Abstract

The current knowledge about neuroprotective mechanisms in humans after status epilepticus is scarce. One reason is the difficulty to measure possible mediators of these neuroprotective mechanisms. The dawn of microRNA detection in the cerebrospinal fluid (CSF) and the recent advancements in measuring proteins in the CSF such as progranulin, which is, e.g., responsible for neurite outgrowth and limiting exceeding neuroinflammatory responses, have given us new insights into putative neuroprotective mechanisms following status epilepticus. This should complement the animal data. In this review, we cover what is known about the role of progranulin as well as the links between microRNA changes and the progranulin pathway following status epilepticus in humans and animals hypothesizing neuroprotective and neurorehabilitative effects. Progranulin has also been found to feature prominently in the neuroprotective processes under hypoxic conditions and initiating neurorehabilitative processes. These properties may be used therapeutically, e.g., through drugs that raise the progranulin levels and therefore the cerebral progranulin levels as well with the goal of improving the outcome after status epilepticus.

Highlights

  • Status epilepticus (SE) is a devastating and common acute disease in neurology and emergency care [1]

  • The aim of this review is to provide an overview of the data on PGRN and status epilepticus including the proteins and miRNA strongly related to PGRN hypothesizing the role of these proteins in the neuroregenerative and neuroprotective mechanisms during and after status epilepticus

  • We found a significant increase of PGRN in the cerebrospinal fluid (CSF) after status epilepticus

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Summary

Introduction

Status epilepticus (SE) is a devastating and common acute disease in neurology and emergency care [1]. Possibly during other forms of status epilepticus, hypoxic and inflammatory stress are initiated together with microglia and macrophage activation [2,3]. This stress induces several cerebral processes resulting in severe neuronal damage and worsening the clinical outcome. As a response to status epilepticus, PGRN is secreted by activated microglia as part of neuroregeneration and probably neuroprotection. This has been shown in rats [5] and presumably in humans [6], though further research is needed here. The aim of this review is to provide an overview of the data on PGRN and status epilepticus including the proteins and miRNA strongly related to PGRN hypothesizing the role of these proteins in the neuroregenerative and neuroprotective mechanisms during and after status epilepticus

Progranulin
Progranulin in Neuroinflammation and Hypoxia
Progranulin in Epilepsy
Progranulin and MicroRNA
Progranulin and Therapeutic Intervention
Findings
Conclusions
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