von Rüden Eva-Lotta, Potschka Heidrun, Tipold Andrea, Stein Veronika M
Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University (LMU) Munich, Germany.
Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University (LMU) Munich, Germany.
Vet J. 2023 Aug-Sep;298-299:106014. doi: 10.1016/j.tvjl.2023.106014. Epub 2023 Jun 29.
The lack of therapeutics that prevent the development of epilepsy, improve disease prognosis or overcome drug resistance represents an unmet clinical need in veterinary as well as in human medicine. Over the past decade, experimental studies and studies in human epilepsy patients have demonstrated that neuroinflammatory processes are involved in epilepsy development and play a key role in neuronal hyperexcitability that underlies seizure generation. Targeting neuroinflammatory signaling pathways may provide a basis for clinically relevant disease-modification strategies in general, and moreover, could open up new therapeutic avenues for human and veterinary patients with drug-resistant epilepsy. A sound understanding of the neuroinflammatory mechanisms underlying seizure pathogenesis in canine patients is therefore essential for mechanism-based discovery of selective epilepsy therapies that may enable the development of new disease-modifying treatments. In particular, subgroups of canine patients in urgent needs, e.g. dogs with drug-resistant epilepsy, might benefit from more intensive research in this area. Moreover, canine epilepsy shares remarkable similarities in etiology, disease manifestation, and disease progression with human epilepsy. Thus, canine epilepsy is discussed as a translational model for the human disease and epileptic dogs could provide a complementary species for the evaluation of antiepileptic and antiseizure drugs. This review reports key preclinical and clinical findings from experimental research and human medicine supporting the role of neuroinflammation in the pathogenesis of epilepsy. Moreover, the article provides an overview of the current state of knowledge regarding neuroinflammatory processes in canine epilepsy emphasizing the urgent need for further research in this specific field. It also highlights possible functional impact, translational potential and future perspectives of targeting specific inflammatory pathways as disease-modifying and multi-target treatment options for canine epilepsy.
缺乏能够预防癫痫发生、改善疾病预后或克服耐药性的治疗方法,这在兽医医学和人类医学中都是尚未满足的临床需求。在过去十年中,实验研究以及对人类癫痫患者的研究表明,神经炎症过程参与癫痫的发生发展,并在癫痫发作所基于的神经元过度兴奋中起关键作用。一般而言,针对神经炎症信号通路可能为具有临床相关性的疾病改善策略提供基础,此外,还可为耐药性癫痫的人类和兽医患者开辟新的治疗途径。因此,深入了解犬类患者癫痫发病机制背后的神经炎症机制,对于基于机制发现选择性癫痫治疗方法至关重要,这些方法可能推动新的疾病改善治疗方法的开发。特别是,迫切需要进行更多研究的犬类患者亚组,例如耐药性癫痫犬,可能会从该领域更深入的研究中受益。此外,犬类癫痫在病因、疾病表现和疾病进展方面与人类癫痫有显著相似之处。因此,犬类癫痫被视为人类疾病的转化模型,癫痫犬可为抗癫痫和抗惊厥药物的评估提供一个补充物种。本综述报告了实验研究和人类医学的关键临床前和临床研究结果,支持神经炎症在癫痫发病机制中的作用。此外,本文概述了目前关于犬类癫痫中神经炎症过程的知识状况,强调了在这一特定领域进行进一步研究的迫切需求。它还强调了针对特定炎症途径作为犬类癫痫的疾病改善和多靶点治疗选择可能产生的功能影响、转化潜力和未来前景。