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High-probability grants
According to our matching algorithm, Shilpa D. Kadam is the likely recipient of the following grants.
Years |
Recipients |
Code |
Title / Keywords |
Matching score |
2014 — 2015 |
Kadam, Shilpa Dattatray |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Neonatal Ischemic Seizures: Age and Gender Susceptibility to Refractoriness @ Hugo W. Moser Res Inst Kennedy Krieger
DESCRIPTION (provided by applicant): The immature brain is susceptible to post-ischemic seizures. Current clinical practice includes empiric treatments with phenobarbital (PB) as first line for confirmed or suspected seizures in the newborn. This proposal will investigate the age and gender dependent differences in KCC2 expression and modulation following ischemic neonatal brains of CD1 mice. In preparation we have established the age-dependent increase in KCC2 expression and the age-dependent efficacy of first line anticonvulsant drug, phenobarbital on neonatal ischemic seizures in-vivo in P7, P10 and P12 pups. We have found phenobarbital to be inefficacious in suppressing ischemic seizures at P7 and significantly efficacious at P10 and P12 using quantitative video-EEG. Our data show a significant biological sex related difference both in the severity of post-ischemic seizures and in the efficacy of phenobarbital to suppress seizures at P7. The following hypotheses will be tested in the CD1 mouse model of neonatal stroke induced by unilateral common carotid ligation only (i.e., no global hypoxia): 1.Ischemic insults downregulate the acute and delay the sub-acute developmental expression profile of the adult-form electroneutral chloride cotransporter KCC2 (chloride-extruding K-Cl cotransporter) at P7 and P10; 2. Early blocking of KCC2 downregulation following ischemia may be a novel strategy to prevent emergence of refractory neonatal seizures. 3. Quantitative video-EEG of acute post-stroke events from P7 and P10 CD1 pups and their response to standard and novel anticonvulsants like PB and bumetanide (BTN; potent NKCC1 antagonist) will help predict the efficacy of combination therapies immediate versus early after blocking KCC2 downregulation following neonatal stroke. The added inefficacy of novel anticonvulsant BTN; a potent NKCC1 antagonist detected in our previously funded study by the EFA (2011) has highlighted the importance of the differential efficacy of BTN in different seizure models. Especially of interest are our preliminary findings that KCC2 is downregulated after ischemia in this model whereas NKCC1 expression remains stable with trends towards upregulation. Therefore the mechanism by which acute seizures are induced in immature brains and the specific effect that protocol has on enhancing or worsening chloride cotransporter function by phosphorylation or degradation of KCC2 may dictate the efficacy of anticonvulsants that depend on the chloride gradient for their anti-seizure effects. Post-ischemic response of preventing KCC2 downregulation to immediate treatment with combination therapy of phenobarbital and NKCC1 antagonist bumetanide will be investigated and compared to early treatment after the occurrence of ischemic seizures and evaluated for sexual dimorphism.
|
0.937 |
2017 — 2021 |
Kadam, Shilpa Dattatray |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Mechanisms Regulating Kcc2 Hypofunction During Refractory Seizures in a Mouse Model of Ischemic Neonatal Seizures @ Hugo W. Moser Res Inst Kennedy Krieger
Project summary/abstract: The long-term goal of this research project is to gain an understanding of the broader relationship between phenobarbital-resistant seizures in neonates, the role of KCC2 hypofunction in the emergence of refractory seizures, and the efficacy of novel KCC2 functional enhancers in a mouse model of neonatal ischemic seizures. Refractory neonatal seizures are highly correlated with childhood seizure syndromes and cognitive disabilities. The development of more effective therapies will benefit from a deeper understanding of the pathophysiology and mechanisms of underlying refractoriness and epileptogenesis in animal models. The KCC2 chloride co-transporter is the chief Cl- extruder in central nervous system neurons. Severe impairment in a neurons ability to extrude Cl- reverses the transmembrane Cl- gradient resulting in GABA mediated depolarization instead of hyperpolarization. Excitotoxic insults in neonatal brains are often associated with severe seizure burdens that are commonly refractory to first-line therapeutic interventions with GABA agonists like phenobarbital. Our previous work has shown that ischemia significantly downregulates Cl- co-transporter KCC2 expression but NKCC1 expression which is the Cl- importer remains unaffected with trends of upregulation in post-ischemic brains. Rescuing the pathophysiological hypofunction of KCC2 following ischemic insults is an untested strategy in neonatal brains. Hypothesis: Rescuing KCC2 hypofunction in neonatal ischemia will restore the physiological levels of synaptic inhibition and neuronal network activity. This rescue will prevent the emergence of refractory seizures and successfully reduce seizure burdens with GABA agonists which in turn will be disease modifying in the long-term. Aims: 1.Plot the dynamics of early and acute KCC2 degradation following ischemia and investigate the regulation of intrinsic KCC2 hypofunction during ischemic seizures. 2. Document the KCC2 degradation related depolarization of cortical neurons following ischemia and the effects of a KCC2 agonist on such depolarization in-vitro 3. Rescue refractory ischemic - seizures in-vivo with a novel KCC2 agonist and quantitate effect on long-term co-morbidities. Deliverables: Upon successful completion of this project, we will move closer to understanding the link between the dynamic changes of KCC2 expression during neonatal seizures to the emergence of refractoriness. Impact and Innovation: Understanding the mechanisms by which the immature brain is transformed with repeated seizures in the neonatal period will help guide evidence-based strategies into treatments for intractable seizures that are often associated with severe long-term co-morbidities in children. 1
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0.937 |