The role of inflammation in etiopathogenesis of pharmacoresistant epilepsy and refractory status epilepticus

Česká verzia

Authors: Š. Aulická ^1-3; K. Česká ¹; J. Šána ^2,4; T. Loja ²; P. Jabandžiev ^2,5; J. Papež ⁵; P. Danhofer ¹; H. Vinohradská ⁶; I. Doležalová ⁷; M. Brázdil ⁷; P. Štourač ⁸; H. Ošlejšková ¹; O. Slabý ²
Authors place of work: Centrum pro epilepsie Brno, Klinika dětské neurologie LF MU a FN Brno ¹; Výzkumná skupina Ondřeje Slabého – Středoevropský technologický institut (CEITEC) ²; Klinika dětské onkologie LF MU a FN Brno ³; Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno ⁴; Pediatrická klinika LF MU a FN Brno ⁵; Oddělení klinické biochemie, FN Brno ⁶; Centrum pro epilepsie Brno, I. neurologická klinika LF MU a FN u sv. Anny v Brně ⁷; Klinika dětské anesteziologie a resuscitace LF MU a FN Brno ⁸
Published in the journal: Cesk Slov Neurol N 2020; 83(1): 8-13
Category: Review Article
doi: https://doi.org/10.14735/amcsnn20208

Summary

Brain inflammation represents a common substrate of pharmacoresistant epilepsy of different etiologies and it can directly affect neuronal excitability. Neuromodulatory properties of some proinflammatory molecules (cytokines, chemokines) may be responsible for hyperexcitability in neuronal networks. The relation between inflammation and epilepsy is reciprocal. The inflammatory processes in the brain may participate in initiating seizure activity and simultaneously they may be a consequence of the recurrence of the seizures. Pharmacological studies on experimental models focused on IL-1β/ IL-1R1, HMGB1/ TLR4 and COX-2/ prostaglandin systems demostrate that these inflammatory pathways significantly in triggering and recurring seizure activity. Status epilepticus (SE) leads to development of inflammatory processes which can be detected in brain tissue, cerebrospinal fluid and blood serum. Prolonged seizures and SE lead to fast and prolonged activation of specific inflammatory pathways in brain areas accordant with the epileptogenic zone. Understanding the complex role of inflammation in the generation and exacerbation of epilepsy and development of pharmacoresistance in epilepsy is crucial for the identification of new molecular targets for therapeutic intervention in these patients.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Keywords:

Cytokines – chemokines – pharmacoresistant epilepsy – refractory status epilepticus – polymorphisms

Zdroje

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