Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Biochemical and pharmacological effects of gamma-vinyl GABA (Vigabatrin, GVG), and irreversible enzyme-activated inhibitor of 4-aminobutyrate: 2-oxoglutarate aminotransferase (EC 2.6.1.19; GABA-T), were measured in mice. This anticonvulsant produced a time- and dose-dependent elevation of the GABA, phenylalanine and lysine contents of cortical tissue and simultaneously decreased glutamate, aspartate and alanine levels. In addition, GVG caused a biphasic change in glutamine concentrations (a decline 1-4 hours after administration, followed 20 hours later by an increase). Moreover, we found a new, as yet unidentified amino acid in the brain eluting with the same retention time as alpha-aminoadipic acid from an HPLC cation-exchange column. The level of this novel chemical entity was greatly increased by GVG 20 hours after injection of the drug. At all tested intervals between 1 and 60 hours after injection, GVG was ineffective against maximal electroshock. The GABA-T inhibitor dose-dependently protected mice against isoniazid-induced seizures, simultaneously causing an increase in brain GABA concentrations. However, this apparent correlation applied only until 4 hours after treatment. To better define the anticonvulsant profile of GVG, groups of mice were treated, 1, 2, 4, and 24 hours prior to challenge with convulsant doses of strychnine, pentetrazole (PTZ), and picrotoxin, and brain amino acid levels, including brain concentrations of GVG, were measured. In all instances, the time dependency of the anticonvulsant effects of GVG and of increases in brain GABA levels differed. Amino acid concentrations in animals treated only with GVG were similar to those in animals given GVG and a chemical convulsant. GVG showed no selectivity for seizures produced by impairment of GABA-ergic neurotransmission. Although GVG is an effective GABA-T inhibitor, it apparently affects several other pyridoxal-phosphate-dependent cerebral enzymes and/or interacts with other neurotransmitter systems as well.
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PMID:Gamma-vinyl GABA: comparison of neurochemical and anticonvulsant effects in mice. 341 34

Vigabatrin (GVG) (3 g/day) and placebo were compared as an add-on to standard therapy in therapy-resistant epileptic patients using a double-blind crossover design with randomized treatment allocation. Twenty-three patients entered the trial, with four dropping out due to either increased seizure frequency following the cross-over from GVG to placebo (n = 1), intolerance to GVG therapy (n = 2), or poor seizure record (n = 1). Of the 19 patients who completed the study, 17 had partial seizures, eight of whom had secondary generalization and two who had primary generalized seizures. Compared with placebo, GVG was associated with a significant reduction in seizure frequency (p less than 0.01), with 11 of 19 patients experiencing greater than 50% reduction in weekly seizure occurrence, two showing a 25-50% reduction, four unchanged, and two showing an increase in seizures. Global efficacy ratings were greater in the GVG period for 15 patients (p less than 0.05) compared with one in whom there was no period difference and two in whom ratings were higher in the placebo period. Fourteen of the 19 patients indicated a preference for the GVG period. Adverse effects observed during GVG treatment were generally mild and consisted of drowsiness, confusion, nausea, irritability, and constipation. No clinically significant alterations in laboratory test results were observed. No treatment-related changes in plasma concentrations of concomitant antiepileptic drugs were noted. These results confirm the antiepileptic efficacy of oral GVG in refractory epileptics.
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PMID:Double-blind, placebo-controlled study of vigabatrin (gamma-vinyl GABA) in drug-resistant epilepsy. 351 4

The efficacy and tolerability of vigabatrin (gamma-vinyl GABA, GVG), given as add-on therapy to 23 adult outpatients with severe drug-resistant epilepsy (17 with partial seizures), were studied using a double-blind, placebo-controlled, crossover design. The study consisted of two 7-week periods during which vigabatrin and placebo were administered in random sequence. Dosage was 1.0 g twice daily for patients weighing less than or equal to 65 kg and 1.5 g twice daily for patients weighing greater than 65 kg. Three patients were dropped from the study, two for reasons unrelated to treatment and one because of the appearance of vertigo, headache, dysarthria, and ataxia, which subsided rapidly when vigabatrin was stopped (3 g daily). Sixteen of the 20 patients available for analysis showed a decrease in the total number of seizures as compared with the placebo period. Of these, 12 showed a greater than 50% reduction in seizure frequency and 4 of the 12 showed a greater than 75% reduction. Both the total number of seizures and the number of partial seizures were significantly reduced by vigabatrin (p less than 0.01). Only in the patient who dropped out were severe adverse effects seen. The most frequently reported unwanted effect was mild drowsiness, which developed in seven patients on vigabatrin and in one on placebo. Positive effects, however, were also seen with six patients who reported an improved sense of well-being while receiving vigabatrin as compared with only 1 during the placebo period. No consistent changes in electrocardiogram (ECG), electroencephalogram (EEG), and visual-, auditory-, and somatosensory-evoked potentials were seen during the study.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Vigabatrin in the treatment of epilepsy: a double-blind, placebo-controlled study. 353 69

gamma-Vinyl GABA (GVG), an irreversible inhibitor of GABA degradation, was administered to seizure-susceptible gerbils at different dosage regimens. After acute i.p. administration, GVG dose dependently protected the animals against air blast-induced seizures with an ED50 of 50 mg/kg. After oral administration, GVG exerted similar anticonvulsant potency. However, during subchronic daily oral dosing of 100 mg/kg GVG, tolerance developed to the anticonvulsant effect of the treatment. No tolerance was observed with daily oral dosing of 50 mg/kg or every other day and every third day dosing of 100 mg/kg GVG. The disadvantage of the two latter dosage regimens was that no sufficient seizure control was obtained on the days between two administrations. Determination of GABA levels in 11 brain regions of gerbils after subchronic treatment with the different dosage regimens of GVG indicated that tolerance during treatment with daily administration of 100 mg/kg GVG could be the consequence of feedback reduction of GABA synthesis. The data suggest that the choice of suitable dosage regimens for chronic treatment is more critical with GVG than with other antiepileptic drugs, because compensatory mechanisms within the GABA system may develop when GVG-induced GABA accumulation is too marked.
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PMID:One to three day dose intervals during subchronic treatment of epileptic gerbils with gamma-vinyl GABA: anticonvulsant efficacy and alterations in regional brain GABA levels. 369 61

Injection of gamma-vinyl aminobutyric acid (GVG) into the anterior thalamus protected rats against pentylenetetrazol (PTZ) seizures but not against maximal electroshock (MES) seizures. Injection of GVG into the substantia nigra protected against MES seizures but not against PTZ seizures. Both types of seizures were prevented by injections into both of the above brain regions. These data indicate that separate neuronal circuits mediate PTZ and MES seizures.
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PMID:Anterior thalamus and substantia nigra: two distinct structures mediating experimental generalized seizures. 380 76

The effects of bilateral microinjection of gamma-vinyl GABA (GVG, an irreversible inhibitor of GABA-T) were tested during the development of seizures induced by i.p. administration of 10 mg/kg of kainic acid. Intrahippocampal injection of GVG prevents the development of the seizures at an early stage in about half of the cases. In the remaining animals status epilepticus comparable to that of controls develops. Intra-amygdaloid injection reduces the severity of the seizures from the first motor limbic signs. Finally, intranigral injection prevents the appearance of convulsive status epilepticus or, when it develops, reduces its duration. The role that these three structures could play in the electro-clinical development of kainic acid-induced seizures is discussed.
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PMID:[Role of the hippocampus, amygdala and the substantia nigra in the evolution of status epilepticus induced by systemic injection of kainic acid in the rat]. 652 78

In a pilot single-blind study, gamma-vinyl GABA, an enzyme-activated irreversible inhibitor of GABA-transaminase (GABA-T), was administered orally to 10 epileptic patients who were refractory to conventional anticonvulsant therapy. Daily doses of 1 g and 2 g for 2 weeks each as add-on therapy were followed by 2 weeks of placebo treatment. CSF obtained from suboccipital and lumbar punctures demonstrated dose-related increases in concentrations of free and total GABA and homocarnosine with treatment, but no changes in 5-hydroxyindoleacetic acid or homovanillic acid levels, indicating effective and selective CNS GABA-T inhibition. These biochemical changes were associated with decreased seizure frequency in seven patients, decreased seizure severity in one, no change in one, and possible worsening in one. gamma-Vinyl GABA may be useful in the therapy of epilepsy.
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PMID:Biochemical and clinical effects of gamma-vinyl GABA in patients with epilepsy. 653 6

Vigabatrin (gamma-vinyl-GABA or GVG) is an irreversible inhibitor of gamma-aminobutyric acid transaminase (GABA-T), which is an enzyme responsible for gamma-aminobutyric acid (GABA) catabolism. Inhibition of GABA catabolism increases brain concentration of GABA, a neural inhibitor. GVG has been found to be a potent new anti-epileptic drug, especially in the treatment of refractory epilepsy, in particular of complex partial seizures. Three patients who developed a severe status epilepitus while on GVG treatment are reported. A possible proconvulsive effect of GVG is hypothesized, which might result from disinhibition in the nigro-collicular pathway due to increased GABA-levels.
Seizure 1995 Jun
PMID:Status epilepticus during vigabatrin treatment: a report of three cases. 767 Jul 70

To determine whether the substantia nigra GABAergic anticonvulsant effects depend on GABAB receptor activation, we tested the effects of intranigral CGP 35,348 (a GABAB receptor antagonist) alone or in combination with gamma-vinyl-GABA (GVG; a GABA-transaminase inhibitor) on flurothyl seizures in rat pups and adult rats. In pups, nigral infusions of CGP 35,348 decreased the thresholds for clonic and tonic seizures and attenuated the anticonvulsant effects of GVG. In adults, nigral infusions of CGP 35,348 did not alter seizure thresholds. The data suggest that, in rat pups, nigral GABAB receptors regulate, in part, flurothyl-induced seizures.
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PMID:Further evidence of involvement of substantia nigra GABAB receptors in seizure suppression in developing rats. 795 29

The discovery of gamma-aminobutyric acid (GABA) as the first major inhibitory neurotransmitter and a program exploring the use of enzyme inhibition as a therapeutic tool provided the basis for the conception of vigabatrin (VGB, Sabril). This molecule, an analogue of GABA, has a highly specific activity as an enzyme-activated irreversible inhibitor of GABA-transaminase causing several-fold increases in the concentration of brain GABA. In animal models for epilepsy, it was found to have a rather different spectrum of activity than conventional antiepileptic drugs (AEDs). The clinical development of VGB was delayed by the finding of focal areas of reversible microvacuolation in the white matter of the brains of rodents and dogs. An extensive human safety program has confirmed that this finding is species specific and does not occur in humans. Clinically, VGB is well tolerated and has been shown to be specially effective in the management of partial seizures that have failed to respond to other AEDs. In most controlled studies, about 50% of patients with previously uncontrolled seizures have a 50% reduction in frequency and about 4-5% become seizure-free. In children, it also appears to be especially effective in the management of infantile spasms as well as in partial seizures. VGB offers a significant improvement in the management of epilepsy and is now under development as a first-line agent.
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PMID:Vigabatrin. 803 66


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