Review Article

Krüppel-like factors: potential roles in blood-brain barrier dysfunction and epileptogenesis

Ana Beatriz Santos1, Andreia Carona1,2, Miren Ettcheto3,4,5,6, Antoni Camins3,4,5,6, Amílcar Falcão1,2, Ana Fortuna1,2, Joana Bicker1,2
1 University of Coimbra, Faculty of Pharmacy, Coimbra, Portugal
2 University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research, Coimbra, Portugal
3 Biomedical Research Networking Center in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
4 Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Science, Universitat de Barcelona, Barcelona, Spain
5 Institute of Neuroscience, Universitat de Barcelona, Barcelona, Spain
6 Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
Correspondence to: Joana Bicker: joana.bicker@gmail.com,
DOI: 10.1038/s41401-024-01285-w
Received: 22 December 2023
Accepted: 7 April 2024
Advance online: 29 April 2024

Abstract

Epilepsy is a chronic and debilitating neurological disorder, known for the occurrence of spontaneous and recurrent seizures. Despite the availability of antiseizure drugs, 30% of people with epilepsy experience uncontrolled seizures and drug resistance, evidencing that new therapeutic options are required. The process of epileptogenesis involves the development and expansion of tissue capable of generating spontaneous recurrent seizures, during which numerous events take place, namely blood-brain barrier (BBB) dysfunction, and neuroinflammation. The consequent cerebrovascular dysfunction results in a lower seizure threshold, seizure recurrence, and chronic epilepsy. This suggests that improving cerebrovascular health may interrupt the pathological cycle responsible for disease development and progression. Krüppel-like factors (KLFs) are a family of zinc-finger transcription factors, encountered in brain endothelial cells, glial cells, and neurons. KLFs are known to regulate vascular function and changes in their expression are associated with neuroinflammation and human diseases, including epilepsy. Hence, KLFs have demonstrated various roles in cerebrovascular dysfunction and epileptogenesis. This review critically discusses the purpose of KLFs in epileptogenic mechanisms and BBB dysfunction, as well as the potential of their pharmacological modulation as therapeutic approach for epilepsy treatment.
Keywords: blood-brain barrier; cerebrovascular dysfunction; epigenetics; epilepsy; krüppel-like factors; neuroinflammation

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