title: Progressive NKCC1-dependent neuronal chloride accumulation during neonatal seizures.
abstract: Seizures induce excitatory shifts in the reversal potential for GABA(A)-receptor-mediated responses, which may contribute to the intractability of electro-encephalographic seizures and preclude the efficacy of widely used GABAergic anticonvulsants such as phenobarbital. We now report that, in intact hippocampi prepared from neonatal rats and transgenic mice expressing Clomeleon, recurrent seizures progressively increase the intracellular chloride concentration ([Cl(-)](i)) assayed by Clomeleon imaging and invert the net effect of GABA(A) receptor activation from inhibition to excitation assayed by the frequency of action potentials and intracellular Ca(2+) transients. These changes correlate with increasing frequency of seizure-like events and reduction in phenobarbital efficacy. The Na(+)-K(+)-2Cl(-) (NKCC1) cotransporter blocker bumetanide inhibited seizure-induced neuronal Cl(-) accumulation and the consequent facilitation of recurrent seizures. Our results demonstrate a novel mechanism by which seizure activity leads to [Cl(-)](i) accumulation, thereby increasing the probability of subsequent seizures. This provides a potential mechanism for the early crescendo phase of neonatal seizures.
authors.affiliation: Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Volodymyr I
authors.initials: VI
authors.lastname: Dzhala
authors.forename: Kishore V
authors.initials: KV
authors.lastname: Kuchibhotla
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Glykys
authors.forename: Kristopher T
authors.initials: KT
authors.lastname: Kahle
authors.forename: Waldemar B
authors.initials: WB
authors.lastname: Swiercz
authors.forename: Guoping
authors.initials: G
authors.lastname: Feng
authors.forename: Thomas
authors.initials: T
authors.lastname: Kuner
authors.forename: George J
authors.initials: GJ
authors.lastname: Augustine
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Bacskai
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Staley
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D002712:Chlorides / Q000378:metabolism* / Q000502:physiology; D018450:Disease Progression; D005260:Female; D006624:Hippocampus / Q000737:chemistry / Q000378:metabolism / Q000502:physiology; D007424:Intracellular Fluid / Q000737:chemistry / Q000378:metabolism; D008297:Male; D051379:Mice; D009474:Neurons / Q000737:chemistry / Q000378:metabolism*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012008:Recurrence; D012640:Seizures / Q000378:metabolism*; D028021:Sodium-Potassium-Chloride Symporters / Q000502:physiology*; D064506:Solute Carrier Family 12, Member 2; D013997:Time Factors
chemical_list: D002712:Chlorides; C578878:Slc12a2 protein, mouse; C578879:Slc12a2 protein, rat; D028021:Sodium-Potassium-Chloride Symporters; D064506:Solute Carrier Family 12, Member 2
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