Onat Filiz, Andersson My, Çarçak Nihan
Department of Medical Pharmacology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, 34684 Istanbul, Türkiye.
Institute of Health Sciences, Department of Neuroscience, Acibadem Mehmet Ali Aydinlar University, 34684 Istanbul, Türkiye.
Cells. 2025 Jan 10;14(2):94. doi: 10.3390/cells14020094.
Epilepsy is a chronic neurological disorder marked by recurrent seizures, significantly impacting individuals worldwide. Current treatments are often ineffective for a third of patients and can cause severe side effects, necessitating new therapeutic approaches. Glial cells, particularly astrocytes, microglia, and oligodendrocytes, are emerging as crucial targets in epilepsy management. Astrocytes regulate neuronal homeostasis, excitability, and synaptic plasticity, playing key roles in maintaining the blood-brain barrier (BBB) and mediating neuroinflammatory responses. Dysregulated astrocyte functions, such as reactive astrogliosis, can lead to abnormal neuronal activity and seizure generation. They release gliotransmitters, cytokines, and chemokines that may exacerbate or mitigate seizures. Microglia, the innate immune cells of the CNS, contribute to neuroinflammation, glutamate excitotoxicity, and the balance between excitatory and inhibitory neurotransmission, underscoring their dual role in seizure promotion and protection. Meanwhile, oligodendrocytes, primarily involved in myelination, also modulate axonal excitability and contribute to the neuron-glia network underlying seizure pathogenesis. Understanding the dynamic interactions of glial cells with neurons provides promising avenues for novel epilepsy therapies. Targeting these cells may lead to improved seizure control and better clinical outcomes, offering hope for patients with refractory epilepsy.
癫痫是一种慢性神经系统疾病,其特征为反复发作的癫痫发作,对全球各地的个体产生重大影响。目前的治疗方法对三分之一的患者往往无效,并且可能导致严重的副作用,因此需要新的治疗方法。神经胶质细胞,特别是星形胶质细胞、小胶质细胞和少突胶质细胞,正成为癫痫治疗中的关键靶点。星形胶质细胞调节神经元的内环境稳态、兴奋性和突触可塑性,在维持血脑屏障(BBB)和介导神经炎症反应中发挥关键作用。星形胶质细胞功能失调,如反应性星形胶质细胞增生,可导致神经元活动异常和癫痫发作。它们释放神经胶质递质、细胞因子和趋化因子,这些物质可能会加重或减轻癫痫发作。小胶质细胞是中枢神经系统的固有免疫细胞,参与神经炎症、谷氨酸兴奋性毒性以及兴奋性和抑制性神经传递之间的平衡,凸显了它们在癫痫发作促进和保护中的双重作用。同时,主要参与髓鞘形成的少突胶质细胞也调节轴突兴奋性,并参与癫痫发病机制的神经元-神经胶质网络。了解神经胶质细胞与神经元之间的动态相互作用为新型癫痫治疗提供了有前景的途径。针对这些细胞可能会改善癫痫控制并带来更好的临床结果,为难治性癫痫患者带来希望。
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