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Editorial: Recent Advances in Pathophysiological Studies and Treatment of Epilepsy

机译:社论:病理生理研究和癫痫治疗的最新进展

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Epilepsy is a common neurological condition defined by recurrent, unprovoked seizures that affect 1–2% of the population worldwide. However, a little is known about both the cellular and network mechanisms of epilepsy. Therefore, in the present issue, we aimed to provide a comprehensive review of the literature on epilepsy in selected experts. Firstly, miRNA studies were conducted on human and animal models to clarify the foundation for exploring research of miRNA in epilepsy. Several target genes and pathways of miRNA which related to the therapeutic methods to epilepsy [ 1 , 2 ]. Dr. Ma reported that epilepsy biomarkers might be used as an identification of epileptic condition [ 3 ]. Secondly, substance P is widely distributed in the regions of the central nervous system associated with epilepsy and it contributes to the initiation and maintenance phases of epilepsy. In vivo , substance P binds to the neurokinin-1 receptor and modulates the biological activity of the receptor. Although NK-1 receptor antagonists have anti-epileptic properties in animal models [ 4 , 5 ], the clinical efficacy of these drugs has not yet been verified. Therefore, Dr. Chi provides an overview of current understanding of the structural and functional mechanisms of the substance P involved in regulating epilepsy pathologic process [ 6 ]. Thirdly, an increasing number of studies have shown that the activation of the 5-HT_(3)receptor can inhibit epileptic seizures, while inhibition of the 5HT_(3)receptor can promote spike waves. [ 7 - 9 ]. In this review, Dr. Huo discussed the relationship between the 5HT_(3)receptor and epilepsy, It may provide a new insight into clinical application of epilepsy treatment. In the past decades, despite the continuous development of antiepileptic drugs, there are still many patients with epilepsy progressing to drug-resistant epilepsy. Currently, surgical treatment is the only possible way to cure drug-resistant epilepsy. However, surgical treatment alone often results in postoperative recurrence of epilepsy. Antiepileptic comprehensive treatment mainly based on surgery is capable of effectively reducing the recurrence rate of epilepsy [ 10 - 12 ]. In this review, Dr Sheng summarized the pathogenesis of drug-resistant epilepsy and current comprehensive treatment mainly based on surgery. It may provide some insight into epilepsy treatment. Choline alfoscerate (α-GPC) and Cytidine 5’-diphosphocholine (CDP-Choline) are both acetylcholine precursors and are considered to act as pro-cholinergic nootropic agents. whether acetylcholine precursors have a similar effect on treating cognitive impairment in patients with epilepsy remains controversial. Dr Lee reported that acetylcholine precursors in seizure-experienced animals have produced variable results that are dependent on the timing of administration. Early administration of CDP-choline immediately after seizure increased neuronal death, blood-brain barrier (BBB) disruption and microglial activation in the hippocampus. However, administration of α-GPC starting 3 weeks after seizure (late administration) improved cognitive function through reduced neuronal death and BBB disruption, and increased neurogenesis in the hippocampus [ 13 , 14 ]. It may be attributed to both epileptogenic features and neuroprotective functions of several acetylcholine precursors. Herbal medicine has always been traditionally a part of treatment of epilepsy. This is because herbal medicines are generally well tolerated, with fewer side effects. Many herbal remedies have been tested and proved effective in animal models of epilepsy [ 15 ]. Dr. Stephen briefly highlights some herbs that have been studied for their anticonvulsant activity in animal models. Some vaccines cause a small increased risk of febrile seizures. Therefore, there has been some controversy is about their safety; particularly, concerns have been rising about febrile seizures [ 16 , 17 ]. Today, the safety profile of vaccinations is greatly improved. Dr. Wang helped the reader to improve their understanding of the relationship between the different vaccines and febrile seizures to be able to reduce the risk of developing febrile seizures following vaccination. Recently, increasing studies have established the beneficial effects of ketogenic diet on epileptic seizure reduction. Both basic experiments and clinical trials demonstrated that ketogenic diet significantly reduced seizure frequency with mild adverse effects [ 18 , 19 ]. Dr. Zhang reviewed how ketogenic diet treatment exerts its anticonvulsant effects, which may help to understand the development of epilepsy and provide new treatment targets. Some patients after stroke may develop post-stroke epilepsy, which has a negative effect on stroke prognosis and the quality of life [ 20 ]. In this review, Dr. Zhao describes new aspects emerging from research about post-stroke epilepsy, including definition, epidemiology, risk factors, mechanism, accessory exam
机译:癫痫病是一种常见的神经系统疾病,由反复发作,无故发作引起,定义为影响全球1-2%的人口。然而,对癫痫的细胞机制和网络机制都知之甚少。因此,在本期中,我们旨在对选定专家的癫痫文献进行全面的综述。首先,对人和动物模型进行了miRNA研究,以澄清探索癫痫中miRNA研究的基础。 miRNA的几种靶基因和途径与癫痫的治疗方法有关[1,2]。马博士报道,癫痫的生物标志物可能被用来鉴定癫痫病的病情[3]。其次,P物质广泛分布在与癫痫有关的中枢神经系统区域,并有助于癫痫的起始和维持阶段。在体内,P物质结合神经激肽1受体并调节该受体的生物学活性。尽管NK-1受体拮抗剂在动物模型中具有抗癫痫作用[4,5],但尚未验证这些药物的临床疗效。因此,Chi博士概述了目前参与调节癫痫病理过程的P物质的结构和功能机制[6]。第三,越来越多的研究表明5-HT_(3)受体的激活可以抑制癫痫发作,而抑制5HT_(3)受体则可以促进尖峰波。 [7-9]。在这篇综述中,霍博士讨论了5HT_(3)受体与癫痫之间的关系,这可能为癫痫治疗的临床应用提供新的见解。在过去的几十年中,尽管抗癫痫药不断发展,但仍有许多癫痫病患者发展为耐药性癫痫病患者。当前,外科治疗是治愈耐药性癫痫的唯一可能方法。但是,仅靠外科手术治疗通常会导致癫痫术后复发。以手术为主的抗癫痫综合治疗能够有效降低癫痫的复发率[10-12]。在这篇综述中,盛博士总结了耐药性癫痫的发病机理以及目前主要基于手术的综合治疗方法。它可以为癫痫治疗提供一些见识。磷胆碱(α-GPC)和5'-二磷酸胆碱(CDP-胆碱)都是乙酰胆碱的前体,被认为是促胆碱能促智剂。乙酰胆碱前体在治疗癫痫患者的认知障碍中是否具有类似作用仍存在争议。 Lee博士报告说,在癫痫发作的动物中乙酰胆碱前体产生的可变结果取决于给药时间。癫痫发作后立即给予CDP-胆碱可增加神经元死亡,海马的血脑屏障(BBB)破坏和小胶质细胞活化。然而,癫痫发作后3周开始服用α-GPC(晚期服用)可通过减少神经元死亡和BBB破坏来改善认知功能,并增加海马的神经发生[13,14]。它可能归因于几种乙酰胆碱前体的癫痫发生特征和神经保护功能。传统上,草药一直是癫痫治疗的一部分。这是因为草药通常具有良好的耐受性,且副作用较少。已对许多草药进行了测试,并证明在癫痫动物模型中有效[15]。 Stephen博士简要介绍了一些已在动物模型中研究其抗惊厥活性的草药。一些疫苗会引起高热惊厥的风险增加。因此,关于它们的安全性存在一些争议。特别是,人们对高热惊厥的关注日益增加[16,17]。如今,疫苗接种的安全性已大大改善。 Wang博士帮助读者增进了对不同疫苗与高热惊厥之间关系的了解,从而降低了接种疫苗后发生高热惊厥的风险。最近,越来越多的研究确定了生酮饮食对减少癫痫发作的有益作用。基础实验和临床试验均表明,生酮饮食可显着降低癫痫发作频率,并具有轻微的不良反应[18,19]。张博士回顾了生酮饮食疗法如何发挥其抗惊厥作用,这可能有助于了解癫痫的发展并提供新的治疗目标。中风后的一些患者可能会发展中风后癫痫病,这对中风的预后和生活质量有负面影响[20]。在这篇综述中,赵医生描述了中风后癫痫研究的新方面,包括定义,流行病学,危险因素,机制,辅助检查。

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