Аннотация
Современные стратегии лечения эпилепсии основаны главным образом на нормализации взаимодействия возбуждающей и тормозной системы, что оказывается не эффективным у пациентов с фармакорезистентной формой эпилепсии. Нейровоспалительные процессы в эпилептическом очаге и в его перифокальной зоне могут быть причиной развития апоптоза, а также могут играть роль в формировании лекарственной устойчивости. В биоптатах серого и белого вещества височной доли головного мозга пациентов с фармакорезистентной эпилепсией, полученных интраоперационно, с помощью иммуноблоттинга было проанализировано содержание про- и антиапоптотических белков (p-NF-kB, TNF-α, p53, FAS, caspase-3, caspase-9). В коре и белом веществе перифокальной зоны выявлено повышенное содержание проапоптотических белков на фоне дисбаланса белков путей выживания. При этом, вероятно, активация апоптоза по внешнему пути происходит в перифокальной зоне, тогда как в эпилептическом очаге присутствуют белки характерные для активации протективных путей. Активное нейровоспаление в эпилептическом очаге и перифокальной зоне височной доли может способствовать развитию резистентности к противоэпилептическим препаратам и прогрессированию нейродегенерации у таких пациентов.
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