Hosford D A, Wang Y
Department of Medicine (Neurology), Duke University Medical Center, North Carolina 27705, USA.
Epilepsia. 1997 Apr;38(4):408-14. doi: 10.1111/j.1528-1157.1997.tb01729.x.
Traditional methods of preclinical screening have predicted the effects of a putative antiepileptic drug (AED) against human absence seizures by testing its efficacy against clonic seizures in the high-dose pentylenetetrazole (PTZ) model. This high-dose PTZ model correctly predicted the efficacy of ethosuximide (ESM), benzodiazepines, and valproate (VPA) and the lack of efficacy of phenytoin (PHT) and carbamazepine (CBZ). However, the high-dose PTZ model erred in predictions for (a) phenobarbital (PB) (PTZ: efficacy; human: nonefficacy); (b) lamotrigine (LTG) (PTZ: nonefficacy; human: efficacy); (c) vigabatrin (VGB) (PTZ: nonefficacy; human: proabsence effect); and (d) tiagabine (TGB) (PTZ: efficacy; human: possible proabsence). It also appears to have erred in predictions for gabapentin (GBP) (PTZ: efficacy) and topiramate (TPM) (PTZ: efficacy). Because the lh/lh genetic model of absence seizures correctly predicted effects of ESM, clonazepam, VPA, PHT, CBZ, and PB against human absence seizures, we performed this study to test the predictive utility of the lh/lh model for LTG, VGB, TGB, GBP, and TPM.
Bipolar recording electrodes were implanted bilaterally into frontal neocortex of 8-week-old male lh/lh mice. With the exception of VGB, vehicle or drugs were administered intraperitoneally (i.p.) on alternating days, and an EEG was used to record effects on seizure frequency. With VGB, vehicle was administered i.p. on day 1, and gradually increasing doses of VGB were administered on successive days. Drug and vehicle effects were compared in corresponding 15-min epochs of the 150-min period after administration.
LTG (4.8-144 micromol/kg) significantly (p < 0.04) reduced seizure frequency (by 65%) compared with vehicle. In contrast, VGB (0.35-11 mmol/kg) and TGB (0.27-27 micromol/kg) significantly increased seizure frequency (300-700%) and seizure duration (1,700-1,800%; p < 0.001). GBP (18 micromol/kg to 1.8 mmol/kg) and TPM (8.9-295 micromol/kg) had no significant effect on seizure frequency.
In contrast to the high-dose PTZ model, the lh/lh model correctly predicted the antiabsence effect of LTG, the possible proabsence effects of VGB and TGB, and the lack of effect of GBP and TPM. The lh/lh model appears to be superior to the high-dose PTZ model in predicting efficacy of putative AEDs against human absence seizures.
传统的临床前筛选方法通过在高剂量戊四氮(PTZ)模型中测试假定抗癫痫药物(AED)对阵挛性癫痫发作的疗效,来预测其对人类失神性癫痫发作的影响。该高剂量PTZ模型正确预测了乙琥胺(ESM)、苯二氮䓬类药物和丙戊酸盐(VPA)的疗效以及苯妥英(PHT)和卡马西平(CBZ)的无效性。然而,高剂量PTZ模型在以下预测中出现错误:(a)苯巴比妥(PB)(PTZ模型:有效;人类:无效);(b)拉莫三嗪(LTG)(PTZ模型:无效;人类:有效);(c)氨己烯酸(VGB)(PTZ模型:无效;人类:促失神效应);以及(d)噻加宾(TGB)(PTZ模型:有效;人类:可能促失神)。它在对加巴喷丁(GBP)(PTZ模型:有效)和托吡酯(TPM)(PTZ模型:有效)的预测中似乎也出现了错误。由于失神性癫痫发作的lh/lh基因模型正确预测了ESM、氯硝西泮、VPA、PHT、CBZ和PB对人类失神性癫痫发作的影响,我们进行了本研究以测试lh/lh模型对LTG、VGB、TGB、GBP和TPM的预测效用。
将双极记录电极双侧植入8周龄雄性lh/lh小鼠的额叶新皮质。除VGB外,在交替日经腹腔(i.p.)给予赋形剂或药物,并用脑电图记录对癫痫发作频率的影响。对于VGB,在第1天经腹腔给予赋形剂,并在随后几天逐渐增加VGB的剂量。在给药后150分钟的相应15分钟时间段内比较药物和赋形剂的作用。
与赋形剂相比,LTG(4.8 - 144微摩尔/千克)显著(p < 0.04)降低了癫痫发作频率(降低65%)。相比之下,VGB(0.35 - 11毫摩尔/千克)和TGB(0.27 - 27微摩尔/千克)显著增加了癫痫发作频率(300 - 700%)和发作持续时间(1700 - 1800%;p < 0.001)。GBP(18微摩尔/千克至1.8毫摩尔/千克)和TPM(8.9 - 295微摩尔/千克)对癫痫发作频率无显著影响。
与高剂量PTZ模型不同,lh/lh模型正确预测了LTG的抗失神作用、VGB和TGB的可能促失神作用以及GBP和TPM的无效性。在预测假定AED对人类失神性癫痫发作的疗效方面,lh/lh模型似乎优于高剂量PTZ模型。