2014 issue 2

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Volume 30, issue 2

Review article

Epilepsy: inflammation and blood-brain barrier in the pathogenesis of the disease – new therapeutic targets

Agnieszka M. Cudna1, Iwona Kurkowska-Jastrzębska2
1. Instytut Psychiatrii i Neurologii, II Klinika Neurologiczna, Pracownia Neuroimmunologii; Warszawski Uniwersytet Medyczny, Katedra i Zakład Farmakologii Doświadczalnej i Klinicznej
2. Instytut Psychiatrii i Neurologii, II Klinika Neurologii
Farmakoterapia w Psychiatrii i Neurologii, 2014, 2, 91–111
Keywords: cytokines, inflammation, epilepsy, blood-brain barriers

Abstract

In recent years, the infl ammatory reactions and the associated disturbance of the blood-brain barrier integrity have been found to affect the course of the disease and the response to treatment in both the experimental models as well as in patients with epilepsy. Increased permeability of the blood-brain barrier causes the influx of leukocytes and the accumulation of albumin leading to the activation of glial cells. Glial cells, through secreted chemokines and cytokines (e.g. IL1β, IL6, TNFα) activate the endothelium. Moreover, proinfl ammatory factors are involved in the mechanism of neuronal hyperexcitability, including interactions with the neurotransmitter systems (e.g. glutamate, GABA) and the modifi cation of the external environment of the nerve cells, which consequently leads to the formation of seizures. The interaction between the blood-brain barrier and the glial cells may represent a new therapeutic target for the treatment of refractory epilepsy.

Address for correspondence:
Agnieszka Maria Cudna
Instytut Psychiatrii i Neurologii, II Klinika Neurologiczna
ul. Sobieskiego 9, 02-957 Warszawa, Poland
e-mail: acudna@ipin.edu.pl