ULOGA GLIJA ĆELIJA, KRVNO-MOŽDANE BARIJERE I CITOKINA U NASTANKU KONVULZIJA: IMPLIKACIJE ZA TERAPEUTSKE MODALITETE
Sažetak
Epilepsija predstavlja hroničnu, učestalu neurološku bolest koja se karakteriše prolaznom, paroksizmalnom i hipersinhronom aktivnošću moždanih neurona, a manifestuje se u obliku konvulzivnih napada. Razvija se kroz proces epileptogeneze koji podrazumeva poremećaj ekcitabilnosti neurona, uspostavalje kritičnih međuveza između neurona, razvoj nervne hiperekscitabilnosti i degeneracije, kao i reorganizaciju neuronske mreže.
Postoje brojni različiti mehanizmi epileptogeneze koji uključuju neuroiflamacijju koja je u skorašnjem vremenu označena kao značajan i novi mehanizam. U ovom revijskom radu cilj će biti da se rasvetle najnovija činjenična saznanja o neuroiflamaciji kao patogeneteskom faktoru epileptogeneze.
Neuroiflamacija se karakteriše strukturnom i funkcionalnom alteracijom glijanih ćelija u CNS-u, nakupljenjem ćelija imuniteta poreklom izvan CNS-a uz disfunkciju krvno-moždane barijere (KMB). Moremećaj ekstracelularne mikrosredine u CNS-u je takođe često praćen povećanom sintezom proinflamatornih citokina (IL-6, IL-1β, TNF-α, IFN-γ) i hemokina u CNS-u. Uzajamno dejstvo između alteracije glijalnih ćelija, disfunkcije KMB, citokina i hemokina, dovodi do uspostavljanja pozitivne povratne sprege u kaskadnom procesu epileptogeneze.
Još u vek je nejasno da li neuroiflamacija dovodi do epileptogeneze ili je samo posledica iste, ali, postoje jasne činjenice koje ukazuju da postoji pozitivna povratna sprega između ova dva procesa. Činjenica da postoji povezanost ova dva procesa može biti korisno saznanje u smislu iznalaženja potentnijih terapeutskih tretmana neuroiflamacije koji bi doveli do pozitivnih efekata u lečenju pacijenata sa epilepsijom.
Ključne reči: epilepsija, epileptogneza, neuroinflamacija, alterajija glijanih ćelija, disfukncija KMB, citokini, hemokini
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