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Świąder MJ, Świąder K, Zakrocka I, Krzyżanowski M, Wróbel A, Łuszczki JJ, Czuczwar SJ. Long-term vigabatrin treatment modifies pentylenetetrazole-induced seizures in mice: focused on GABA brain concentration. Pharmacol Rep 2020; 72:322-330. [PMID: 32048251 DOI: 10.1007/s43440-019-00037-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/24/2019] [Accepted: 10/11/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND The goal of our study was to examine the long-term effect of vigabatrin (VGB), a γ-aminobutyric acid aminotransferase (GABA-AT) inhibitor on clonazepam (CLO), ethosuximide (ETX) and valproate (VPA) anticonvulsive activity against pentylenetetrazole (PTZ)-induced seizures in mice. METHODS VGB was administered for 3 and 7 days. Convulsions were evoked by PTZ at its CD97 (99 mg/kg). The influence of CLO, ETX and VPA alone or in combination with VGB on motor performance and long-term memory was analyzed. γ-aminobutyric acid (GABA) concentration in mice brain and plasma as well as glutamate decarboxylase (GAD) activity was measured. RESULTS After 3 days of treatment, VGB in doses up to 500 mg/kg increased PTZ-induced seizure threshold, whereas after 7 days VGB (at the dose of 125 mg/kg) inhibited clonic seizures in experimental mice. 7 days of VGB administration did not change the protective effect of CLO, ETX and VPA against PTZ-induced seizures. 7 days of VGB treatment at a subthreshold dose of 75 mg/kg decreased TD50 of ETX and CLO in the chimney test, but did not affect TD50 value for VPA. 7 days of VGB administration in combination with AEDs did not affect long-term memory in mice. VGB after 3 days or 7 days of administration increased brain GABA concentration. GAD activity was decreased after 3 and 7 days of VGB administration. CONCLUSIONS The presented results confirm anticonvulsive activity of VGB through GABA metabolism alteration and suggest care when combining VGB with ETX or CLO in the therapy.
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Affiliation(s)
- Mariusz J Świąder
- Department of Experimental and Clinical Pharmacology, Collegium Pathologicum, Medical University of Lublin, ul. Jaczewskiego 8b, 20-090, Lublin, Poland.
| | - Katarzyna Świąder
- Department of Applied Pharmacy, Medical University of Lublin, ul. Chodźki 1, 20-093, Lublin, Poland
| | - Izabela Zakrocka
- Department of Nephrology, Medical University of Lublin, ul. Jaczewskiego 8, 20-090, Lublin, Poland
| | - Maciej Krzyżanowski
- Department of Pathophysiology, Medical University of Lublin, ul. Jaczewskiego 8b, 20-090, Lublin, Poland
| | - Andrzej Wróbel
- 2nd Department of Gynecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-090, Lublin, Poland
| | - Jarogniew J Łuszczki
- Department of Pathophysiology, Medical University of Lublin, ul. Jaczewskiego 8b, 20-090, Lublin, Poland
| | - Stanisław J Czuczwar
- Department of Pathophysiology, Medical University of Lublin, ul. Jaczewskiego 8b, 20-090, Lublin, Poland
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Hatori T, Sugiyama Y, Yamashita S, Hirakubo Y, Nonaka K, Ichihashi K. Vigabatrin Therapy for Infantile Spasms in a Case of Cardiofaciocutaneous Syndrome with Cardiac Hypertrophy Developing during Adrenocorticotropic Hormone Treatment. J NIPPON MED SCH 2016; 83:167-71. [PMID: 27680485 DOI: 10.1272/jnms.83.167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In a patient with cardiofaciocutaneous syndrome complicated by intractable infantile spasms (West syndrome), cardiac hypertrophy developed during adrenocorticotropic hormone treatment. Various types of antiepileptic drugs, intravenous immunoglobulin, thyrotropin releasing hormone, and a ketogenic diet were ineffective in this case. However, vigabatrin both decreased clinical seizures and improved electroencephalogram findings. Although vigabatrin has not been approved for use in Japan, the results in the present case suggest that this drug should be considered as an alternative therapy for cases of infantile spasms associated with syndromes involving cardiomyopathy or its potential risk factors, such as cardiofaciocutaneous syndrome.
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Affiliation(s)
- Takayuki Hatori
- Department of Pediatrics, Jichi Medical University Saitama Medical Center
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Malaspina P, Roullet JB, Pearl PL, Ainslie GR, Vogel KR, Gibson KM. Succinic semialdehyde dehydrogenase deficiency (SSADHD): Pathophysiological complexity and multifactorial trait associations in a rare monogenic disorder of GABA metabolism. Neurochem Int 2016; 99:72-84. [PMID: 27311541 DOI: 10.1016/j.neuint.2016.06.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 12/21/2022]
Abstract
Discovered some 35 years ago, succinic semialdehyde dehydrogenase deficiency (SSADHD) represents a rare, autosomal recessively-inherited defect in the second step of the GABA degradative pathway. Some 200 patients have been reported, with broad phenotypic and genotypic heterogeneity. SSADHD represents an unusual neurometabolic disorder in which two neuromodulatory agents, GABA (and the GABA analogue, 4-hydroxybutyrate), accumulate to supraphysiological levels. The unexpected occurrence of epilepsy in several patients is counterintuitive in view of the hyperGABAergic state, in which sedation might be expected. However, the epileptic status of some patients is most likely represented by broader imbalances of GABAergic and glutamatergic neurotransmission. Cumulative research encompassing decades of basic and clinical study of SSADHD reveal a monogenic disease with broad pathophysiological and clinical phenotypes. Numerous metabolic perturbations unmasked in SSADHD include alterations in oxidative stress parameters, dysregulation of autophagy and mitophagy, dysregulation of both inhibitory and excitatory neurotransmitters and gene expression, and unique subsets of SNP alterations of the SSADH gene (so-called ALDH5A1, or aldehyde dehydrogenase 5A1 gene) on the 6p22 chromosomal arm. While seemingly difficult to collate and interpret, these anomalies have continued to open novel pathways for pharmacotherapeutic considerations. Here, we present an update on selected aspects of SSADHD, the ALDH5A1 gene, and future avenues for research on this rare disorder of GABA metabolism.
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Affiliation(s)
- P Malaspina
- Department of Biology, University "Tor Vergata", Rome, Italy
| | - J-B Roullet
- Division of Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, WA, USA
| | - P L Pearl
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - G R Ainslie
- Division of Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, WA, USA
| | - K R Vogel
- Division of Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, WA, USA
| | - K M Gibson
- Division of Experimental and Systems Pharmacology, College of Pharmacy, Washington State University, Spokane, WA, USA.
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Coelho VR, Vieira CG, de Souza LP, Moysés F, Basso C, Papke DKM, Pires TR, Siqueira IR, Picada JN, Pereira P. Antiepileptogenic, antioxidant and genotoxic evaluation of rosmarinic acid and its metabolite caffeic acid in mice. Life Sci 2015; 122:65-71. [PMID: 25498895 DOI: 10.1016/j.lfs.2014.11.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 11/01/2014] [Accepted: 11/17/2014] [Indexed: 12/30/2022]
Abstract
AIMS Antioxidant compounds have been extensively investigated as a pharmacological alternatives to prevent epileptogenesis. Rosmarinic acid (RA) and caffeic acid (CA) are compounds with antioxidant properties, and RA has been shown to inhibit GABA transaminase activity (in vitro). Our aim was to evaluate the effect of RA and CA on seizures induced by pentylenotetrazole (PTZ) using the kindling model in mice. MAIN METHODS Male CF-1 mice were treated once every three days during 16days with RA (1, 2 or 4mg/kg; i.p.), or CA (1, 4 or 8mg/kg; i.p.), or positive controls diazepam (1mg/kg; i.p.) or vigabatrin (600mg/kg; p.o.), 30min before PTZ administration (50mg/kg; s.c.). After the last treatment, animals were sacrificed and the cortex was collected to evaluate free radicals (determined by 2',7'-dichlorofluorescein diacetate probe), superoxide dismutase (SOD) and genotoxic activity (Alkaline Comet Assay). KEY FINDINGS Rosmarinic acid 2mg/kg increased latency and decreased percentage of seizures, only on the 4th day of observation. The other tested doses of RA and CA did not show any effect. Rosmarinic acid 1mg/kg, CA 4mg/kg and CA 8mg/kg decreased free radicals, but no dose altered the levels of enzyme SOD. In the comet assay, RA 4mg/kg and CA 4mg/kg reduced the DNA damage index. SIGNIFICANCE Some doses of rosmarinic acid and CA tested showed neuroprotective action against oxidative and DNA damage produced in the kindling epilepsy model, although they did not produce antiepileptogenic effect in vivo.
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Affiliation(s)
- Vanessa Rodrigues Coelho
- Laboratório de Neurofarmacologia e Toxicologia Pré-Clínica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Caroline Gonçalves Vieira
- Laboratório de Neurofarmacologia e Toxicologia Pré-Clínica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luana Pereira de Souza
- Laboratório de Neurofarmacologia e Toxicologia Pré-Clínica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felipe Moysés
- Laboratório de Neuropsicofarmacologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Carla Basso
- Laboratório de Neuropsicofarmacologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Thienne Rocha Pires
- Laboratório de Genética Toxicológica, Universidade Luterana do Brasil, Canoas, RS, Brazil
| | - Ionara Rodrigues Siqueira
- Laboratório de Neuropsicofarmacologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Patrícia Pereira
- Laboratório de Neurofarmacologia e Toxicologia Pré-Clínica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Nielsen JC, Tolbert D, Patel M, Kowalski KG, Wesche DL. Vigabatrin pediatric dosing information for refractory complex partial seizures: results from a population dose-response analysis. Epilepsia 2014; 55:e134-8. [PMID: 25311090 DOI: 10.1111/epi.12825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2014] [Indexed: 01/28/2023]
Abstract
We predicted vigabatrin dosages for adjunctive therapy for pediatric patients with refractory complex partial seizures (rCPS) that would produce efficacy comparable to that observed for approved adult dosages. A dose-response model related seizure-count data to vigabatrin dosage to identify dosages for pediatric rCPS patients. Seizure-count data were obtained from three pediatric and two adult rCPS clinical trials. Dosages were predicted for oral solution and tablet formulations. Predicted oral solution dosages to achieve efficacy comparable to that of a 1 g/day adult dosage were 350 and 450 mg/day for patients with body weight ranges 10-15 and >15-20 kg, respectively. Predicted oral solution dosages for efficacy comparable to a 3 g/day adult dosage were 1,050 and 1,300 mg/day for weight ranges 10-15 and >15-20 kg, respectively. Predicted tablet dosage for efficacy comparable to a 1 g/day adult dosage was 500 mg/day for weight ranges 25-60 kg. Predicted tablet dosage for efficacy comparable to a 3 g/day adult dosage was 2,000 mg for weight ranges 25-60 kg. Vigabatrin dosages were identified for pediatric rCPS patients with body weights ≥10 kg.
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Affiliation(s)
- Jace C Nielsen
- Ann Arbor Pharmacometrics Group, Ann Arbor, Michigan, U.S.A
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Ben-Menachem E. Medical management of refractory epilepsy-Practical treatment with novel antiepileptic drugs. Epilepsia 2014; 55 Suppl 1:3-8. [DOI: 10.1111/epi.12494] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2013] [Indexed: 01/21/2023]
Affiliation(s)
- Elinor Ben-Menachem
- Institute of Clinical Neuroscience and Physiology; Sahlgrenska University Hospital; Goteborg Sweden
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Abstract
Vigabatrin, an irreversible inhibitor of γ-aminobutyric acid transaminase, is an antiepileptic drug indicated in the United States as adjunctive therapy for adult patients with refractory complex partial seizures who have responded inadequately to several alternative treatments and for monotherapy treatment of infantile spasms in patients 1 month to 2 years of age. Approval of vigabatrin in the United States was contingent on the implementation of a Risk Evaluation and Mitigation Strategy (REMS) to manage the threat of a progressive, permanent bilateral concentric peripheral visual field defects (pVFDs) that may occur in patients treated with vigabatrin. The REMS is designed to promote compliance with evidence-based recommendations for baseline (within 4 weeks of the start of treatment) ophthalmologic evaluations and ongoing vision monitoring in all patients treated with vigabatrin. In view of the challenges associated with visual field testing in patients with epilepsy and in infants, clinicians must understand the qualitative (pattern of damage), quantitative (degree of damage), electrophysiologic, and adjunctive techniques recommended for monitoring vigabatrin-treated patients. The objectives of ongoing research are to characterize the onset, progression, and risk of developing vision loss during the first year of vigabatrin treatment and to evaluate the potential of noninvasive imaging as a method for monitoring retinal changes corresponding to the pVFD. This article provides an overview of visual field testing procedures and electroretinography, summarizes the clinical characteristics of vigabatrin-associated pVFDs, and provides recommendations for visual field and visual electrophysiology testing relevant to both adult and infant patients treated with vigabatrin.
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Affiliation(s)
- R C Sergott
- Wills Eye Institute, Neuro-Ophthalmology Service, Thomas Jefferson University Medical College, Philadelphia, PA 19107, USA.
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Millichap JG. Vigabatrin Trials and Dose Recommendations. Pediatr Neurol Briefs 2012. [DOI: 10.15844/pedneurbriefs-26-1-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Affiliation(s)
- W D Shields
- Division of Pediatric Neurology, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, CA 90095-1752, USA.
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Abstract
Vigabatrin is an antiepileptic drug used in more than 50 countries as adjunctive therapy for the treatment of refractory complex partial seizures (rCPS) in adults. First approved in the United Kingdom in 1989, vigabatrin was approved for use in the United States by the Food and Drug Administration in 2009. Although most clinical trials of vigabatrin have been conducted in Europe, three major trials, including two pivotal trials, were conducted in the United States. These trials have demonstrated efficacy and tolerability findings similar to those observed from the European trials. Results of the US trials have demonstrated vigabatrin to be an effective and generally well-tolerated therapy for rCPS in adults, with an optimal dosage of 3 g/day for most patients, and an onset of response generally within 2 weeks. This review focuses on the design and results of the three major US trials of vigabatrin in adults with rCPS.
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Affiliation(s)
- E Faught
- Department of Neurology, Emory University, Atlanta, GA 30308, USA.
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