Napolioni Valerio, Moavero Romina, Curatolo Paolo
Laboratory of Human Genetics, Department of Molecular, Cellular and Animal Biology, University of Camerino, Camerino, Italy.
Brain Dev. 2009 Feb;31(2):104-13. doi: 10.1016/j.braindev.2008.09.013. Epub 2008 Nov 22.
Tuberous Sclerosis Complex (TSC) is a multisystem genetic disorder with variable phenotypic expression, due to a mutation in one of the two genes, TSC1 and TSC2, and a subsequent hyperactivation of the downstream mTOR pathway, resulting in increased cell growth and proliferation. The central nervous system is consistently involved in TSC, with 90% of individuals affected showing structural abnormalities, and almost all having some degree of CNS clinical manifestations, including seizures, cognitive impairment and behavioural problems. TSC is proving to be a particularly informative model for studying contemporary issues in developmental neurosciences. Recent advances in the neurobiology of TSC from molecular biology, molecular genetics, and animal model studies provide a better understanding of the pathogenesis of TSC-related neurological symptoms. Rapamycin normalizes the dysregulated mTOR pathway, and recent clinical trials have demonstrated its efficacy in various TSC manifestations, suggesting the possibility that rapamycin may have benefit in the treatment of TSC brain disease.
结节性硬化症(TSC)是一种多系统遗传性疾病,具有可变的表型表达,这是由于两个基因TSC1和TSC2之一发生突变,以及随后下游mTOR通路的过度激活,导致细胞生长和增殖增加。中枢神经系统始终会受到TSC的影响,90%的患者会出现结构异常,几乎所有患者都有一定程度的中枢神经系统临床表现,包括癫痫发作、认知障碍和行为问题。事实证明,TSC是研究发育神经科学当代问题的一个特别有参考价值的模型。来自分子生物学、分子遗传学和动物模型研究的TSC神经生物学最新进展,让人们对TSC相关神经症状的发病机制有了更好的理解。雷帕霉素可使失调的mTOR通路恢复正常,最近的临床试验已证明其在各种TSC表现中的疗效,这表明雷帕霉素可能对治疗TSC脑部疾病有益。