Özlem Uzunkaya Ethemoğlu1, Nalan Kayrak2, Bilge Bılgıç3, Günay Gül4, Demet Yandim Kuşçu5, Dursun Kirbaş6. 1. Department of Neurology, Harran University School of Medicine, Şanlıurfa, Turkey. 2. Private Practice, Neurology, Assoc. Prof., İstanbul, Turkey. 3. Department of Pathology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey. 4. Neurology and Neurosurgery Department, Bakırköy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatry, İstanbul, Turkey. 5. Neurology Department, MedAmerikan Medical Center, İstanbul, Turkey. 6. Department of Neurology, Gaziosmanpaşa Hospital, İstanbul, Turkey.
Abstract
INTRODUCTION: The overproduction of the efflux transporters in the blood-brain barrier is considered to play a role in the development of drug resistance in mesial temporal lobe epilepsy (MTLE) patients. The aim of the present study was to investigate the relationship of clinical features of patients with MTLE accompanied by hippocampal sclerosis (HS) and the p-glycoprotein (p-gp) expression and neuronal loss in the hippocampus. METHODS: This study included a total of 33 patients who underwent selective amygdala-hippocampectomy operation. A detailed medical history of each patient, including age, side of HS, sex, age of habitual seizure onset, duration of habitual seizures, type and age of initial precipitating injury, presence and duration of latent period, presence and duration of silent period, monthly seizure frequency within 1 year prior to operation, mean age at the time of operation was evaluated retrospectively. RESULTS: The p-gp expression was significantly higher in the patient group with a seizure frequency of more than 15 days per month and a disease duration of more than 20 years. There was no significant difference between the p-gp expression and the clinical features of the MTLE-HS patients. CONCLUSION: These results suggest that p-gp expression is affected by disease duration and seizure frequency rather than a patient's clinical and pathological properties. In patients with HS-MTLE, potential use of the p-gp inhibitors as additional therapy and developing novel drugs not carried by multidrug carriers expressed in blood-brain barrier should be regarded as the new treatment targets. Copyright:
INTRODUCTION: The overproduction of the efflux transporters in the blood-brain barrier is considered to play a role in the development of drug resistance in mesial temporal lobe epilepsy (MTLE) patients. The aim of the present study was to investigate the relationship of clinical features of patients with MTLE accompanied by hippocampal sclerosis (HS) and the p-glycoprotein (p-gp) expression and neuronal loss in the hippocampus. METHODS: This study included a total of 33 patients who underwent selective amygdala-hippocampectomy operation. A detailed medical history of each patient, including age, side of HS, sex, age of habitual seizure onset, duration of habitual seizures, type and age of initial precipitating injury, presence and duration of latent period, presence and duration of silent period, monthly seizure frequency within 1 year prior to operation, mean age at the time of operation was evaluated retrospectively. RESULTS: The p-gp expression was significantly higher in the patient group with a seizure frequency of more than 15 days per month and a disease duration of more than 20 years. There was no significant difference between the p-gp expression and the clinical features of the MTLE-HS patients. CONCLUSION: These results suggest that p-gp expression is affected by disease duration and seizure frequency rather than a patient's clinical and pathological properties. In patients with HS-MTLE, potential use of the p-gp inhibitors as additional therapy and developing novel drugs not carried by multidrug carriers expressed in blood-brain barrier should be regarded as the new treatment targets. Copyright:
Authors: Eleonora Aronica; Jan A Gorter; Marja Ramkema; Sandra Redeker; Filiz Ozbas-Gerçeker; Edwin A van Vliet; George L Scheffer; Rik J Scheper; Paul van der Valk; Johannes C Baayen; Dirk Troost; Filiz Ozbas-Gerçerer Journal: Epilepsia Date: 2004-05 Impact factor: 5.864