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Objective: To develop a constitutively active K(+) leak channel using TREK-1 (TWIK-related potassium channel 1; TREK-M) that is resistant to compensatory down-regulation by second messenger cascades, and to validate the ability of TREK-M to silence hyperactive neurons using cultured hippocampal neurons. To test if adenoassociated viral (AAV) delivery of TREK-M could reduce the duration of status epilepticus and reduce neuronal death induced by lithium-pilocarpine administration.
Methods: Molecular cloning techniques were used to engineer novel vectors to deliver TREK-M via plasmids, lentivirus, and AAV using a cytomegalovirus (CMV)-enhanced GABRA4 promoter. Electrophysiology was used to characterize the activity and regulation of TREK-M in human embryonic kidney (HEK-293) cells, and the ability to reduce spontaneous activity in cultured hippocampal neurons. Adult male rats were injected bilaterally with self-complementary AAV particles composed of serotype 5 capsid into the hippocampus and entorhinal cortex. Lithium-pilocarpine was used to induce status epilepticus. Seizures were monitored using continuous video-electroencephalography (EEG) monitoring. Neuronal death was measured using Fluoro-Jade C staining of paraformaldehyde-fixed brain slices.
Results: TREK-M inhibited neuronal firing by hyperpolarizing the resting membrane potential and decreasing input resistance. AAV delivery of TREK-M decreased the duration of status epilepticus by 50%. Concomitantly it reduced neuronal death in areas targeted by the AAV injection.
Significance: These findings demonstrate that TREK-M can silence hyperexcitable neurons in the brain of epileptic rats and treat acute seizures. This study paves the way for an alternative gene therapy treatment of status epilepticus, and provides the rationale for studies of AAV-TREK-M's effect on spontaneous seizures in chronic models of temporal lobe epilepsy.
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http://dx.doi.org/10.1111/epi.12472 | DOI Listing |
Neurology
October 2025
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD.
Objectives: Status epilepticus (SE) is a life-threatening neurologic emergency. Although health disparities in epilepsy are well-documented, disparities in SE mortality are not fully understood. This study analyzes mortality trends and demographics in the United States from 1999 through 2020.
View Article and Find Full Text PDFEpileptic Disord
September 2025
Department of Neurology, Neurocritical Care and Neurorehabilitation, Christian Doppler University Hospital, Centre for Cognitive Neuroscience, Member of the European Reference Network EpiCARE, Paracelsus Medical University of Salzburg, Salzburg, Austria.
Neurol Clin Pract
October 2025
Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Program in Trauma, University of Maryland, Baltimore, MD.
Background And Objectives: Guidelines for super-refractory status epilepticus (SRSE) evaluation, management, and prognostication are lacking. Characterization of practice patterns could identify trends and potential areas for future inquiry. We surveyed clinicians who manage SRSE to better understand practice approaches to SRSE evaluation, management, and prognostication.
View Article and Find Full Text PDFNeurologia (Engl Ed)
September 2025
Especialista en Neurofisiología Clínica, Servicio de Neurofisiología Clínica, Hospital Universitario de Burgos, Burgos.
Introduction: The electroencephalogram (EEG) is a useful tool in the diagnosis of pathologies such as non-convulsive status epilepticus (NCSE) or brain death (BD), cardiac arrest (CA), and status epilepticus (SE) treatment monitoring. In addition, it provides irreplaceable information depending on the time it is performed, as is the case with the diagnosis of epilepsy after a first epileptic seizure (ES) or to differentiate these from non-epileptic paroxysmal events (NEPE). Its usefulness is maintained outside the usual working day, but it is not available in many centers.
View Article and Find Full Text PDFClin Pharmacol Drug Dev
September 2025
Shandong Xinhua Pharmaceutical Co., Ltd., Zibo, China.
Epilepsy is one of the most severe neurological disorders in the world, which might seriously endanger the lives of patients. Phenobarbital is an important medicine clinically used for the treatment of epilepsy, and it is irreplaceable in the treatment of generalized tonic-clonic seizures, focal seizures, status epilepticus, and pediatric epilepsy. However, the original research medicine of phenobarbital has not been launched in China.
View Article and Find Full Text PDF