Zeng Ling-Hui, Xu Lin, Gutmann David H, Wong Michael
Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Ann Neurol. 2008 Apr;63(4):444-53. doi: 10.1002/ana.21331.
Tuberous sclerosis complex (TSC) represents one of the most common genetic causes of epilepsy. TSC gene inactivation leads to hyperactivation of the mammalian target of rapamycin signaling pathway, raising the intriguing possibility that mammalian target of rapamycin inhibitors might be effective in preventing or treating epilepsy in patients with TSC. Mice with conditional inactivation of the Tsc1 gene primarily in glia (Tsc1(GFAP)CKO mice) develop glial proliferation, progressive epilepsy, and premature death. Here, we tested whether rapamycin could prevent or reverse epilepsy, as well as other cellular and molecular brain abnormalities in Tsc1(GFAP)CKO mice.
Tsc1(GFAP)CKO mice and littermate control animals were treated with rapamycin or vehicle starting at postnatal day 14 (early treatment) or 6 weeks of age (late treatment), corresponding to times before and after onset of neurological abnormalities in Tsc1(GFAP)CKO mice. Mice were monitored for seizures by serial video-electroencephalogram and for long-term survival. Brains were examined histologically for astrogliosis and neuronal organization. Expression of phospho-S6 and other molecular markers correlating with epileptogenesis was measured by Western blotting.
Early treatment with rapamycin prevented the development of epilepsy and premature death observed in vehicle-treated Tsc1(GFAP)CKO mice. Late treatment with rapamycin suppressed seizures and prolonged survival in Tsc1(GFAP)CKO mice that had already developed epilepsy. Correspondingly, rapamycin inhibited the abnormal activation of the mammalian target of rapamycin pathway, astrogliosis, and neuronal disorganization, and increased brain size in Tsc1(GFAP)CKO mice.
Rapamycin has strong efficacy for preventing seizures and prolonging survival in Tsc1(GFAP)CKO mice.
结节性硬化症(TSC)是癫痫最常见的遗传病因之一。TSC基因失活导致雷帕霉素哺乳动物靶点信号通路过度激活,这引发了一种有趣的可能性,即雷帕霉素抑制剂可能对预防或治疗TSC患者的癫痫有效。主要在胶质细胞中条件性失活Tsc1基因的小鼠(Tsc1(GFAP)CKO小鼠)会出现胶质细胞增殖、进行性癫痫和过早死亡。在此,我们测试了雷帕霉素是否能预防或逆转Tsc1(GFAP)CKO小鼠的癫痫以及其他细胞和分子水平的脑异常。
从出生后第14天(早期治疗)或6周龄(晚期治疗)开始,对Tsc1(GFAP)CKO小鼠和同窝对照动物给予雷帕霉素或赋形剂治疗,这分别对应于Tsc1(GFAP)CKO小鼠神经异常发作之前和之后的时间。通过连续视频脑电图监测小鼠的癫痫发作情况,并监测其长期存活情况。对大脑进行组织学检查,以观察星形胶质细胞增生和神经元组织情况。通过蛋白质免疫印迹法检测与癫痫发生相关的磷酸化S6及其他分子标志物的表达。
雷帕霉素早期治疗可预防未接受治疗的Tsc1(GFAP)CKO小鼠出现癫痫和过早死亡。雷帕霉素晚期治疗可抑制已发生癫痫的Tsc1(GFAP)CKO小鼠的癫痫发作并延长其存活时间。相应地,雷帕霉素可抑制Tsc1(GFAP)CKO小鼠雷帕霉素哺乳动物靶点信号通路的异常激活、星形胶质细胞增生和神经元紊乱,并增加其脑体积。
雷帕霉素在预防Tsc1(GFAP)CKO小鼠癫痫发作和延长其存活时间方面具有强大功效。