The Role of Drug Transporters in RE Development

In 2002, Kwan and Brodie proposed the P-gp positive seizure axis. This theory suggests that expression of ABCBl is a progressive process that depends on intensity and time constancy of seizure injury. It was found in a cohort of 52 5 epileptic patients that the number of patients who develop RE directly correlates with the number and frequency of epileptic seizures before the onset of drug therapy. 

Wadkins and Roepe found that ABCBl-expressing neurons exhibit significantly lower membrane potentials (At /(, = —10 to —20 mV physiological membrane potential A )/o of —60 mV) [49, 50]. Based on this observation, Lazarowski et al. put forth a hypothesis to explain the contribution of neuronal ABCBl expression to RE development. They stipulate that the persistently low resting membrane potential in ABCBl-positive neurons would facilitate glutamergic signaling and would thus 

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