Targeting LDH enzymes with a stiripentol analog to treat epilepsy

N Sada, S Lee, T Katsu, T Otsuki, T Inoue - Science, 2015 - science.org
N Sada, S Lee, T Katsu, T Otsuki, T Inoue
Science, 2015science.org
Neuronal excitation is regulated by energy metabolism, and drug-resistant epilepsy can be
suppressed by special diets. Here, we report that seizures and epileptiform activity are
reduced by inhibition of the metabolic pathway via lactate dehydrogenase (LDH), a
component of the astrocyte-neuron lactate shuttle. Inhibition of the enzyme LDH
hyperpolarized neurons, which was reversed by the downstream metabolite pyruvate. LDH
inhibition also suppressed seizures in vivo in a mouse model of epilepsy. We further found …
Neuronal excitation is regulated by energy metabolism, and drug-resistant epilepsy can be suppressed by special diets. Here, we report that seizures and epileptiform activity are reduced by inhibition of the metabolic pathway via lactate dehydrogenase (LDH), a component of the astrocyte-neuron lactate shuttle. Inhibition of the enzyme LDH hyperpolarized neurons, which was reversed by the downstream metabolite pyruvate. LDH inhibition also suppressed seizures in vivo in a mouse model of epilepsy. We further found that stiripentol, a clinically used antiepileptic drug, is an LDH inhibitor. By modifying its chemical structure, we identified a previously unknown LDH inhibitor, which potently suppressed seizures in vivo. We conclude that LDH inhibitors are a promising new group of antiepileptic drugs.
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