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CNS & Neurological Disorders - Drug Targets

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ISSN (Print): 1871-5273
ISSN (Online): 1996-3181

Research Article

Spontaneous Recurrent Seizures Mediated Cardiac Dysfunction via mTOR Pathway Upregulation: A Putative Target for SUDEP Management

Author(s): Supriya Sharma, Arindam G. Mazumder, Anil K. Rana, Vikram Patial and Damanpreet Singh*

Volume 18, Issue 7, 2019

Page: [555 - 565] Pages: 11

DOI: 10.2174/1871527318666190801112027

Price: $65

Abstract

Background: Alteration in electrophysiology, leading to cardiac dysfunction and subsequently a nontraumatic death is a complication of epilepsy known as “SUDEP” (Sudden Unexpected Death in Epilepsy).

Aims: The present study was designed to understand the molecular changes and cardiac parameters during different phases of epileptogenesis in lithium-pilocarpine (Li-pilo) rat model of epilepsy.

Methods: The animals were exposed to Li-pilo to induce Spontaneous Recurrent Seizures (SRS). Noninvasive blood pressure and electrocardiography was recorded at 7th, 28th and 75th day following pilocarpine administration, considered as latent, initial and late SRS phases, respectively. The serum biochemistry, cardiac histopathology, protein and mRNA expressions were studied, following electrocardiography on day 75.

Results: The mean arterial pressure decreased during the latent phase, thereafter it progressively increased during the initial and the late SRS phases, as compared to the basal and the latent phase. Histopathological analysis of the heart sections indicated hypertrophy, degenerative changes and fibrous tissue deposition in epileptic animals, along with increased levels of lactate dehydrogenase and creatine kinase-MB in the serum. The expression of HIF-1α, phospho-S6, phospho-mTOR, TGF-β, collagen I and Na+/K+-ATPase α1 proteins, and mRNA levels of HIF-1α, mTOR, Rps6, Scn1b, Scn3b, Nav1.5 and TGF-β were increased in the cardiac tissue of epileptic animals, as compared to control.

Conclusion: Our results conclusively showed that Li-pilo-induced SRS leads to cardiac dysfunction via mTOR pathway upregulation, thus suggested the regulatory control of mTOR pathway as a potential target for SUDEP management.

Keywords: Cardiomyopathy, fibrosis, HIF-1α, hypoxia, Na+/K+- ATPase α1, ribosomal S6.

Graphical Abstract

[1]
Sokka A, Olsen P, Kirjavainen J, et al. Etiology, syndrome diagnosis, and cognition in childhood-onset epilepsy: A population-based study. Epilepsia Open 2017; 2(1): 76-83.
[http://dx.doi.org/10.1002/epi4.12036] [PMID: 29750215]
[2]
Burtscher J, Schwarzer C. The opioid system in temporal lobe epilepsy: functional role and therapeutic potential. Front Mol Neurosci 2017; 10: 245.
[http://dx.doi.org/10.3389/fnmol.2017.00245] [PMID: 28824375]
[3]
Goldberg EM, Coulter DA. Mechanisms of epileptogenesis: A convergence on neural circuit dysfunction. Nat Rev Neurosci 2013; 14(5): 337-49.
[http://dx.doi.org/10.1038/nrn3482] [PMID: 23595016]
[4]
Feng Y, Zhang S, Zhang Z, et al. Understanding genotypes and phenotypes of the mutations in voltage-gated sodium channel α subunits in epilepsy. CNS Neurol Disord Drug Targets 2019; 18(4): 266-72.
[http://dx.doi.org/10.2174/1871527317666181026164825]
[5]
Surges R, Thijs RD, Tan HL, Sander JW. Sudden unexpected death in epilepsy: Risk factors and potential pathomechanisms. Nat Rev Neurol 2009; 5(9): 492-504.
[http://dx.doi.org/10.1038/nrneurol.2009.118] [PMID: 19668244]
[6]
Singh D, Mishra A, Goel RK. Effect of saponin fraction from Ficus religiosa on memory deficit, and behavioral and biochemical impairments in pentylenetetrazol kindled mice. Epilepsy Behav 2013; 27(1): 206-11.
[http://dx.doi.org/10.1016/j.yebeh.2012.11.004] [PMID: 23332444]
[7]
Scorza FA, de Albuquerque M, Arida RM, Cavalheiro EA. Sudden unexpected death in epilepsy: Are winter temperatures a new potential risk factor? Epilepsy Behav 2007; 10(3): 509-10.
[http://dx.doi.org/10.1016/j.yebeh.2007.02.012] [PMID: 17400027]
[8]
Rugg-Gunn FJ, Holdright D. Epilepsy and the heart. Br J Cardiol 2010; 17: 223-9.
[9]
Scorza FA, Arida RM, Cysneiros RM, et al. The brain-heart connection: Implications for understanding sudden unexpected death in epilepsy. Cardiol J 2009; 16(5): 394-9.
[PMID: 19753516]
[10]
Ravindran K, Powell KL, Todaro M, O’Brien TJ. The pathophysiology of cardiac dysfunction in epilepsy. Epilepsy Res 2016; 127: 19-29.
[http://dx.doi.org/10.1016/j.eplepsyres.2016.08.007] [PMID: 27544485]
[11]
Jansen K, Lagae L. Cardiac changes in epilepsy. Seizure 2010; 19(8): 455-60.
[http://dx.doi.org/10.1016/j.seizure.2010.07.008] [PMID: 20688543]
[12]
Sevcencu C, Struijk JJ. Autonomic alterations and cardiac changes in epilepsy. Epilepsia 2010; 51(5): 725-37.
[http://dx.doi.org/10.1111/j.1528-1167.2009.02479.x] [PMID: 20067509]
[13]
Nei M, Mintzer S, Skidmore C, Sperling MR, Ho RT. Heart rate and blood pressure in sudden unexpected death in epilepsy (SUDEP). Epilepsy Res 2016; 122: 44-6.
[http://dx.doi.org/10.1016/j.eplepsyres.2016.02.008] [PMID: 26921856]
[14]
Nascimento FA, Tseng ZH, Palmiere C, et al. Pulmonary and cardiac pathology in sudden unexpected death in epilepsy (SUDEP). Epilepsy Behav 2017; 73: 119-25.
[http://dx.doi.org/10.1016/j.yebeh.2017.05.013] [PMID: 28633090]
[15]
Oppenheimer S. Cerebrogenic cardiac arrhythmias: Cortical lateralization and clinical significance. Clin Auton Res 2006; 16(1): 6-11.
[http://dx.doi.org/10.1007/s10286-006-0276-0] [PMID: 16477489]
[16]
Mazumder AG, Sharma P, Patial V, Singh D. Ginkgo biloba L. attenuates spontaneous recurrent seizures and associated neurological conditions in lithium-pilocarpine rat model of temporal lobe epilepsy through inhibition of mammalian target of rapamycin pathway hyperactivation. J Ethnopharmacol 2017; 204: 8-17.
[http://dx.doi.org/10.1016/j.jep.2017.03.060] [PMID: 28390940]
[17]
Racine RJ. Modification of seizure activity by electrical stimulation. II. Motor seizure. Electroencephalogr Clin Neurophysiol 1972; 32(3): 281-94.
[http://dx.doi.org/10.1016/0013-4694(72)90177-0] [PMID: 4110397]
[18]
Gupta M, Sharma P, Mazumder AG, Patial V, Singh D. Dwindling of cardio damaging effect of isoproterenol by Punica granatum L. peel extract involve activation of nitric oxide-mediated Nrf2/ARE signaling pathway and apoptosis inhibition. Nitric Oxide 2015; 50: 105-13.
[http://dx.doi.org/10.1016/j.niox.2015.09.002] [PMID: 26363155]
[19]
Konopelski P, Ufnal M. Electrocardiography in rats: A comparison to human. Physiol Res 2016; 65(5): 717-25.
[PMID: 27429108]
[20]
Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2−ΔΔCT method. methods 2001; 25: 402-2.
[21]
Devinsky O. Effects of seizures on autonomic and cardiovascular function. Epilepsy Curr 2004; 4(2): 43-6.
[http://dx.doi.org/10.1111/j.1535-7597.2004.42001.x] [PMID: 15562299]
[22]
Devinsky O, Spruill T, Thurman D, Friedman D. Recognizing and preventing epilepsy-related mortality: A call for action. Neurology 2016; 86(8): 779-86.
[http://dx.doi.org/10.1212/WNL.0000000000002253] [PMID: 26674330]
[23]
Read MI, Andreianova AA, Harrison JC, Goulton CS, Sammut IA, Kerr DS. Cardiac electrographic and morphological changes following status epilepticus: Effect of clonidine. Seizure 2014; 23(1): 55-61.
[http://dx.doi.org/10.1016/j.seizure.2013.09.012] [PMID: 24139618]
[24]
Scorza FA, Arida RM, Naffah-Mazzacoratti Mda G, Scerni DA, Calderazzo L, Cavalheiro EA. The pilocarpine model of epilepsy: What have we learned? An Acad Bras Cienc 2009; 81(3): 345-65.
[http://dx.doi.org/10.1590/S0001-37652009000300003] [PMID: 19722008]
[25]
Curia G, Longo D, Biagini G, Jones RS, Avoli M. The pilocarpine model of temporal lobe epilepsy. J Neurosci Methods 2008; 172(2): 143-57.
[http://dx.doi.org/10.1016/j.jneumeth.2008.04.019] [PMID: 18550176]
[26]
Mazumder AG, Padwad YS, Singh D. Anticancer mammalian target of rapamycin (mTOR) signaling pathway inhibitors: Current status, challenges and future prospects in management of epilepsy. CNS Neurol Disord Drug Targets 2016; 15: 945-55.
[PMID: 27306063]
[27]
Opherk C, Coromilas J, Hirsch LJ. Heart rate and EKG changes in 102 seizures: Analysis of influencing factors. Epilepsy Res 2002; 52(2): 117-27.
[http://dx.doi.org/10.1016/S0920-1211(02)00215-2] [PMID: 12458028]
[28]
Vitorino PR, Gomes KP, Ghazale PP, et al. Coronary vasodilation impairment in pilocarpine model of epilepsy. Epilepsy Behav 2019; 90: 7-10.
[http://dx.doi.org/10.1016/j.yebeh.2018.10.037] [PMID: 30476810]
[29]
Suorsa E, Korpelainen JT, Ansakorpi H, et al. Heart rate dynamics in temporal lobe epilepsy-A long-term follow-up study. Epilepsy Res 2011; 93(1): 80-3.
[http://dx.doi.org/10.1016/j.eplepsyres.2010.10.005] [PMID: 21093218]
[30]
Bealer SL, Little JG, Metcalf CS, Brewster AL, Anderson AE. Autonomic and cellular mechanisms mediating detrimental cardiac effects of status epilepticus. Epilepsy Res 2010; 91(1): 66-73.
[http://dx.doi.org/10.1016/j.eplepsyres.2010.06.013] [PMID: 20650612]
[31]
Devinsky O, Perrine K, Theodore WH. Interictal autonomic nervous system function in patients with epilepsy. Epilepsia 1994; 35(1): 199-204.
[http://dx.doi.org/10.1111/j.1528-1157.1994.tb02933.x] [PMID: 8112246]
[32]
Klabunde RE. Neurohumoral control of the heart and circulation.In: Cardiovascular physiology concepts. 2nd ed. Philadelphia, USA: Lippincott Williams & Wilkins 2012; pp. 124-47.
[33]
Peng S, Yu Y, Hao K, et al. Heart rate-corrected QT interval duration is significantly associated with blood pressure in Chinese hypertensives. J Electrocardiol 2006; 39(2): 206-10.
[http://dx.doi.org/10.1016/j.jelectrocard.2005.08.007] [PMID: 16580421]
[34]
Klimas J, Stankovicova T, Kyselovic J, Bacharova L. Prolonged QT interval is associated with blood pressure rather than left ventricular mass in spontaneously hypertensive rats. Clin Exp Hypertens 2008; 30(7): 475-85.
[http://dx.doi.org/10.1080/10641960802443399] [PMID: 18855252]
[35]
Katholi RE, Couri DM. Left ventricular hypertrophy: Major risk factor in patients with hypertension: Update and practical clinical applications. Int J Hypertens 2011; 2011495349
[http://dx.doi.org/10.4061/2011/495349] [PMID: 21755036]
[36]
Wong KY, Wong SY, McSwiggan S, et al. Myocardial fibrosis and QTc are reduced following treatment with spironolactone or amiloride in stroke survivors: A randomised placebo-controlled cross-over trial. Int J Cardiol 2013; 168(6): 5229-33.
[http://dx.doi.org/10.1016/j.ijcard.2013.08.027] [PMID: 23993727]
[37]
Biet M, Morin N, Lessard-Beaudoin M, et al. Prolongation of action potential duration and QT interval during epilepsy linked to increased contribution of neuronal sodium channels to cardiac late Na+ current: Potential mechanism for sudden death in epilepsy. Circ Arrhythm Electrophysiol 2015; 8(4): 912-20.
[http://dx.doi.org/10.1161/CIRCEP.114.002693] [PMID: 26067667]
[38]
Bazett HC. An analysis of the time relations of electrocardiograms. Heart 1920; 7: 353-70.
[39]
Lai YC, Li N, Lawrence W, et al. Myocardial remodeling and susceptibility to ventricular tachycardia in a model of chronic epilepsy. Epilepsia Open 2018; 3(2): 213-23.
[http://dx.doi.org/10.1002/epi4.12107] [PMID: 29881800]
[40]
Legriel S, Bruneel F, Dalle L, et al. Recurrent takotsubo cardiomyopathy triggered by convulsive status epilepticus. Neurocrit Care 2008; 9(1): 118-21.
[http://dx.doi.org/10.1007/s12028-008-9107-6] [PMID: 18506637]
[41]
Metcalf CS, Poelzing S, Little JG, Bealer SL. Status epilepticus induces cardiac myofilament damage and increased susceptibility to arrhythmias in rats. Am J Physiol Heart Circ Physiol 2009; 297(6): H2120-7.
[http://dx.doi.org/10.1152/ajpheart.00724.2009] [PMID: 19820194]
[42]
Vranyac-Tramoundanas A, Harrison JC, Sawant PM, Kerr DS, Sammut IA. Ischemic cardiomyopathy following seizure induction by domoic Acid. Am J Pathol 2011; 179(1): 141-54.
[http://dx.doi.org/10.1016/j.ajpath.2011.03.017] [PMID: 21703399]
[43]
Dobaczewski M, Chen W, Frangogiannis NG. Transforming growth factor (TGF)-β signaling in cardiac remodeling. J Mol Cell Cardiol 2011; 51(4): 600-6.
[http://dx.doi.org/10.1016/j.yjmcc.2010.10.033] [PMID: 21059352]
[44]
Talasaz AH, Khalili H, Jenab Y, Salarifar M, Broumand MA, Darabi F. N-Acetylcysteine effects on transforming growth factor-β and tumor necrosis factor-α serum levels as pro-fibrotic and inflammatory biomarkers in patients following ST-segment elevation myocardial infarction. Drugs R D 2013; 13(3): 199-205.
[http://dx.doi.org/10.1007/s40268-013-0025-5] [PMID: 24048773]
[45]
Bodor GS. Biochemical markers of myocardial damage. EJIFCC 2016; 27(2): 95-111.
[PMID: 27683523]
[46]
Nass RD, Meiling S, Andrié RP, Elger CE, Surges R. Laboratory markers of cardiac and metabolic complications after generalized tonic-clonic seizures. BMC Neurol 2017; 17(1): 187.
[http://dx.doi.org/10.1186/s12883-017-0965-4] [PMID: 28927394]
[47]
Wong KC. Correlation between serum lactate dehydrogenase (LDH) and seizure-an observation in clinical cases. IJASEAT 2016; 4: 99-103.
[http://dx.doi.org/10.13140/rg.2.1.1849.3525/1]
[48]
Deng X, Xie Y, Chen Y. Effect of neuroinflammation on ABC transporters: Possible contribution to refractory epilepsy. CNS Neurol Disord Drug Targets 2018; 17(10): 728-35.
[http://dx.doi.org/10.2174/1871527317666180828121820] [PMID: 30152292]
[49]
Zang K, Zhang Y, Hu J, Wang Y. The large conductance calcium-and voltage-activated potassium channel (BK) and epilepsy. CNS Neurol Disord Drug Targets 2018; 17(4): 248-54.
[http://dx.doi.org/10.2174/1871527317666180404104055] [PMID: 29623857]
[50]
Zhu Y, Zhang S, Feng Y, Xiao Q, Cheng J, Tao J. The Yin and Yang of BK channels in epilepsy. CNS Neurol Disord Drug Targets 2018; 17(4): 272-9.
[http://dx.doi.org/10.2174/1871527317666180213142403] [PMID: 29437015]
[51]
Stefanon I, Cade JR, Fernandes AA, et al. Ventricular performance and Na+-K+ ATPase activity are reduced early and late after myocardial infarction in rats. Braz J Med Biol Res 2009; 42(10): 902-11.
[http://dx.doi.org/10.1590/S0100-879X2009005000015] [PMID: 19787147]
[52]
Rook MB, Evers MM, Vos MA, Bierhuizen MF. Biology of cardiac sodium channel Nav1.5 expression. Cardiovasc Res 2012; 93(1): 12-23.
[http://dx.doi.org/10.1093/cvr/cvr252] [PMID: 21937582]
[53]
Tan HL, Bink-Boelkens MT, Bezzina CR, et al. A sodium-channel mutation causes isolated cardiac conduction disease. Nature 2001; 409(6823): 1043-7.
[http://dx.doi.org/10.1038/35059090] [PMID: 11234013]
[54]
Pesce L, Comellas A, Sznajder JI. β-adrenergic agonists regulate Na-K-ATPase via p70S6k. Am J Physiol Lung Cell Mol Physiol 2003; 285(4): L802-7.
[http://dx.doi.org/10.1152/ajplung.00266.2002] [PMID: 12704019]
[55]
Gordan R, Gwathmey JK, Xie LH. Autonomic and endocrine control of cardiovascular function. World J Cardiol 2015; 7(4): 204-14.
[http://dx.doi.org/10.4330/wjc.v7.i4.204] [PMID: 25914789]
[56]
Hainsworth R, Drinkhill MJ, Rivera-Chira M. The autonomic nervous system at high altitude. Clin Auton Res 2007; 17(1): 13-9.
[http://dx.doi.org/10.1007/s10286-006-0395-7] [PMID: 17264976]
[57]
Collins TR. Low oxygen during seizures tied to heart problems. Neurol Today 2011; 11: 20-5.
[http://dx.doi.org/10.1097/01.NT.0000407795.99796.2b]
[58]
Semenza GL. Hypoxia-inducible factor 1 and cardiovascular disease. Annu Rev Physiol 2014; 76: 39-56.
[http://dx.doi.org/10.1146/annurev-physiol-021113-170322] [PMID: 23988176]
[59]
Malhotra R, Tyson DW, Rosevear HM, Brosius FC III. Hypoxia-inducible factor-1alpha is a critical mediator of hypoxia induced apoptosis in cardiac H9c2 and kidney epithelial HK-2 cells. BMC Cardiovasc Disord 2008; 8: 9.
[http://dx.doi.org/10.1186/1471-2261-8-9] [PMID: 18447926]
[60]
Cerrada I, Ruiz-Saurí A, Carrero R, et al. Hypoxia-inducible factor 1 alpha contributes to cardiac healing in mesenchymal stem cells-mediated cardiac repair. Stem Cells Dev 2013; 22(3): 501-11.
[http://dx.doi.org/10.1089/scd.2012.0340] [PMID: 22873764]
[61]
Sciarretta S, Volpe M, Sadoshima J. Mammalian target of rapamycin signaling in cardiac physiology and disease. Circ Res 2014; 114(3): 549-64.
[http://dx.doi.org/10.1161/CIRCRESAHA.114.302022] [PMID: 24481845]
[62]
Zhang H, Qian DZ, Tan YS, et al. Digoxin and other cardiac glycosides inhibit HIF-1α synthesis and block tumor growth. Proc Natl Acad Sci USA 2008; 105(50): 19579-86.
[http://dx.doi.org/10.1073/pnas.0809763105] [PMID: 19020076]
[63]
Shioi T, McMullen JR, Tarnavski O, et al. Rapamycin attenuates load-induced cardiac hypertrophy in mice. Circulation 2003; 107(12): 1664-70.
[http://dx.doi.org/10.1161/01.CIR.0000057979.36322.88] [PMID: 12668503]
[64]
Gao XM, Wong G, Wang B, et al. Inhibition of mTOR reduces chronic pressure-overload cardiac hypertrophy and fibrosis. J Hypertens 2006; 24(8): 1663-70.
[http://dx.doi.org/10.1097/01.hjh.0000239304.01496.83] [PMID: 16877971]
[65]
Simm A, Schlüter K, Diez C, Piper HM, Hoppe J. Activation of p70(S6) kinase by β-adrenoceptor agonists on adult cardiomyocytes. J Mol Cell Cardiol 1998; 30(10): 2059-67.
[http://dx.doi.org/10.1006/jmcc.1998.0768] [PMID: 9799659]
[66]
Hernández G, Lal H, Fidalgo M, et al. A novel cardioprotective p38-MAPK/mTOR pathway. Exp Cell Res 2011; 317(20): 2938-49.
[http://dx.doi.org/10.1016/j.yexcr.2011.09.011] [PMID: 22001647]
[67]
Li X, Zhu Q, Liu Y, Yang Z, Li B. Gastrodin protects myocardial cells against hypoxia/reoxygenation injury in neonatal rats by inhibiting cell autophagy through the activation of mTOR signals in PI3K-Akt pathway. J Pharm Pharmacol 2018; 70(2): 259-67.
[http://dx.doi.org/10.1111/jphp.12838] [PMID: 29148068]
[68]
Qadir MI, Anwar S. Sirtuins in brain aging and neurological disorders. Crit Rev Eukaryot Gene Expr 2017; 27(4): 321-9.
[http://dx.doi.org/10.1615/CritRevEukaryotGeneExpr.2017019532] [PMID: 29283326]
[69]
Ghosh HS, McBurney M, Robbins PD. SIRT1 negatively regulates the mammalian target of rapamycin. PLoS One 2010; 5(2)e9199
[http://dx.doi.org/10.1371/journal.pone.0009199] [PMID: 20169165]

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