Jóźwiak Sergiusz, Lasoń Władysław, Bijak Maria, Katulska Katarzyna
Klinika Neurologii i Epileptologii, Instytut Pomnik-Centrum Zdrowia Dziecka, al. Dzieci Polskich 20, 04-736 Warszawa.
Neurol Neurochir Pol. 2005 Nov-Dec;39(6):497-508.
Last years brought a large number of papers shedding light on the molecular and genetic background of epilepsy. The aim of the present work was to review recent literature concerning this issue. In the first section, the authors presented biochemical and functional characteristics of receptors and ion channels. Mutations in their genes can lead to epileptic seizure development. Particularly, the role of GABA receptors as well as voltage-gated sodium, calcium and potassium channels in epilepsy pathogenesis was discussed. The second part of the work focuses on clinical implications of these receptors and channels disturbances. Epileptic syndromes with proved genetic defect are presented on the basis of recent literature and OMIM (Online Mendelian Inheritance in Man) database. The authors point out that reviewed results show vast heterogeneity of many known epileptic syndromes. On the other hand, defects in the same locus can result in heterogeneous phenotypes. This can indicate multifactorial pathogenesis of epilepsy and implicate further revision of epilepsies and epileptic seizures classification.
近年来出现了大量揭示癫痫分子和遗传背景的论文。本研究的目的是回顾有关这一问题的近期文献。在第一部分,作者介绍了受体和离子通道的生化及功能特性。它们基因中的突变可导致癫痫发作的发生。特别讨论了γ-氨基丁酸(GABA)受体以及电压门控钠、钙和钾通道在癫痫发病机制中的作用。研究的第二部分聚焦于这些受体和通道紊乱的临床意义。基于近期文献和《人类孟德尔遗传在线》(OMIM)数据库,介绍了具有已证实遗传缺陷的癫痫综合征。作者指出,回顾结果显示许多已知癫痫综合征存在巨大异质性。另一方面,同一基因座的缺陷可导致异质表型。这可能表明癫痫的多因素发病机制,并意味着需要进一步修订癫痫和癫痫发作的分类。