# Inflammatory regulation of epileptogenesis after status epilepticus

> **NIH NIH R01** · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · 2024 · $385,000

## Abstract

PROJECT SUMMARY
As the second most common neurological emergency, status epilepticus (SE) is a group of life-threatening
conditions that are characterized by hypersynchronous epileptic activity that lasts for five minutes or longer
without full return of consciousness, and the overall SE-associated mortality rate in adults is about 20-30%.
The generalized convulsive SE constitutes about 45-74% of all cases and has long been known to trigger
neuronal damage, and patients who survive SE can develop long-term neurological sequelae. As such, SE
triggers changes in the brain that can lead to lifelong epilepsy and overall increases the risk of epilepsy by
more than three times compared to non-SE seizures. Despite an increasing list of US FDA-approved
antiseizure drugs (ASDs), about 23-43% of SE patients will progress to refractory SE and do not satisfactorily
respond to current medications, and the mortality rates in these patients can approach up to 39%. Current
ASDs are also well known for their broad neurotoxic adverse effects that are often unbearable and can further
complicate the management of seizures. It is another unfortunate fact that these medications only provide
symptomatic relief and have not been shown to prevent the development of epilepsy after de novo SE or
modify the progression of seizures. Development of the prevention and/or modification strategies for post-SE
epilepsy must hinge on a good understanding of signaling pathways that are provoked by SE and in turn
trigger epileptogenic processes, such as brain cytokine surge, reactive gliosis, neuronal damage, blood-brain
barrier disruption, and brain infiltration of leukocytes and blood proteins, which eventually accumulate in the
occurrence of unprovoked seizures, i.e., chronic epilepsy. Previous studies by us and others show that the
prostaglandin E2 (PGE2) receptor EP2 plays essential roles in brain inflammation, neuronal damage, and
behavioral deficits after SE in rodents. Our results from the previous grant cycle also reveal that Gαs-coupled
EP2 regulates microglial activation to release cytokines via its downstream effector – exchange protein
activated by cAMP (EPAC), and the SE-upregulated EPAC in turn contributes to neuroinflammation. Objective
of this proposed study is to reveal the molecular and cellular mechanisms whereby PGE2/EP2/EPAC axis
triggers these neuroinflammatory processes after SE and thus contributes to acquired epilepsy and behavioral
comorbidities. To achieve this goal, we will use multiple in vitro (aim 1) and in vivo (aims 2 and 3) models
engaging a unique set of genetic and pharmacological approaches that we developed during the previous
funding cycle. Completion of this study will provide novel insights into the regulation of neuroinflammatory
processes in the epileptogenesis after de novo SE, which should be also relevant to epilepsies triggered by
other brain insults, such as strokes, TBIs, brain infections and tumors, owing to the shared commonalities ...

## Key facts

- **NIH application ID:** 10799518
- **Project number:** 2R01NS100947-07
- **Recipient organization:** UNIVERSITY OF TENNESSEE HEALTH SCI CTR
- **Principal Investigator:** Jianxiong Jiang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $385,000
- **Award type:** 2
- **Project period:** 2018-08-03 → 2028-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10799518

## Citation

> US National Institutes of Health, RePORTER application 10799518, Inflammatory regulation of epileptogenesis after status epilepticus (2R01NS100947-07). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10799518. Licensed CC0.

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