title: Hippocampal expression of heat shock proteins in mesial temporal lobe epilepsy with psychiatric comorbidities and their relation to seizure outcome.
abstract: OBJECTIVE
  Biologic substrates behind the close association between mesial temporal lobe epilepsy (MTLE) and psychiatric comorbidities are largely unknown. Heat shock protein 70 (HSP70) and HSP90 are ubiquitous molecular chaperones that play important roles in functions from cellular stress response to receptor trafficking control. There are controversial findings regarding HSP expression in epilepsy. Our goal was to examine HSP70 and HSP90 expression within the human hippocampal formation of MTLE patients with and without comorbid major depression and psychosis. In addition, we investigated the possible correlation between HSP expression and seizure outcome.
  
  
  METHODS
  MTLE hippocampi of subjects without psychiatric history, MTLE and major depression, and MTLE and interictal psychosis derived from epilepsy surgery and control necropsies were investigated for neuronal densities, HSP70 and HSP90 immunoreactive area.
  
  
  RESULTS
  Increased HSP expression in MTLE and decreased HSP expression in MTLE with psychosis cases were detailed. Patients taking fluoxetine showed increased HSP90 expression in CA1, and those taking haloperidol decreased HSP90 in the granular layer and subiculum. MTLE patients with complete seizure remission presented with decreased HSP70 expression in CA4 and subiculum and decreased HSP90 expression in the granular layer.
  
  
  CONCLUSIONS
  The present results provide the first demonstration of HSP expression in human MTLE hippocampal formation with and without psychiatric comorbidities. Distinct HSP70 and HSP90 expression might explain some of the structural and synaptic alterations differentially regulated in MTLE with and without psychiatric comorbidities. Increased HSPs expression in key hippocampal subfields would reflect increased epileptogenicity and poorer outcome of epilepsy surgery.
authors.affiliation: Department of Neurosciences and Behavior, Ribeirao Preto School of Medicine, University of Sao Paulo (USP), Ribeirao Preto, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of Sao Paulo (USP), Ribeirao Preto, Brazil.
authors.forename: Ludmyla
authors.initials: L
authors.lastname: Kandratavicius
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Hallak
authors.forename: Carlos G
authors.initials: CG
authors.lastname: Carlotti
authors.forename: Joao A
authors.initials: JA
authors.lastname: Assirati
authors.forename: Joao P
authors.initials: JP
authors.lastname: Leite
mesh_terms: D000328:Adult; D015897:Comorbidity; D004569:Electroencephalography / Q000379:methods; D004833:Epilepsy, Temporal Lobe / Q000453:epidemiology* / Q000378:metabolism / Q000628:therapy; D005260:Female; D006360:Heat-Shock Proteins / Q000378:metabolism*; D006624:Hippocampus / Q000378:metabolism*; D006801:Humans; D008297:Male; D012640:Seizures / Q000453:epidemiology* / Q000378:metabolism / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D006360:Heat-Shock Proteins
keywords: Heat shock protein; Major depression; Psychosis; Seizure outcome; Temporal lobe epilepsy