人类遗传性癫痫的发病机制。
Mechanisms of human inherited epilepsies.
作者信息
Reid Christopher A, Berkovic Samuel F, Petrou Steven
机构信息
Howard Florey Institute, The University of Melbourne, Parkville, Melbourne, Australia.
出版信息
Prog Neurobiol. 2009 Jan 12;87(1):41-57. doi: 10.1016/j.pneurobio.2008.09.016. Epub 2008 Oct 5.
It is just over a decade since the discovery of the first human epilepsy associated ion channel gene mutation. Since then mutations in at least 25 different genes have been described, although the strength of the evidence for these genes having a pathogenic role in epilepsy varies. These discoveries are allowing us to gradually begin to unravel the molecular basis of this complex disease. In the epilepsies, virtually all the established genes code for ion channel subunits. This has led to the concept that the idiopathic epilepsies are a family of channelopathies. This review first introduces the epilepsy syndromes linked to mutations in the various genes. Next it collates the genetic and functional analysis of these genes. This part of the review is divided into voltage-gated channels (Na+, K+, Ca2+, Cl(-) and HCN), ligand-gated channels (nicotinic acetylcholine and GABA(A) receptors) and miscellaneous proteins. In some cases significant advances have been made in our understanding of the molecular and cellular deficits caused by mutations. However, the link between molecular deficit and clinical phenotype is still unknown. Piecing together this puzzle should allow us to understand the underlying pathology of epilepsy ultimately providing novel therapeutic strategies to complete the clinic-bench-clinic cycle.
自首个与人类癫痫相关的离子通道基因突变被发现至今,不过十多年时间。从那时起,至少已有25种不同基因的突变被描述,尽管这些基因在癫痫中具有致病作用的证据强度各不相同。这些发现使我们能够逐渐开始揭示这种复杂疾病的分子基础。在癫痫中,几乎所有已确定的基因都编码离子通道亚基。这就引出了一个概念,即特发性癫痫是一类通道病。本综述首先介绍与各种基因突变相关的癫痫综合征。接下来整理这些基因的遗传和功能分析。综述的这一部分分为电压门控通道(Na+、K+、Ca2+、Cl-和HCN)、配体门控通道(烟碱型乙酰胆碱和GABA(A)受体)以及其他杂项蛋白。在某些情况下,我们对由突变导致的分子和细胞缺陷的理解取得了重大进展。然而,分子缺陷与临床表型之间的联系仍然未知。拼凑这个谜题应能让我们了解癫痫的潜在病理,最终提供新的治疗策略,以完成临床-基础研究-临床的循环。