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Adenosine kinase (ADK) is the chief adenosine removing enzyme in the brain. Experimental research has highlighted that ADK is a diagnostic and a therapeutic marker for epilepsy. Clinical research from patients with pharmacoresistant epilepsy also indicated that maladaptive changes of ADK lead to recurrent seizures in human chronic epilepsy, including Rasmussen encephalitis, focal cortical dysplasia, mesial temporal lobe epilepsy and Sturge-Weber syndrome. In addition, a subpopulation of remaining neurons demonstrated a revertant fetal expression pattern within the lesions are increasing, indicating that the early stage of developmental microenvironment alteration may impair the temporal transient expression pattern of neuronal ADK from fetal to postnatal brains. Increasing levels of ADK expression and adenosine deficiency caused by high levels of ADK played a crucial role in pharmacoresistant epilepsy and epilepsy associated comorbidities. Dysfunction of adenosine system may be a common pathologic hallmark of human pharmacoresistant epilepsy, which suggested the specific targets in the treatment of epilepsy, comorbidities associated with epilepsy in the patients. Future studies will undoubtedly seek to find the novel therapies targeting on ADK and to uncover the mechanism responsible for these future epilepsy therapies.

Adenosine Kinase, a Common Pathologic Biomarker for Human Pharmacoresistant Epilepsy