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About 1% of the world's population suffers from epilepsy, and currently available drugs are not effective in about one third of patients. In such patients, a diet rich in ketones rather than glucose can suppress hyperexcitability in neurons and thereby control seizures, but the metabolic enzymes involved have not been identified. Recent evidence shows that it is immune system cells — astrocytes — that cause neurons to become hyperexcitable. A Japanese team wondered if epilepsy patients could be treated by altering astrocyte metabolism.
The team showed that lactic dehydrogenase (LDH) in astrocytes and in neurons is important in generating seizures. LDH generates lactate in astrocytes, which then travels to adjacent neurons and serves as fuel …