧-2-[18F]-氟-D-葡萄糖([18F]FDG)正电子发射断层扫描(PET)评估脑葡萄糖代谢。还评估了海马完整性、神经退行性变和反应性星形胶质增生的标志物。
FLU 既不能预防 SE 的发生,也不能影响[18F]FDG PET 评估的脑葡萄糖低代谢。关于神经组织化学研究,FLU 既不能预防神经元损伤,也不能预防海马反应性星形胶质增生。相反,FLU 增加了 SE 后存活大鼠的死亡率并对体重产生负面影响。
我们的结果不支持单次剂量 FLU 的急性抗惊厥作用。此外,FLU 在锂-匹罗卡品 SE 大鼠模型中未显示短期神经保护或抗炎作用。此外,在给予的剂量下,FLU 会产生有害影响。