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Introduction: The overproduction of the efflux transporters in the bloodbrain barrier is considered to play a role in the development of drug
resistance in mesial temporal lobe epilepsy (MTLE) patients. The aim of
the present study was to investigate the relationship of clinical features of
patients with MTLE accompanied by hippocampal sclerosis (HS) and the
p-glycoprotein (p-gp) expression and neuronal loss in the hippocampus.
Methods: This study included a total of 33 patients who underwent
selective amygdala-hippocampectomy operation. A detailed medical
history of each patient, including age, side of HS, sex, age of habitual
seizure onset, duration of habitual seizures, type and age of initial
precipitating injury, presence and duration of latent period, presence
and duration of silent period, monthly seizure frequency within 1 year
prior to operation, mean age at the time of operation was evaluated
retrospectively.
Results: The p-gp expression was significantly higher in the patient group
with a seizure frequency of more than 15 days per month and a disease
duration of more than 20 years. There was no significant difference
between the p-gp expression and the clinical features of the MTLE-HS
patients.
Conclusion: These results suggest that p-gp expression is affected by
disease duration and seizure frequency rather than a patient’s clinical
and pathological properties. In patients with HS-MTLE, potential use of
the p-gp inhibitors as additional therapy and developing novel drugs not
carried by multidrug carriers expressed in blood-brain barrier should be
regarded as the new treatment targets.
Keywords: P-glycoprotein, hippocampal sclerosis, mesial temporal lobe
epilepsy, drug resistance