title: Blood-brain barrier leakage may lead to progression of temporal lobe epilepsy.
abstract: Leakage of the blood-brain barrier (BBB) is associated with various neurological disorders, including temporal lobe epilepsy (TLE). However, it is not known whether alterations of the BBB occur during epileptogenesis and whether this can affect progression of epilepsy. We used both human and rat epileptic brain tissue and determined BBB permeability using various tracers and albumin immunocytochemistry. In addition, we studied the possible consequences of BBB opening in the rat for the subsequent progression of TLE. Albumin extravasation in human was prominent after status epilepticus (SE) in astrocytes and neurons, and also in hippocampus of TLE patients. Similarly, albumin and tracers were found in microglia, astrocytes and neurons of the rat. The BBB was permeable in rat limbic brain regions shortly after SE, but also in the latent and chronic epileptic phase. BBB permeability was positively correlated to seizure frequency in chronic epileptic rats. Artificial opening of the BBB by mannitol in the chronic epileptic phase induced a persistent increase in the number of seizures in the majority of rats. These findings indicate that BBB leakage occurs during epileptogenesis and the chronic epileptic phase and suggest that this can contribute to the progression of epilepsy.
authors.affiliation: Epilepsy Institute of The Netherlands (SEIN), Heemstede.
authors.forename: E A
authors.initials: EA
authors.lastname: van Vliet
authors.forename: S
authors.initials: S
authors.lastname: da Costa Araújo
authors.forename: S
authors.initials: S
authors.lastname: Redeker
authors.forename: R
authors.initials: R
authors.lastname: van Schaik
authors.forename: E
authors.initials: E
authors.lastname: Aronica
authors.forename: J A
authors.initials: JA
authors.lastname: Gorter
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000418:Albumins; D000818:Animals; D001812:Blood-Brain Barrier / Q000503:physiopathology*; D001921:Brain / Q000378:metabolism; D002908:Chronic Disease; D004396:Coloring Agents; D018450:Disease Progression; D004569:Electroencephalography / Q000379:methods; D004833:Epilepsy, Temporal Lobe / Q000378:metabolism / Q000503:physiopathology*; D005070:Evans Blue; D005452:Fluoresceins; D006801:Humans; D008297:Male; D008875:Middle Aged; D009930:Organic Chemicals; D010539:Permeability; D051381:Rats; D017207:Rats, Sprague-Dawley; D013226:Status Epilepticus / Q000503:physiopathology
chemical_list: D000418:Albumins; D004396:Coloring Agents; D005452:Fluoresceins; D009930:Organic Chemicals; C435731:fluoro jade; D005070:Evans Blue