Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung City 42743, Taiwan.
School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien City 97004, Taiwan.
Int J Mol Sci. 2023 Aug 24;24(17):13143. doi: 10.3390/ijms241713143.
Epilepsy is a multifactorial neurologic disease that often leads to many devastating disabilities and an enormous burden on the healthcare system. Until now, drug-resistant epilepsy has presented a major challenge for approximately 30% of the epileptic population. The present article summarizes the validated rodent models of seizures employed in pharmacological researches and comprehensively reviews updated advances of novel antiseizure candidates in the preclinical phase. Newly discovered compounds that demonstrate antiseizure efficacy in preclinical trials will be discussed in the review. It is inspiring that several candidates exert promising antiseizure activities in drug-resistant seizure models. The representative compounds consist of derivatives of hybrid compounds that integrate multiple approved antiseizure medications, novel positive allosteric modulators targeting subtype-selective γ-Aminobutyric acid type A receptors, and a derivative of cinnamamide. Although the precise molecular mechanism, pharmacokinetic properties, and safety are not yet fully clear in every novel antiseizure candidate, the adapted approaches to design novel antiseizure medications provide new insights to overcome drug-resistant epilepsy.
癫痫是一种多因素的神经疾病,常导致许多严重的残疾,并给医疗保健系统带来巨大负担。到目前为止,大约 30%的癫痫患者患有耐药性癫痫,这仍是一个主要挑战。本文总结了在药理学研究中使用的经过验证的啮齿动物癫痫模型,并全面回顾了临床前阶段新型抗癫痫候选药物的最新进展。本文将讨论在临床前试验中具有抗癫痫疗效的新发现化合物。令人鼓舞的是,有几种候选药物在耐药性癫痫模型中表现出有希望的抗癫痫活性。代表性化合物包括多种已批准的抗癫痫药物的混合化合物的衍生物、针对亚型选择性γ-氨基丁酸 A 型受体的新型正变构调节剂,以及肉桂酰胺的衍生物。尽管每种新型抗癫痫候选药物的精确分子机制、药代动力学特性和安全性尚不完全清楚,但设计新型抗癫痫药物的适应方法为克服耐药性癫痫提供了新的见解。