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Relationship: 2781
Title
Overactivation, NMDARs leads to Status epilepticus
Upstream event
Downstream event
Key Event Relationship Overview
AOPs Referencing Relationship
AOP Name | Adjacency | Weight of Evidence | Quantitative Understanding | Point of Contact | Author Status | OECD Status |
---|---|---|---|---|---|---|
Acetylcholinesterase Inhibition Leading to Neurodegeneration | adjacent | Moderate | Low | Karen Watanabe (send email) | Under development: Not open for comment. Do not cite |
Taxonomic Applicability
Sex Applicability
Sex | Evidence |
---|---|
Unspecific | High |
Life Stage Applicability
Term | Evidence |
---|---|
All life stages | High |
Key Event Relationship Description
N-methyl-D-aspartate (NMDA) receptors are ligand and voltage-gated receptors. They require both a post-synaptic depolarization to remove the Mg2+ block and binding of glutamate for receptor activation (Kandel et al., 2013). High frequency stimulation that occurs during seizure activity aides in removal of the Mg2+ block through depolarization of the affected neuron. The conditions for NMDA receptor activation are ideal as there is prolonged firing and overall increased depolarization during seizure activity (Kapur, 2018). Sustainment of seizure activity for greater than 5 minutes develops into status epilepticus (McDonough and Shih, 1997).
Evidence Collection Strategy
Evidence was collected in multiple ways: literature searches of external databases, review of related KEs and KERS in the AOPWiki, and consultation with experts. Extensive literature searches were conducted in Scopus, Pubmed, and Google Scholar using keywords applicable to each KE, with an initial focus on zebrafish data to then focusing on rat data. Related KEs and KERs in the AOPWiki were also reviewed for relevant evidence and their sources. The “snowball method” was used to find additional articles, i.e., relevant citations within an article were obtained if they provided additional evidence. EndNote reference managing software was used to store results from the literature searches and when possible, a pdf of the manuscript was attached to each record. Papers were reviewed and categorized by whether they contained data to support one or more parts of the AOP. An Excel spreadsheet was used to record reviewed papers and any information worth noting.
Evidence Supporting this KER
Biological Plausibility
NMDA receptor activation through intraperitoneal administration of NMDA has been shown to cause seizure activity in developing and young adult rats with a marked decrease in effect with age (Mares and Velísek, 1992). NMDA receptors appear to play a role in the upregulation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors and downregulation of gamma-aminobutyric acid A (GABAA) receptors through calcium dependent mechanisms during status epilepticus, which ultimately aids in the self-sustainment of seizure activity (Joshi et al., 2017, Kapur, 2018). Furthermore, seizure termination can be seen to occur with application of NMDA receptor antagonists, as evidenced below.
Empirical Evidence
- Status epilepticus induced by exposure to soman in guinea pigs either reduced or arrested after treatment with MK-801, an NMDA receptor antagonist, or was prevented entirely by pretreatment with MK-801 (Sparenborg et al., 1992). An earlier experiment under the same conditions showed similar results (Braitman and Sparenborg, 1989).
- Status epilepticus was induced through electrical stimulation in 13–15-week-old male Wistar rats and was successfully terminated using MK-801 (Mazarati and Wasterlain, 1999).
- Adult male Sprague-Dawley rats had status epilepticus induced through electrical stimulation which was shown to be refractory to GABAergic drugs, but was still successfully terminated using ketamine, an NMDA receptor antagonist (Borris et al., 2000).
Uncertainties and Inconsistencies
Rats exposed to diisopropylfluorophosphate (DFP) manifested status epilepticus and did not respond to treatment with MK-801 (Deshpande et al., 2010). This is in contrast to the effects seen in the above experiments involving soman or electrical stimulation (Mazarati and Wasterlain, 1999, Sparenborg et al., 1992), suggesting that DFP may include mechanisms that are involved in the initiation and/or maintenance of seizure activity.
Known modulating factors
Quantitative Understanding of the Linkage
Response-response Relationship
Time-scale
Known Feedforward/Feedback loops influencing this KER
Domain of Applicability
The effect of overactivation of NMDA receptors leading to seizure activity has been shown in vertebrate species. Notably, in vivo evidence is provided above in empirical evidence for both rats and guinea pigs (Borris et al., 2000, Braitman and Sparenborg, 1989, Mazarati and Wasterlain, 1999, Sparenborg et al., 1992)
References
Borris, D. J., Bertram, E. H. & Kapur, J. 2000. Ketamine controls prolonged status epilepticus. Epilepsy Res, 42, 117-22. DOI: 10.1016/s0920-1211(00)00175-3.
Braitman, D. J. & Sparenborg, S. 1989. MK-801 protects against seizures induced by the cholinesterase inhibitor soman. Brain Research Bulletin, 23, 145-148. DOI: 10.1016/0361-9230(89)90173-1.
Deshpande, L. S., Carter, D. S., Blair, R. E. & DeLorenzo, R. J. 2010. Development of a prolonged calcium plateau in hippocampal neurons in rats surviving status epilepticus induced by the organophosphate diisopropylfluorophosphate. Toxicol Sci, 116, 623-31. DOI: 10.1093/toxsci/kfq157.
Joshi, S., Rajasekaran, K., Sun, H., Williamson, J. & Kapur, J. 2017. Enhanced AMPA receptor-mediated neurotransmission on CA1 pyramidal neurons during status epilepticus. Neurobiol Dis, 103, 45-53. DOI: 10.1016/j.nbd.2017.03.017.
Kandel, E., Schwartz, J., Jessell, T., Siegelbaum, S. & Hudspeth, A. J. 2013. Synaptic Integration in the Central Nervous System. Principles of Neural Science, Fifth Edition. Blacklick, United States: McGraw-Hill Publishing.
Kapur, J. 2018. Role of NMDA receptors in the pathophysiology and treatment of status epilepticus. Epilepsia Open, 3, 165-168. DOI: 10.1002/epi4.12270.
Mares, P. & Velísek, L. 1992. N-methyl-D-aspartate (NMDA)-induced seizures in developing rats. Brain Res Dev Brain Res, 65, 185-9. DOI: 10.1016/0165-3806(92)90178-y.
Mazarati, A. M. & Wasterlain, C. G. 1999. N-methyl-D-asparate receptor antagonists abolish the maintenance phase of self-sustaining status epilepticus in rat. Neurosci Lett, 265, 187-90. DOI: 10.1016/s0304-3940(99)00238-4.
McDonough, J. H., Jr. & Shih, T. M. 1997. Neuropharmacological mechanisms of nerve agent-induced seizure and neuropathology. Neurosci Biobehav Rev, 21, 559-79. DOI: 10.1016/s0149-7634(96)00050-4.
Sparenborg, S., Brennecke, L. H., Jaax, N. K. & Braitman, D. J. 1992. Dizocilpine (MK-801) arrests status epilepticus and prevents brain damage induced by soman. Neuropharmacology, 31, 357-68. DOI: 10.1016/0028-3908(92)90068-z.