A ketogenic diet suppresses seizures in mice through adenosine A 1 receptors

Susan A. Masino, Tianfu Li, Panos Theofilas, Ursula S. Sandau, David N. Ruskin, Bertil B. Fredholm, Jonathan D. Geiger, Eleonora Aronica, Detlev Boison

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Abstract

A ketogenic diet (KD) is a high-fat, low-carbohydrate metabolic regimen; its effectiveness in the treatment of refractory epilepsy suggests that the mechanisms underlying its anticonvulsive effects differ from those targeted by conventional antiepileptic drugs. Recently, KD and analogous metabolic strategies have shown therapeutic promise in other neurologic disorders, such as reducing brain injury, pain, and inflammation. Here, we have shown that KD can reduce seizures in mice by increasing activation of adenosine A1 receptors (A1Rs). When transgenic mice with spontaneous seizures caused by deficiency in adenosine metabolism or signaling were fed KD, seizures were nearly abolished if mice had intact A1Rs, were reduced if mice expressed reduced A1Rs, and were unaltered if mice lacked A 1Rs. Seizures were restored by injecting either glucose (metabolic reversal) or an A1R antagonist (pharmacologic reversal). Western blot analysis demonstrated that the KD reduced adenosine kinase, the major adenosine-metabolizing enzyme. Importantly, hippocampal tissue resected from patients with medically intractable epilepsy demonstrated increased adenosine kinase. We therefore conclude that adenosine deficiency may be relevant to human epilepsy and that KD can reduce seizures by increasing A1R-mediated inhibition.

Original languageEnglish (US)
Pages (from-to)2679-2683
Number of pages5
JournalJournal of Clinical Investigation
Volume121
Issue number7
DOIs
StatePublished - Jul 1 2011

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Ketogenic Diet
Adenosine
Seizures
Adenosine Kinase
Epilepsy
Adenosine A1 Receptors
Encephalitis
Nervous System Diseases
Anticonvulsants
Brain Injuries
Transgenic Mice
Western Blotting
Fats
Carbohydrates
Glucose
Pain
Enzymes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Masino, S. A., Li, T., Theofilas, P., Sandau, U. S., Ruskin, D. N., Fredholm, B. B., ... Boison, D. (2011). A ketogenic diet suppresses seizures in mice through adenosine A 1 receptors. Journal of Clinical Investigation, 121(7), 2679-2683. https://doi.org/10.1172/JCI57813

A ketogenic diet suppresses seizures in mice through adenosine A 1 receptors. / Masino, Susan A.; Li, Tianfu; Theofilas, Panos; Sandau, Ursula S.; Ruskin, David N.; Fredholm, Bertil B.; Geiger, Jonathan D.; Aronica, Eleonora; Boison, Detlev.

In: Journal of Clinical Investigation, Vol. 121, No. 7, 01.07.2011, p. 2679-2683.

Research output: Contribution to journalArticle

Masino, SA, Li, T, Theofilas, P, Sandau, US, Ruskin, DN, Fredholm, BB, Geiger, JD, Aronica, E & Boison, D 2011, 'A ketogenic diet suppresses seizures in mice through adenosine A 1 receptors', Journal of Clinical Investigation, vol. 121, no. 7, pp. 2679-2683. https://doi.org/10.1172/JCI57813
Masino SA, Li T, Theofilas P, Sandau US, Ruskin DN, Fredholm BB et al. A ketogenic diet suppresses seizures in mice through adenosine A 1 receptors. Journal of Clinical Investigation. 2011 Jul 1;121(7):2679-2683. https://doi.org/10.1172/JCI57813
Masino, Susan A. ; Li, Tianfu ; Theofilas, Panos ; Sandau, Ursula S. ; Ruskin, David N. ; Fredholm, Bertil B. ; Geiger, Jonathan D. ; Aronica, Eleonora ; Boison, Detlev. / A ketogenic diet suppresses seizures in mice through adenosine A 1 receptors. In: Journal of Clinical Investigation. 2011 ; Vol. 121, No. 7. pp. 2679-2683.
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