Abstract

Temporal Lobe Epilepsy (TLE) is the most common form of human epilepsy and available treatments with antiepileptic drugs are not disease-modifying therapies. The neuroinflammation, neuronal death and exacerbated plasticity that occur during the silent period, following the initial precipitating event (IPE), seem to be crucial for epileptogenesis. Damage Associated Molecular Patterns (DAMP) such as HMGB-1, are released early during this period concomitantly with a phenomenon of reactive gliosis and neurodegeneration. Here, using a combination of primary neuronal and glial cell cultures, we show that exposure to HMGB-1 induces dendrite loss and neurodegeneration in a glial-dependent manner. In glial cells, loss of function studies showed that HMGB-1 exposure induces NF-κB activation by engaging a signaling pathway that involves TLR2, TLR4, and RAGE. In the absence of glial cells, HMGB-1 failed to induce neurodegeneration of primary cultured cortical neurons. Moreover, purified astrocytes were unable to fully respond to HMGB-1 with NF-κB activation and required microglial cooperation. In agreement, in vivo HMGB-1 blockage with glycyrrhizin, immediately after pilocarpine-induced status epilepticus (SE), reduced neuronal degeneration, reactive astrogliosis and microgliosis in the long term. We conclude that microglial-astroglial cooperation is required for astrocytes to respond to HMGB-1 and to induce neurodegeneration. Disruption of this HMGB-1 mediated signaling pathway shows beneficial effects by reducing neuroinflammation and neurodegeneration after SE. Thus, early treatment strategies during the latency period aimed at blocking downstream signaling pathways activated by HMGB-1 are likely to have a significant effect in the neuroinflammation and neurodegeneration that are proposed as key factors in epileptogenesis.

Highlights

  • Epilepsy is a devastating neurological disease characterized by recurrent seizures

  • HMGB-1 is a prototypical Damage Associated Molecular Patterns (DAMP) released after cell injury and capable of activating innate immune responses

  • Extracellular HMGB-1 interacts with TLR2, TLR4, and Receptor for Advanced Glycation End products (RAGE) to induce innate immunity activation and neuroinflammation within the Central Nervous System (CNS) (Qiu et al, 2010; Yang et al, 2010; Weber et al, 2015; reviewed in Tian et al, 2017)

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Summary

Introduction

Epilepsy is a devastating neurological disease characterized by recurrent seizures. A significant number of patients develop refractory epilepsy that is unresponsive to currently available treatments, which leaves them with very limited clinical options, being surgical resection of the epileptic focus the most common choice. Retrospective studies have shown that most patients suffering of Temporal Lobe Epilepsy (TLE), the most common human epilepsy, refer an initial precipitating event (IPE) in early childhood, followed by a silent period when the epileptic seizures begin (Cendes et al, 1993; French et al, 1993; Hamati-Haddad and Abou-Khalil, 1998; Theodore et al, 1999; Blume, 2006; Majores et al, 2007). Previous studies performed in our laboratory, during the latency period that follows pilocarpine-induced seizures, have shown early neuroinflammation, macrophage infiltration and exacerbated neuronal plasticity, which seem to have a main role in the epileptogenesis (Rossi et al, 2013, 2017)

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