{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:55:19Z","timestamp":1791312919376,"version":"4.3.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,17]],"date-time":"2021-11-17T00:00:00Z","timestamp":1637107200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Reduced anticonvulsant efficacy of benzodiazepines is a problem in the treatment of status epilepticus, with up to 50% of patients failing to respond to their first dose. KCC2 is a neuronal K<jats:sup>+<\/jats:sup>\u2010Cl<jats:sup>\u2212<\/jats:sup> co\u2010transporter that helps set and maintain intracellular Cl<jats:sup>\u2212<\/jats:sup> concentrations. KCC2 functional downregulation is a potential contributor to benzodiazepine resistance. We tested this idea using male and female doxycycline\u2010inducible, conditional transgenic mice to increase the functional expression of KCC2 in pyramidal neurons. We administered mice with two doses of the chemoconvulsant kainic acid (5\u00a0mg\/kg, i.p.) 60\u00a0min apart and quantified the resultant seizures with electroencephalography (EEG) recordings. Overexpression of KCC2 prior to the chemoconvulsant challenge did not affect seizure latency or other measures of seizure severity, but it did increase diazepam's efficacy in stopping EEG seizures. Spike rate, time in seizure, and EEG spectral power following diazepam (5\u00a0mg\/kg, i.p) were all significantly lower in KCC2 overexpression mice as compared to control mice. Our results indicate that, in the context of benzodiazepine resistance during sustained seizures, addressing impaired Cl<jats:sup>\u2212<\/jats:sup> homeostasis alone appreciably improves the efficacy of \u03b3\u2010aminobutyric acid (GABA)ergic inhibition. We therefore suggest the simultaneous targeting of KCC2 and GABA<jats:sub>A<\/jats:sub> receptors as a pathway for improving current anticonvulsant therapeutic strategies.<\/jats:p>","DOI":"10.1111\/epi.17097","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T06:15:03Z","timestamp":1637216103000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Global transgenic upregulation of KCC2 confers enhanced diazepam efficacy in treating sustained seizures"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3795-6375","authenticated-orcid":false,"given":"Dennis L.","family":"Cheung","sequence":"first","affiliation":[{"name":"Department of Physiology School of Medical Sciences Faculty of Medicine UNSW Sydney  Sydney New South Wales Australia"},{"name":"Division of Homeostatic Development Department of Fundamental Neuroscience National Institute for Physiological Sciences  Okazaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Cooke","sequence":"additional","affiliation":[{"name":"School of Electrical Engineering and Telecommunications Faculty of Engineering UNSW Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea S.","family":"Goulton","sequence":"additional","affiliation":[{"name":"Department of Physiology School of Medical Sciences Faculty of Medicine UNSW Sydney  Sydney New South Wales Australia"},{"name":"School of Psychology Faculty of Science UNSW Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanchanok","family":"Chaichim","sequence":"additional","affiliation":[{"name":"Department of Physiology School of Medical Sciences Faculty of Medicine UNSW Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis 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