The antiepileptic action of diphenylhydantoin (DPH) has been explained by two different theories: (a) that DPH stimulates the Na-K pump; (b) that DPH specifically blocks the passive translocation of sodium. Since electrophysiological experiments have recently suggested abnormal synaptic mechanisms as the basis for epileptogenic discharges, the action of DPH on K transport within synaptic terminals isolated from “normal” rat brain cortex was examined directly. A rapid filtration technique was used to assess in vitro potassium transport within synaptosomes. In vivo DPH did not significantly change endogenous K content within synaptosomes. With sodium (50 mM) and potassium (10 mM) concentrations optimal for Na-K pump activity, in vivo and in vitro DPH (10-4 M) had minimal or no effects on total K uptake. DPH stimulated potassium uptake within synaptosomes under two situations: (a) at high sodium (50-100 mM) and low potassium (less than 2 mM) concentrations; (b) when synaptosomes were incubated with ouabain (10-4 M) 50 mM Na and 10 mM K. In both situations, K was leaking out of synaptic terminals and the enhancement in net K uptake roughly corresponded to the ouabain inhibitable segment. In the absence of ouabain, the stimulatory effects of DPH were not observed when K was 2 mM or higher and when Na was 10 mM or lower. The stimulatory effects of in vitro DPH appeared over a range of concentrations from 10-4 to 10-10 M while single intraperitoneal injections of DPH had to be administered for 2 days before its effects were observed on synaptosomal K transport. The present data provided direct evidence for DPH stimulation of active potassium transport within synaptosomes under ionic conditions simulating the depolarized state. At other ionic conditions, DPH had inhibitory or no effects on K uptake. Although the results do not specify whether the effects of DPH on the Na-K pump are direct or indirect, they suggest that the action of DPH depends upon the state of the membrane and the specific ionic environment.
Antonio V. Escueta, Stanley H. Appel