Title:From the Molecular Mechanism to Pre-clinical Results: Anti-epileptic Effects of Fingolimod
Volume: 18
Issue: 11
Author(s): Yam Nath Paudel*, Efthalia Angelopoulou, Christina Piperi, Vadym Gnatkovsky, Iekhsan Othman and Mohd. Farooq Shaikh*
Affiliation:
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor,Malaysia
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor,Malaysia
Keywords:
Epilepsy, fingolimod, drug repurposing, S1P receptor, neuroinflammation.
Abstract:
Epilepsy is a devastating neurological condition characterized by long-term tendency to
generate unprovoked seizures, affecting around 1-2 % of the population worldwide. Epilepsy is a
serious health concern which often associates with other neurobehavioral comorbidities that further
worsen disease conditions. Despite tremendous research, the mainstream anti-epileptic drugs (AEDs)
exert only symptomatic relief leading to 30% of untreatable patients. This reflects the complexity of
the disease pathogenesis and urges the precise understanding of underlying mechanisms in order to
explore novel therapeutic strategies that might alter the disease progression as well as minimize the
epilepsy-associated comorbidities. Unfortunately, the development of novel AEDs might be a difficult
process engaging huge funds, tremendous scientific efforts and stringent regulatory compliance with a
possible chance of end-stage drug failure. Hence, an alternate strategy is drug repurposing, where
anti-epileptic effects are elicited from drugs that are already used to treat non-epileptic disorders.
Herein, we provide evidence of the anti-epileptic effects of Fingolimod (FTY720), a modulator of
sphingosine-1-phosphate (S1P) receptor, USFDA approved already for Relapsing-Remitting Multiple
Sclerosis (RRMS). Emerging experimental findings suggest that Fingolimod treatment exerts
disease-modifying anti-epileptic effects based on its anti-neuroinflammatory properties, potent neuroprotection,
anti-gliotic effects, myelin protection, reduction of mTOR signaling pathway and activation
of microglia and astrocytes. We further discuss the underlying molecular crosstalk associated
with the anti-epileptic effects of Fingolimod and provide evidence for repurposing Fingolimod to
overcome the limitations of current AEDs.
