Empagliflozin modulates seizure activity and oxidative stress in rats with epilepsy
Year 2024,
Volume: 16 Issue: 2, 1195 - 1204, 17.10.2024
Neha Holla
,
Shalini Adiga
,
Meena Kumari
,
Mohandas Rao Kapettu Gadahad
,
Prameetha Naik
Abstract
Drug-resistant epilepsy, a commonly devastating condition, affects more than 50 million people globally. Type 2 diabetes mellitus (T2DM) is associated with an increased risk of neurological disorders, and a potential association between epilepsy and subsequent T2DM has emerged. Inhibiting sodium-glucose linked transporters (SGLTs), which are differentially expressed in the brain, has been shown to reduce epileptic episode activity. This study aimed to evaluate the anticonvulsive effect of empagliflozin in rats with seizures induced by maximal electric shock (MES) and pentylenetetrazol (PTZ). Generalized tonic‒clonic seizures were induced in the rats using an electroconvulsive meter, and pentylenetetrazol was injected to induce absence seizures. The duration of all the stages of seizure and Racine stage scoring (RSS) were performed. Malondialdehyde (MDA), nitric oxide (NO) and reduced glutathione (GSH) levels in the brain tissues were determined. Histopathological analysis of the brain tissues was carried out. A significant (p <0.01) decrease in the duration of tonic hind limb extension (THLE), a significant decrease in the levels of pro-oxidants such as MDA and NO, and an increase in the levels of antioxidants such as GSH were observed in the low dose 10 mg/kg and high dose 20 mg/kg empagliflozin groups compared to the disease control group. Histopathological analysis revealed a greater number of healthy neurons with few dark-stained cells in the treatment groups, suggesting the neuroprotective effect of empagliflozin. The present study showed that empagliflozin modulates epileptic activity. Empagliflozin has a potential role in the management of epilepsy in diabetic patients.
Ethical Statement
The study was carried out in accordance with the rules set forth by the Committee for Control and Supervision of Experimentation on Animals (CCSEA), and the protocol was authorized (IAEC/KMC/65/2021) by the Institutional Animal Ethics Committee.
Supporting Institution
Nil
References
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Year 2024,
Volume: 16 Issue: 2, 1195 - 1204, 17.10.2024
Neha Holla
,
Shalini Adiga
,
Meena Kumari
,
Mohandas Rao Kapettu Gadahad
,
Prameetha Naik
References
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- Blunck JR, Newman JW, Fields RK, Croom JE. (2018) Therapeutic augmentation of ketogenic diet with a sodium-glucose cotransporter 2 inhibitor in a super refractory status epilepticus patient. Epilepsy Behav Case Rep. 10:61-64. doi: 10.1016/j.ebcr.2018.05.002.
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- Lu CL, Chang YH, Sun Y, Li CY. (2018). A population-based study of epilepsy incidence in association with type 2 diabetes and severe hypoglycaemia. Diabetes Res Clin Pract. 140:97-106. doi: 10.1016/j.diabres.2018.03.020.
- Lüttjohann A, Fabene PF, van Luijtelaar G. (2009). A revised Racine's scale for PTZ-induced seizures in rats. Physiol Behav. 98(5):579-586. doi: 10.1016/j.physbeh.2009.09.005.
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- Rovet JF, Ehrlich RM. (1999). The effect of hypoglycemic seizures on cognitive function in children with diabetes: a 7-year prospective study. J Pediatr. 134(4):503-506. doi:10.1016/s0022-3476(99)70211-8.
- Sander JW, Novy J, Keezer MR. (2016). The intriguing relationship between epilepsy and type 1 diabetes mellitus. Diabetologia. 59(7):1569-1570. doi:10.1007/s00125-016-3982-8
- Sarangi SC, Joshi D, Kumar R, Kaleekal T, Gupta YK. (2017). Pharmacokinetic and pharmacodynamic interaction of hydroalcoholic extract of Ocimum sanctum with valproate. Epilepsy Behav.75:203-209. doi: 10.1016/j.yebeh.2017.08.018.
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- Smiałowska M, Wierońska JM, Szewczyk B. (2003). Neuroprotective effect of NPY on kainate neurotoxicity in the hippocampus. Pol J Pharmacol. 55(6):979-986. PMID: 14730092.
- Sudha K, Rao AV, Rao A.(2001). Oxidative stress and antioxidants in epilepsy. Clin Chim Acta.303(1-2):19-24. doi:10.1016/s0009-8981(00)00337-5.
- Tharmaraja T, Ho JSY, Sia CH, et al. (2022). Sodium-glucose cotransporter 2 inhibitors and neurological disorders: a scoping review. Ther Adv Chronic Dis. 13:20406223221086996. doi:10.1177/20406223221086996.
- Thijs RD, Surges R, O'Brien TJ, Sander JW.(2019). Epilepsy in adults. Lancet. 393(10172):689-701. doi: 10.1016/S0140-6736(18)32596-0.. PMID: 30686584.3.
- Tsai KF, Chen YL, Chiou TT, et al. (2021). Emergence of SGLT2 Inhibitors as Powerful Antioxidants in Human Diseases. Antioxidants (Basel). 10(8):1166. doi:10.3390/antiox10081166.
- Wiciński M, Wódkiewicz E, Górski K, Walczak M, Malinowski B. (2020). Perspective of SGLT2 Inhibition in Treatment of Conditions Connected to Neuronal Loss: Focus on Alzheimer's Disease and Ischemia-Related Brain Injury. Pharmaceuticals (Basel). 13(11):379. doi:10.3390/ph13110379.