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Identifying the mechanism of action of the Kv7 channel opener, retigabine in the treatment of epilepsy

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Abstract

Epilepsy is characterized by recurrent epileptic seizures caused by high levels of neuronal excitability in the brain. Voltage-sensitive K+ channels (Kv) of the Kv7 (KCNQ) family encoded by the KCNQ gene are involved in a wide range of cellular processes, i.e., KCNQ2 and KCNQ3 channels mediate M-currents to inhibit neuronal excitability and reduce transmitter release throughout the nervous system. Thus, as a positive allosteric modulator (or opener) of KCNQ channels, retigabine has been the only clinically approved anti-seizure medication that acts on the KCNQ channels. This review discusses the biochemical mechanisms about how retigabine acts on Kv7 channels, significance in neuronal pathophysiology, preclinical efficacy, and clinical stage of development. Additional efforts are being made to emphasize the possible benefits and drawbacks of retigabine compared to currently available medications for treatment-resistant epilepsy.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (No. 81870935) and the Scientific Research Found of Wuhan University of Technology (No. 40122070) to WJ.

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Authors and Affiliations

  1. Hubei Key Laboratory of Nanomedicine for Neurodegenerative Diseases, School of Chemistry, Chemical Engineering and Life Sciences, Wuhan University of Technology, 122 Loushi Rd, Wuhan, 430070, China

    Aqeela Zahra, Jingjing Wang & Jianping Wu

  2. Department of Zoology, University of Sialkot, Sialkot, 51310, Pakistan

    Aqeela Zahra

  3. Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China

    Ru Liu & Jianping Wu

  4. Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100070, China

    Ru Liu & Jianping Wu

  5. National Clinical Research Center for Neurological Disease, Beijing, 100070, China

    Ru Liu & Jianping Wu

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  1. Aqeela Zahra
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  2. Ru Liu
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Contributions

A.Z. and R.L conducted the literature review and wrote the initial draft of the manuscript. W.H., H.M., W.Q., W.Y., and SC made preliminary revisions to the manuscript. J.W. made critical revisions and approved the final version of the manuscript. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Jianping Wu.

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Aqeela Zahra and Ru Liu contributed to this work equally.

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Zahra, ., Liu, R., Wang, J. et al. Identifying the mechanism of action of the Kv7 channel opener, retigabine in the treatment of epilepsy. Neurol Sci 44, 3819–3825 (2023). https://doi.org/10.1007/s10072-023-06955-x

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