New Insights into Epilepsy: From Molecular Physiology to Pathology
A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".
Deadline for manuscript submissions: 25 August 2025 | Viewed by 818
Special Issue Editor
Interests: epilepsy
Special Issue Information
Dear Colleagues,
In 2002, Vezzani et al. wrote that brain inflammation is the pathophysiological cause of epileptic seizures, not a simple predisposing factor, and in 2004 Riazi et al. highlight the role of peripheral inflammation capable of migrating from the intestine to the brain. What has been called the inflammatory response is the way of communication between organs, with repair as the object of communication.
Characteristic of the inflammatory response is the cascade of cytokines, divided into pro-inflammatory ones, which produce greater necrosis, and anti-inflammatory ones which reconstruct the tissues, even more damaged by the former. Therefore, cytokines play an important role in defining the seizure threshold.
Already in 1995, altered cytokine production was evident in epileptic patients, which we now know depends on the biodiversity of the microbiota. While we are always capable of producing the first cytokines, the second ones are produced capable or unable to reconstruct tissues depending on the biodiversity of the microbiota. Furthermore, we know that cytokines are the operational arm of the microbiota with which it controls all the functions of the human body, even the functioning of organs, including the brain and immune system. It is not healthy to entrust the control of the human body to incapable cytokines, in fact this type of inflammatory response, called low-grade chronic, has been defined as the mother of pathologies.
All this leads us to consider the intestine and the microbiota as organs responsible for epileptic seizures, as was already known from Hippocrates, 400 BC, to 1930, when 50% of the treatment on epilepsy was on the ketogenic diet. We have known for some time that ketones are not responsible for its effectiveness in controlling seizures, but rather its anti-inflammatory action, modifying microbiota. Similarly, an intestinal anti-inflammatory action of antiepileptic drugs can contribute to the control of seizures. Thus, an intestinal anti-inflammatory action is reported for levetiracetam, a drug whose effectiveness was discovered causally, having not given answers to the usual tests, for Cannabidiol, and for Topiramate.
To find new therapeutic strategies, we will have to adapt ancient knowledge with current evidence, and understand what the optimal diet is to allow the microbiota to take care of us.
Dr. Paolo Mainardi
Guest Editor
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Keywords
- epilepsy
- molecular pathology
- disease
- therapeutic strategies
- celluar advance
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