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利用系统生物学揭示的抗癫痫药物与组织恢复增强剂联合治疗创伤性脑损伤后的癫痫持续状态

Treatment of Status Epilepticus after Traumatic Brain Injury Using an Antiseizure Drug Combined with a Tissue Recovery Enhancer Revealed by Systems Biology.

作者信息

Kajevu Natallie, Lipponen Anssi, Andrade Pedro, Bañuelos Ivette, Puhakka Noora, Hämäläinen Elina, Natunen Teemu, Hiltunen Mikko, Pitkänen Asla

机构信息

A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland.

Expert Microbiology Unit, Finnish Institute for Health and Welfare, P.O. Box 95, 70701 Kuopio, Finland.

出版信息

Int J Mol Sci. 2023 Sep 13;24(18):14049. doi: 10.3390/ijms241814049.

Abstract

We tested a hypothesis that in silico-discovered compounds targeting traumatic brain injury (TBI)-induced transcriptomics dysregulations will mitigate TBI-induced molecular pathology and augment the effect of co-administered antiseizure treatment, thereby alleviating functional impairment. In silico bioinformatic analysis revealed five compounds substantially affecting TBI-induced transcriptomics regulation, including calpain inhibitor, chlorpromazine, geldanamycin, tranylcypromine, and trichostatin A (TSA). In vitro exposure of neuronal-BV2-microglial co-cultures to compounds revealed that TSA had the best overall neuroprotective, antioxidative, and anti-inflammatory effects. In vivo assessment in a rat TBI model revealed that TSA as a monotherapy (1 mg/kg/d) or in combination with the antiseizure drug levetiracetam (LEV 150 mg/kg/d) mildly mitigated the increase in plasma levels of the neurofilament subunit pNF-H and cortical lesion area. The percentage of rats with seizures during 0-72 h post-injury was reduced in the following order: TBI-vehicle 80%, TBI-TSA (1 mg/kg) 86%, TBI-LEV (54 mg/kg) 50%, TBI-LEV (150 mg/kg) 40% ( < 0.05 vs. TBI-vehicle), and TBI-LEV (150 mg/kg) combined with TSA (1 mg/kg) 30% ( < 0.05). Cumulative seizure duration was reduced in the following order: TBI-vehicle 727 ± 688 s, TBI-TSA 898 ± 937 s, TBI-LEV (54 mg/kg) 358 ± 715 s, TBI-LEV (150 mg/kg) 42 ± 64 ( < 0.05 vs. TBI-vehicle), and TBI-LEV (150 mg/kg) combined with TSA (1 mg/kg) 109 ± 282 s ( < 0.05). This first preclinical intervention study on post-TBI acute seizures shows that a combination therapy with the tissue recovery enhancer TSA and LEV was safe but exhibited no clear benefit over LEV monotherapy on antiseizure efficacy. A longer follow-up is needed to confirm the possible beneficial effects of LEV monotherapy and combination therapy with TSA on chronic post-TBI structural and functional outcomes, including epileptogenesis.

摘要

我们验证了一个假设,即通过计算机发现的针对创伤性脑损伤(TBI)诱导的转录组失调的化合物,将减轻TBI诱导的分子病理学变化,并增强联合使用的抗癫痫治疗的效果,从而减轻功能障碍。计算机生物信息学分析揭示了五种对TBI诱导的转录组调控有显著影响的化合物,包括钙蛋白酶抑制剂、氯丙嗪、格尔德霉素、反苯环丙胺和曲古抑菌素A(TSA)。将神经元-BV2-小胶质细胞共培养物体外暴露于这些化合物,结果显示TSA具有最佳的整体神经保护、抗氧化和抗炎作用。在大鼠TBI模型中的体内评估表明,TSA作为单一疗法(1毫克/千克/天)或与抗癫痫药物左乙拉西坦(LEV 150毫克/千克/天)联合使用时,可轻度减轻神经丝亚基pNF-H血浆水平的升高和皮质损伤面积。受伤后0至72小时内癫痫发作大鼠的百分比按以下顺序降低:TBI-载体组80%,TBI-TSA(1毫克/千克)组86%,TBI-LEV(54毫克/千克)组50%,TBI-LEV(150毫克/千克)组40%(与TBI-载体组相比,P<0.05),以及TBI-LEV(150毫克/千克)联合TSA(1毫克/千克)组30%(与TBI-载体组相比,P<0.05)。累积癫痫发作持续时间按以下顺序缩短:TBI-载体组727±688秒,TBI-TSA组898±937秒,TBI-LEV(54毫克/千克)组358±715秒,TBI-LEV(150毫克/千克)组42±64秒(与TBI-载体组相比,P<0.05),以及TBI-LEV(150毫克/千克)联合TSA(1毫克/千克)组109±282秒(与TBI-载体组相比,P<0.05)。这项关于TBI后急性癫痫发作的首次临床前干预研究表明,组织恢复增强剂TSA与LEV的联合治疗是安全的,但在抗癫痫疗效方面,与LEV单一疗法相比没有明显优势。需要更长时间的随访来确认LEV单一疗法以及TSA联合疗法对TBI后慢性结构和功能结局(包括癫痫发生)可能产生的有益影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/752f/10531083/378c8cb50478/ijms-24-14049-g001.jpg

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