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噻加宾、拉莫三嗪、加巴喷丁和氨己烯酸临床前抗惊厥谱的比较。

Comparison of the preclinical anticonvulsant profiles of tiagabine, lamotrigine, gabapentin and vigabatrin.

作者信息

Dalby N O, Nielsen E B

机构信息

Novo Nordisk, Health Care Discovery, Måløv, Denmark.

出版信息

Epilepsy Res. 1997 Jul;28(1):63-72. doi: 10.1016/s0920-1211(97)00031-4.

Abstract

Tiagabine is a novel antiepileptic drug which has clinical efficacy against complex refractory and myoclonic seizures. The anticonvulsant mechanism of action of tiagabine results from its blockade of neuronal and glial GABA-uptake, thereby increasing GABA levels in the synaptic cleft. Here we present a comparison of the preclinical anticonvulsant profile of tiagabine with that of lamotrigine, gabapentin and vigabatrin in the following tests (all antiepileptic drugs were administered i.p.): seizures induced by pentylentetrazol (PTZ), 6,7-dimethoxy-4-ethyl-b-carboline-3-carboxylate (DMCM) and maximal electroshock (MES); sound induced seizures in DBA/2 mice and finally acute amygdala kindled seizures. Tiagabine was the most potent drug in antagonizing tonic convulsions induced by PTZ, DMCM and sound induced seizures in DBA/2 mice with ED50 values of 2, 2 and 1 mumol/kg, respectively, followed by lamotrigine with ED50 values of 9, 43 and 6 mumol/kg, respectively. Gabapentin and vigabatrin had ED50 values in the same tests of 185, 452, 66 mumol/kg and 2322, > 7740, 3883 mumol/kg, respectively. Tiagabine was the only drug capable of blocking PTZ-induced clonic convulsions (ED50 = 5 mumol/kg), an effect seen at low but not high doses of tiagabine. Lamotrigine was the only drug which antagonized tonic convulsions in the MES test (ED50 = 36 mumol/kg). Therapeutic index (TI) of antiepileptic drugs in NMRI- and DBA/2-mice ranked with decreasing TI lamotrigine > gabapentin > vigabatrin > tiagabine. All drugs reduced the generalized seizures in amygdala kindled rats, but tiagabine and gabapentin furthermore attenuated afterdischarge duration of amygdala kindled seizures. However, an ED50 value against amygdala kindled focal seizures was only obtained for tiagabine (36 mumol/kg). The data here presented show that tiagabine, lamotrigine, gabapentin and vigabatrin possess different preclinical anticonvulsant profiles which is of relevance to the clinical anticonvulsant profiles of the drugs.

摘要

噻加宾是一种新型抗癫痫药物,对复杂难治性癫痫和肌阵挛性癫痫具有临床疗效。噻加宾的抗惊厥作用机制是通过阻断神经元和胶质细胞对γ-氨基丁酸(GABA)的摄取,从而提高突触间隙中GABA的水平。在此,我们比较了噻加宾与拉莫三嗪、加巴喷丁和氨己烯酸在以下试验中的临床前抗惊厥谱(所有抗癫痫药物均腹腔注射给药):由戊四氮(PTZ)、6,7-二甲氧基-4-乙基-β-咔啉-3-羧酸(DMCM)诱导的癫痫发作以及最大电休克(MES);DBA/2小鼠的声音诱导性癫痫发作,以及最后急性杏仁核点燃癫痫发作。在拮抗PTZ、DMCM诱导的强直性惊厥以及DBA/2小鼠的声音诱导性癫痫发作方面,噻加宾是最有效的药物,其半数有效剂量(ED50)分别为2、2和1 μmol/kg,其次是拉莫三嗪,其ED50值分别为9、43和6 μmol/kg。在相同试验中,加巴喷丁和氨己烯酸的ED50值分别为185、452、66 μmol/kg和2322、>7740、3883 μmol/kg。噻加宾是唯一能够阻断PTZ诱导的阵挛性惊厥的药物(ED50 = 5 μmol/kg),这种作用在低剂量而非高剂量的噻加宾时可见。拉莫三嗪是唯一在MES试验中拮抗强直性惊厥的药物(ED50 = 36 μmol/kg)。抗癫痫药物在NMRI小鼠和DBA/2小鼠中的治疗指数(TI)按TI值递减排序为:拉莫三嗪>加巴喷丁>氨己烯酸>噻加宾。所有药物均能减少杏仁核点燃大鼠的全身性癫痫发作,但噻加宾和加巴喷丁还能进一步缩短杏仁核点燃癫痫发作的后放电持续时间。然而,仅获得了噻加宾针对杏仁核点燃局灶性癫痫发作的ED50值(36 μmol/kg)。此处呈现的数据表明,噻加宾、拉莫三嗪、加巴喷丁和氨己烯酸具有不同的临床前抗惊厥谱,这与这些药物的临床抗惊厥谱相关。

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