Evidence mapPaperPMID 41622366Full record

ReviewNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026

The potential role of COX-2/PGs signaling pathway in epileptogenesis and associated neuroinflammation: collusions or serendipity.

Bshra A Alsfouk, Hayder M Al-Kuraishy, Ali I Al-Gareeb, Ahmed M Abdelaziz, Alaa Ismail, Luay M Alkazmi, Athanasios Alexiou, Marios Papadakis, Gaber El-Saber Batiha

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In one paragraph

Review in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Bshra A AlsfoukDepartment of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.ORCID http://orcid.org/0000-0001-6489-6035
Hayder M Al-KuraishyDepartment of Clinical Pharmacology and Medicine, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq.
Ali I Al-GareebDepartment of Clinical Pharmacology and Medicine, College of Medicine, Al-Mustansiriyah University, Baghdad, Iraq.
Ahmed M AbdelazizDepartment of Pharmacology and Toxicology, Faculty of Pharmacy, Sinai University, Arish Branch, Arish, 45511, Egypt. ahmed.abdelaziz@su.edu.eg.ORCID http://orcid.org/0000-0003-4747-8549
Alaa IsmailSchool of Medicine, Taif University, Taif, Saudi Arabia.
Luay M AlkazmiBiology department, faculty of Sciences, Umm Al-Qura University, Makkah, Saudi Arabia.
Athanasios AlexiouDepartment of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW, 2770, Australia.
Marios PapadakisUniversity Hospital Witten-Herdecke, University of Witten, Heusnerstrasse 40, Herdecke, Wuppertal, 42283, Germany. drmariospapadakis@gmail.com.
Gaber El-Saber BatihaDepartment of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhur University, Damanhur, AlBeheira, 22511, Egypt. dr_gaber_batiha@vetmed.dmu.edu.eg.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEpilepsy is a neurological condition characterized by recurrent, spontaneous seizures stemming from sudden, abnormal synchronization of neuronal activity in specific brain regions, driven by structural or functional alterations. This disorder is preceded by epileptogenesis, a dynamic process marked by cellular and molecular changes that heighten brain excitability. Although anti-seizure medications (ASMs) remain the cornerstone of treatment, roughly 30% of patients develop refractory epilepsy, which resists ASMs therapy. Critically, ASMs do not prevent epileptogenesis, implying divergent mechanisms govern disease progression.

methodsThis review evaluates the pathway's contributions to neuroinflammation, epileptogenesis, and epilepsy, and explores the promise of COX-2 inhibitors in managing refractory epilepsy.

resultsEpileptogenesis continues even after seizures manifest and is strongly associated with drug-resistant forms such as temporal lobe epilepsy (TLE). Neuroinflammation, which develops subsequent to the epileptic seizure, aggravates refractory epilepsy by enhancing the extrusion of ASMs across the blood-brain barrier (BBB), reducing their therapeutic efficacy. Following epileptic seizures, cyclooxygenase-2 (COX-2), a key enzyme in prostaglandin (PG) synthesis, is upregulated and activates the COX-2/PG pathway, leading to exacerbation of neuroinflammation and acceleration of epilepsy progression. Furthermore, by inducing neuronal hyperexcitability and epileptogenesis, elevated COX-2 and PG levels correlate with increased seizure severity and frequency.

conclusionConsequently, targeting of the COX-2/PG axis has emerged as a potential therapeutic strategy.

Indexed as

Cyclooxygenase 2EpilepsyNeuroinflammatory DiseasesProstaglandinsSignal TransductionAnimalsAnticonvulsantsBrainCyclooxygenase 2 InhibitorsHumansAnticonvulsantsCyclooxygenase 2Cyclooxygenase 2 InhibitorsProstaglandinsCyclooxygenase 2Cyclooxygenase 2 inhibitorsEpilepsyEpileptogenesisNeuroinflammation

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.