Neurology India Medknow Publications on behalf of the Neurological Society of India ISSN: 0028-3886 EISSN: 1998-4022 Vol. 54, Num. 1, 2006, pp. 63-63

Neurology India, Vol. 54, No. 1, January-March, 2006, pp. 63

Invited Comments

Invited Comments

Hoke Ahmet

Department of Neurology, Johns Hopkins University, School of Medicine Path 509, 600 N. Wolfe St. Baltimore, MD, 21287
Correspondence Address:Department of Neurology, Johns Hopkins University, School of Medicine Path 509, 600 N. Wolfe St. Baltimore, MD, 21287, ahoke@jhmi.edu

Code Number: ni06016

Related article: ni06015

The accompanying article titled ′Erythropoietin preconditioning on hippocampus neuronal apoptosis following status epilepticus induced by Li-pilocarpine in rats through anti-caspase-3 expression′ examines the neuroprotective role of erythropoietin (EPO) in epilepsy. In recent years, EPO and its receptor (EPOR) have been shown to be present in the nervous system and EPO is neuroprotective in models of a variety of neurological illnesses. These range from acute illnesses such as stroke and spinal cord injury to more chronic illnesses such as peripheral neuropathies.[1],[2] A Phase II clinical trial of EPO has been completed[3] and a larger multi-center Phase III trial of EPO in stroke is underway in Germany. The article by Wen and colleagues is the first demonstration that EPO may be of benefit in epilepsy. They use a standard animal model of seizure induction in rats and show that pre-treatment of the animals with EPO partially prevents development of seizures and seizure induced neuronal death in this model. However, this is probably the first step in a line of investigation to evaluate a potential therapeutic role for EPO in epilepsy. In most neuroprotective animal models, the investigators administer the neuroprotective drug first before the insult and then after the insult to mimic what would happen in patients. Unfortunately, this second step was not done in this study and will need to be done before one can be more confident of a potential therapeutic role for EPO in epilepsy. Furthermore, in most patients seizures are part of a chronic epileptic illness and potential utility of EPO needs to be tested in an animal model of chronic epilepsy. Having said that though, recombinant human EPO is relatively safe and can be used in the context of a clinical trial in status epilepticus patients if animal studies show benefit when EPO is given after the onset of seizure activity.

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