ROS-removing nano-medicine for navigating inflammatory microenvironment to enhance anti-epileptic therapy

Improving epilepsy management by targeting P2 × 7 receptor with ROS/electric responsive nanomicelles

BACKGROUND

The intricate pathogenesis of epilepsy, characterized by abnormal neuronal discharges and neuroinflammation, underscores the critical involvement of the adenosine triphosphate (ATP)-P2X purinoceptor 7 (P2 × 7) receptor pathway in inflammation activation. To address this, a reactive oxygen species (ROS)/electric-responsive d-α-tocopheryl polyethylene glycol 1000 succinate (TPGS)-ferrocene-poloxamer nanomicelle (TFP@A) was engineered to deliver the P2 × 7 receptor antagonist A 438,079, aiming to provide a targeted therapeutic strategy for epilepsy management.

METHODS

The study meticulously designed and characterized TFP@A for precise drug delivery through various techniques including transmission electron microscopy (TEM), dynamic light scattering (DLS), and high-performance liquid chromatography (HPLC). Cellular uptake and blood-brain barrier (BBB) permeability were evaluated using fluorescein isothiocyanate (FITC)-labeled TFP@A in vitro and in a brain endothelial cell line (bEnd.3) cell BBB model. In vivo distribution and safety assessments were conducted in an epilepsy mouse model. The impact of TFP@A on epilepsy was investigated through seizure analysis, electroencephalogram (EEG) recordings, and inflammatory pathway assessment.

RESULTS

TFP@A exhibited a robust drug release profile under ROS and electrical stimulation conditions. In vitro studies demonstrated its efficacy in scavenging ROS, reducing oxidative stress, and alleviating cell apoptosis in epilepsy models. Efficient cellular uptake, BBB penetration, and in vivo accumulation in the brain were observed. Notably, TFP@A effectively modulated the P2 × 7 receptor (P2 × 7R)-nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) pathway, inhibiting inflammatory mediators and promoting anti-inflammatory responses.

CONCLUSION

TFP@A loaded with the P2 × 7 receptor antagonist showcases potential therapeutic benefits in suppressing NLRP3 inflammasome activation, mitigating microglial-neuron crosstalk, and ameliorating epilepsy symptoms, positioning it as a promising avenue for targeted epilepsy treatment.

Bio-Nano Innovations Targeting the Neurovascular Complex for Epilepsy Treatment

Epilepsy is a prevalent chronic neurological disorder characterized by seizures resulting from an imbalance between excitatory and inhibitory neurons. While pharmacotherapy remains the standard treatment, traditional pharmacotherapy faces significant challenges, including poor brain penetration, high drug resistance rates, and providing only symptomatic relief, rather than addressing the underlying causes for a comprehensive cure. Recently, the neurovascular complex (NVC) has gained attention for its critical role in the development and progression of epilepsy. Simultaneously, various innovative bio-nanotechnology systems have emerged, specifically designed to enhance drug delivery across the brain and enable precise targeting within the lesion. Herein, this review begins by outlining the core NVC involved in epilepsy treatment, breaking it down into four key components: the blood-brain barrier (BBB), neurons, glial cells, and the microenvironment. The viability of targeting NVC to improve epilepsy therapy is analyzed. Next, innovative bio-nanotechnology systems, detailing their design principles, construction strategies, and preclinical evaluations in epilepsy therapy are highlighted. Finally, the prospects for next-generation nanotechnologies and the challenges that must be overcome for effective clinical translation are discussed. Overall, this review aims to guide the development of more efficient and precise bio-nano therapies, ultimately enhancing treatment outcomes for epilepsy patients.

Rational design of hypochlorous acid-activatable fluorescent probe for diagnostic imaging and therapeutic evaluation in breast cancer recurrence

The recurrent breast cancer (BC) has elicited significant concern due to its rising recurrence rates and associated mortality. However, there is currently no effective detection method to mitigate the deterioration of BC recurrence. The imbalance of HClO content could lead to oxidative stress in the body, which damaging host tissues. Additional, improper regulation of HClO may exacerbate the progression of BC and promote the metastasis of BC cells. Accurately diagnosing and monitoring the HClO levels is crucial for treating BC recurrence. Traditional fluorescent probes for HClO exhibit several limitations, including poor selectivity, susceptibility to photobleaching, a small Stokes shift, and vulnerability to disturbances from excitation and fluorescence self-absorption, which undermine the precise detection of target analytes and restrict their biological applications. Herein, rational designed hypochlorous acid-activatable fluorescent probe (QPIO) was synthesized based on phenothiazine (PZ), quinoline malononitrile (QM), and hemicyanine, which demonstrated high anti-interference capability and a significant Stokes shift for HClO detection. Under various stimuli, QPIO was able to monitor HClO levels in RAW 264.7 and 4T1 cells in the red channel. Furthermore, it elucidated the correlation between HClO concentration and the progression of BC recurrence. Consequently, QPIO was utilized to diagnose recurrent BC, track therapeutic progress, and monitor the recurrence status of breast tumors in mouse models through in vivo HClO fluorescence imaging. It was demonstrated that a close relationship exists between the dynamic changes in HClO levels and BC recurrence, potentially advancing the understanding of the early diagnosis and development of therapeutic agents for recurrent BC.

Stimuli-responsive nanoscale drug delivery system for epilepsy theranostics

Epilepsy is a common neurological disease characterized by distinct pathological changes in the epileptogenic zone. Antiseizure drugs (ASDs) are widely used as the primary treatment for epilepsy. To improve the efficiency of ASDs medication, stimuli-responsive nanoscale drug delivery systems (nanoDDSs), triggered by either endogenous or exogenous factors, have been developed and been considered as a noninvasive and spatial-temporal approach to epilepsy theranostics. In this review, we introduce the pathological variations observed in epileptic lesions such as dysregulated neurotransmitter systems, disrupted ion homeostasis, and dynamic inflammatory cytokine networks. Furthermore, we summarize the recent advances in functional nano-assemblies that could be activated by endogenous stimuli of pathological alterations or exogenous stimuli such as electricity, light, and other interventions. Finally, we discuss the remaining challenges and prospect the insight into perspective of future development in this field. In summary, this review aims to highlight the potential of stimuli-responsive nanoDDSs as precise, controllable and efficient strategies for addressing unresolved issues in epilepsy theranostics. STATEMENT OF SIGNIFICANCE: This review summarizes recent progress in pathological changes such as dysregulated neurotransmitter system, disrupted ion homeostasis and dynamic inflammatory cytokine network, and emphasizes endogenous/exogenous stimuli-responsive nanoscale platforms including neurotransmitter-, ion-, and other stimuli-responsive nanoDDSs, providing the prospects of smart nanoDDSs applications and discussing the challenges to offer generalized guideline for further development of epilepsy theranostics.

Stimuli-Responsive Nano Drug Delivery Systems for the Treatment of Neurological Diseases

Nanomaterials with unparalleled physical and chemical attributes have become a cornerstone in the field of nanomedicine delivery. These materials can be engineered into various functionalized nanocarriers, which have become the focus of research. Stimulus-responsive nanodrug delivery systems (SRDDS) stand out as a sophisticated class of nanocarriers that can release drugs in response to environmental cues. Due to the complex pathogenesis and the multifaceted pathological environment of the nervous system, developing accurate and effective drug therapy with low side-effects is a formidable task. In recent years, SRDDS have been widely used in the treatment of neurological diseases. By customizing SRDDS to align with the specific microenvironment of the nervous system tissues or external stimulation, the efficacy of drug delivery can be enhanced. This review provides an in-depth look at the characteristics of the microenvironment of neurological diseases and highlights case studies of SRDDS tailored to treat these disorders based on the unique stimulation criteria of nervous system tissues or external triggers. Additionally, this review provides a comprehensive overview of the progress and future prospects of SRDDS technology in the treatment of neurological diseases, providing valuable guidance for its transition from fundamental research to clinical application.

Potential inflammatory mechanisms of the ketogenic diet against febrile infection-related epilepsy syndrome

Febrile infection-related epilepsy syndrome (FIRES) is a rare epilepsy syndrome with unclear pathogenesis, characterized by fever-induced, super-refractory status epilepticus and high mortality. Studies have shown that ketogenic diet (KD) is effective in controlling convulsions in FIRES, but its mechanisms are unclear. This paper intends to summarize the mechanisms by which KD may exert effects against FIRES. Clinical studies have shown that patients with FIRES have elevated levels of various inflammatory factors such as interleukin (IL)-6, IL-8, IL-10, and so on. KD may exert anti-FIRES effects through several potential inflammatory pathways, including nuclear factor -κB (NF-κB) and NLR family pyrin domain containing 3 (NLRP3). Furthermore, the Kyoto Encyclopedia of Genes and Genomes (KEGG) network suggested that KD may play an anti-inflammatory role through several pathways such as cellular senescence and neutrophil extracellular trap formation. These mechanisms need to be further investigated.

Nanocarriers-based therapeutic strategy for drug-resistant epilepsy: A systematic review

BACKGROUND

Nanocarriers have been proposed as a solution for drug-resistant epilepsy.

METHODS

A systematic review of animal and in vitro studies was conducted to evaluate the efficacy, toxicity, and biological properties of nanocarriers. Searches were performed in PubMed/Medline and Scopus from March 2023 to March 2024.

RESULTS

Eighteen studies were identified: 2 in vitro, 9 in vivo, and 7 combined. While epilepsy models and seizure control assessments were consistent, there was variability in evaluating the potential toxicity of nanocarriers. Only one study did not show a reduction in brain inflammation, seizures, and cell loss. Nanocarrier toxicity was evaluated just in six studies, all of which indicated low toxicity both in vitro and in vivo.

CONCLUSIONS

Nanocarriers with antiseizure drugs manage seizures, inflammation, oxidative stress, and behavior impairment in drug-resistant epilepsy. Furthermore, nanocarriers are a safe option for delivering antiseizure drugs, though more research is needed to confirm these findings.

Macrophage membrane‒biomimetic nanoparticles target inflammatory microenvironment for epilepsy treatment

Rationale: The clinical treatment of epilepsy is faced with challenges. On the one hand, the effectiveness of existing antiepileptic drugs (AEDs) is limited by the blood‒brain barrier (BBB); on the other hand, changes in the inflammatory microenvironment during epileptogenesis are often neglected. Methods: The death-associated protein kinase 1 inhibitor TC-DAPK6 and the fluorescent probe rhodamine B were encapsulated in hollow mesoporous silica nanocarriers (HMSNs), which were then coated with a macrophage membrane to prepare macrophage membrane-biomimetic nanoparticles, namely, MA@RT-HMSNs. In vitro biotoxicity, cellular uptake, BBB permeability and inflammatory targeting ability were evaluated in cells. The effects of MA@RT-HMSN treatment were explored by immunohistochemistry, TUNEL assay, Western blot analysis, quantitative real-time polymerase chain reaction, electroencephalogram recording and behavioural tests in kainic acid-induced acute and chronic epilepsy model mice. Results: MA@RT-HMSNs showed excellent biocompatibility both in vitro and in vivo. MA@RT-HMSNs successfully crossed the BBB and exhibited increased efficacy in targeted delivery of TC-DAPK6 to inflammatory lesions in epileptic foci. Macrophage membrane coating conferred MA@RT-HMSNs with higher stability, greater cellular uptake, and enhanced TC-DAPK6 bioavailability. Furthermore, MA@RT-HMSNs exerted beneficial therapeutic effects on acute and chronic epilepsy models by alleviating microenvironment inflammation, preventing neuronal death, and inhibiting neuronal excitability and gliosis. Conclusions: MA@RT-HMSNs target inflammatory foci to inhibit death-related protein kinase 1 and exert antiepileptic effects. This study provides a promising biomimetic nanodelivery system for targeted epilepsy therapy.

Advancements in the application of nanotechnology for the management of epileptic seizures

Epilepsy is a common yet complex neurological disorder. Historically, antiseizure medications (ASMs) have faced challenges in crossing the blood-brain barrier (BBB) and targeting the epileptogenic zone, creating a bottleneck in seizure management. Certain nanomaterials can facilitate drug penetration through the BBB and enable stimulus-responsive drug release, thereby enhancing targeted and efficient drug utilization while reducing adverse reactions in other brain tissues and peripherally. This article reviews the current researches on stimulus-responsive nanosystems applicable in antiepileptic therapy, as well as nanotechnology applications that improve the brain delivery of ASMs.

Nanomedicine revolutionizes epilepsy treatment: overcoming therapeutic hurdles with nanoscale solutions

INTRODUCTION

Epilepsy, a prevalent neurodegenerative disorder, profoundly impacts the physical and mental well-being of millions globally. Historically, antiseizure drugs (ASDs) have been the primary treatment modality. However, despite the introduction of novel ASDs in recent decades, a significant proportion of patients still experiences uncontrolled seizures.

AREAS COVERED

The rapid advancement of nanomedicine in recent years has enabled precise targeting of the brain, thereby enhancing therapeutic efficacy for brain diseases, including epilepsy.

EXPERT OPINION

Nanomedicine holds immense promise in epilepsy treatment, including but not limited to enhancing drug solubility and stability, improving drug across blood-brain barrier, overcoming resistance, and reducing side effects, potentially revolutionizing clinical management. This paper provides a comprehensive overview of current epilepsy treatment modalities and highlights recent advancements in nanomedicine-based drug delivery systems for epilepsy control. We discuss the diverse strategies used in developing novel nanotherapies, their mechanisms of action, and the potential advantages they offer compared to traditional treatment methods.

Effect of animal venom toxins on the main links of the homeostasis of mammals (Review)

The human body is affected by environmental factors. The dynamic balance between the organism and its environment results from the influence of natural, anthropogenic and social aspects. The factors of exogenous origin determine development of adaptive changes. The present article summarises the mechanisms of animal venom toxins and homeostasis disruption in the body of mammals. The mechanisms underlying pathological changes are associated with shifts in biochemical reactions. Components of the immune, nervous and endocrine systems are key in the host defense and adaptation processes in response to venom by triggering signalling pathways (PI3kinase pathway, arachidonic acid cascade). Animal venom toxins initiate the development of inflammatory processes, the synthesis of pro-inflammatory mediators (cytokines), ROS, proteolytic enzymes, activate the migration of leukocytes and macrophages. Keratinocytes and endothelial cells act as protective barriers under the action of animal venom toxins on the body of mammals. In addition, the formation of pores in cell membranes, structural changes in cell ion channels are characteristic of the action of animal venom toxins.

Targeting the blood-brain barrier to delay aging-accompanied neurological diseases by modulating gut microbiota, circadian rhythms, and their interplays

The blood-brain barrier (BBB) impairment plays a crucial role in the pathological processes of aging-accompanied neurological diseases (AAND). Meanwhile, circadian rhythms disruption and gut microbiota dysbiosis are associated with increased morbidity of neurological diseases in the accelerated aging population. Importantly, circadian rhythms disruption and gut microbiota dysbiosis are also known to induce the generation of toxic metabolites and pro-inflammatory cytokines, resulting in disruption of BBB integrity. Collectively, this provides a new perspective for exploring the relationship among circadian rhythms, gut microbes, and the BBB in aging-accompanied neurological diseases. In this review, we focus on recent advances in the interplay between circadian rhythm disturbances and gut microbiota dysbiosis, and their potential roles in the BBB disruption that occurs in AAND. Based on existing literature, we discuss and propose potential mechanisms underlying BBB damage induced by dysregulated circadian rhythms and gut microbiota, which would serve as the basis for developing potential interventions to protect the BBB in the aging population through targeting the BBB by exploiting its links with gut microbiota and circadian rhythms for treating AAND.

Three-Step Synthesis of the Antiepileptic Drug Candidate Pynegabine

Pynegabine, an antiepileptic drug candidate in phase I clinical trials, is a structural analog of the marketed drug retigabine with improved chemical stability, strong efficacy, and a better safety margin. The reported shortest synthetic route for pynegabine contains six steps and involves the manipulation of highly toxic methyl chloroformate and dangerous hydrogen gas. To improve the feasibility of drug production, we developed a concise, three-step process using unconventional methoxycarbonylation and highly efficient Buchwald-Hartwig cross coupling. The new synthetic route generated pynegabine at the decagram scale without column chromatographic purification and avoided the dangerous manipulation of hazardous reagents.