Abstract
Status epilepticus (SE) is considered one of the major serious forms of epilepsy with high mortality rate. Since the currently available antiepileptic drugs have low efficacy and high adverse effects, new more efficient and safe therapies are critically needed. There is increasing evidence supporting dietary and alternative therapies for epilepsy, including the ketogenic diet, modified Atkins diet, and omega-3 fatty acids. Recent studies have shown significant prophylactic and therapeutic potential of vitamin D (vit-D) use in many neurological disorders. Therefore, in the present study, the neuroprotective effects and mechanisms of vit-D alone or in combination with lamotrigine have been evaluated in the lithium-pilocarpine model of SE in rats. Rats were divided into five groups: normal group, SE group, lamotrigine (25 mg/kg/day) pretreated group, vit-D (1.5 mcg/kg/day) pretreated group, and group pretreated with vit-D and lamotrigine for 2 weeks. At the end of treatment, SE was induced by single intraperitoneal injection of LiCl (127 mg/kg), followed 24 h later by pilocarpine (30 mg/kg). Seizures’ latency, cognitive performance in Morris water maze, brain oxidative stress biomarkers (glutathione, lipid peroxides, and nitric oxide), brain neurochemistry (γ-aminobutyric acid and glutamate), and brain histopathology have been evaluated. Vit-D prevented pilocarpine-induced behavioral impairments and oxidative stress in the brain; these results were improved in combination with lamotrigine. Vit-D has a promising antiepileptic, neuroprotective, and antioxidant effects. It can be provided to patients as a supportive treatment besides antiepileptic drugs. However, clinical trials are needed to establish its efficacy and safety.
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Abbreviations
- Ca:
-
Calcium
- [Ca 21]i:
-
Cytosolic calcium
- GSH:
-
Glutathione
- GABA:
-
γ-Aminobutyric acid
- IP:
-
Intraperitoneally
- Li-Pc:
-
Lithium-pilocarpine
- NO:
-
Nitric oxide
- SE:
-
Status epilepticus
- TBARS:
-
Thiobarbituric acid-reactive substances
- Vit-D:
-
Vitamin D
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Acknowledgments
The authors would like to thank Abdulmohsen M. Alsofi, Abdullah M. Binjabi, and Hassan S. Tawakkul, Undergraduate Medical Student, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia, for their great help in the experimental part of the study.
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AM conceived and designed the study, conducted the systematic review, conducted the statistical analysis, and drafted the paper. NS contributed to experimental part and interpreting the findings and revised the paper. AA, MA, II, NE, GB, and SG are involved in the critical revision of the paper. All authors edited and approved the final version of the manuscript to be published. AM had full access to data in the study and had final responsibility for the decision to submit for publication.
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This article has been funded by the ICSR Umm Al-Qura University, Saudi Arabia (Grant No. 43509015).
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Mahfoz, A.M., Abdel-Wahab, A.F., Afify, M.A. et al. Neuroprotective effects of vitamin D alone or in combination with lamotrigine against lithium-pilocarpine model of status epilepticus in rats. Naunyn-Schmiedeberg's Arch Pharmacol 390, 977–985 (2017). https://doi.org/10.1007/s00210-017-1400-5
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DOI: https://doi.org/10.1007/s00210-017-1400-5