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生酮饮食:作用机制假说

The ketogenic diet: proposed mechanisms of action.

作者信息

Nylen Kirk, Likhodii Sergei, Burnham W McIntyre

机构信息

Department of Pharmacology and University of Toronto Epilepsy Research Program (UTERP), University of Toronto, Toronto, Ontario M5S 1A8, Canada.

出版信息

Neurotherapeutics. 2009 Apr;6(2):402-5. doi: 10.1016/j.nurt.2009.01.021.

DOI:10.1016/j.nurt.2009.01.021
PMID:19332336
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5084220/
Abstract

The ketogenic diet is a high-fat, low-carbohydrate diet used to treat drug-resistant seizures, especially in children. A number of possible mechanisms of action have been proposed to explain the anticonvulsant effects of the diet. Four of these hypothetical mechanisms are discussed in the present article: the pH hypothesis, the metabolic hypotheses, the amino acid hypothesis, and the ketone hypothesis.

摘要

生酮饮食是一种高脂肪、低碳水化合物的饮食,用于治疗耐药性癫痫发作,尤其是在儿童中。人们提出了许多可能的作用机制来解释这种饮食的抗惊厥作用。本文讨论了其中四种假设机制:pH值假说、代谢假说、氨基酸假说和酮假说。

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1
The ketogenic diet: proposed mechanisms of action.生酮饮食:作用机制假说
Neurotherapeutics. 2009 Apr;6(2):402-5. doi: 10.1016/j.nurt.2009.01.021.
2
The Anticonvulsant Effects of Ketogenic Diet on Epileptic Seizures and Potential Mechanisms.生酮饮食对癫痫发作的抗惊厥作用及其潜在机制。
Curr Neuropharmacol. 2018;16(1):66-70. doi: 10.2174/1570159X15666170517153509.
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[Effectiveness of a ketogenic diet in children with refractory epilepsy: a systematic review].生酮饮食对难治性癫痫儿童的疗效:一项系统评价
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Ketogenic diet improves core symptoms of autism in BTBR mice.生酮饮食可改善 BTBR 小鼠自闭症核心症状。
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Ketone bodies in epilepsy.癫痫中的酮体。
J Neurochem. 2012 Apr;121(1):28-35. doi: 10.1111/j.1471-4159.2012.07670.x. Epub 2012 Feb 7.
6
Ketogenic diet: overview, types, and possible anti-seizure mechanisms.生酮饮食:概述、类型和可能的抗癫痫机制。
Nutr Neurosci. 2021 Apr;24(4):307-316. doi: 10.1080/1028415X.2019.1627769. Epub 2019 Jun 26.
7
Control of seizures by ketogenic diet-induced modulation of metabolic pathways.通过生酮饮食诱导的代谢途径调节来控制癫痫发作。
Amino Acids. 2017 Jan;49(1):1-20. doi: 10.1007/s00726-016-2336-7. Epub 2016 Sep 28.
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A unifying mechanism of ketogenic diet action: The multiple roles of nicotinamide adenine dinucleotide.生酮饮食作用的统一机制:烟酰胺腺嘌呤二核苷酸的多种作用。
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Metabolism and epilepsy: Ketogenic diets as a homeostatic link.代谢与癫痫:生酮饮食作为一种体内平衡的联系。
Brain Res. 2019 Jan 15;1703:26-30. doi: 10.1016/j.brainres.2018.05.049. Epub 2018 Jun 6.
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Possible mechanism for the effect of ketogenic diet in cases of uncontrolled seizures. The reconsideration of acetone theory.生酮饮食对癫痫发作难以控制病例产生影响的可能机制。对丙酮理论的重新审视。
Med Hypotheses. 2007;68(6):1382-8. doi: 10.1016/j.mehy.2006.10.041. Epub 2006 Dec 12.

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Nutrients. 2022 Nov 23;14(23):4977. doi: 10.3390/nu14234977.
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Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis.生酮饮食患者肾结石的发病率及特征:一项系统评价与荟萃分析
Diseases. 2021 May 25;9(2):39. doi: 10.3390/diseases9020039.
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Ketogenic diet in endocrine disorders: Current perspectives.内分泌疾病中的生酮饮食:当前观点
J Postgrad Med. 2017 Oct-Dec;63(4):242-251. doi: 10.4103/jpgm.JPGM_16_17.
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Adenosine receptors and epilepsy: current evidence and future potential.腺苷受体与癫痫:当前证据及未来潜力
Int Rev Neurobiol. 2014;119:233-55. doi: 10.1016/B978-0-12-801022-8.00011-8.
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Neuroactive peptides as putative mediators of antiepileptic ketogenic diets.神经活性肽作为抗癫痫生酮饮食的潜在介质。
Front Neurol. 2014 Apr 29;5:63. doi: 10.3389/fneur.2014.00063. eCollection 2014.
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The neuropathology of obesity: insights from human disease.肥胖的神经病理学:从人类疾病中得到的启示。
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Effects of infantile repeated hyperglycemia on neuronal density of hippocampus and pentylentetrazol induced convulsions in male wistar rats.婴儿期反复高血糖对雄性 Wistar 大鼠海马神经元密度和戊四氮诱导惊厥的影响。
Iran J Basic Med Sci. 2012 Jul;15(4):951-7.
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Ketogenic diet: rapid onset of selenium deficiency-induced cardiac decompensation.生酮饮食:硒缺乏诱导的心脏代偿失调迅速发作。
Pediatr Cardiol. 2012 Jun;33(5):834-8. doi: 10.1007/s00246-012-0219-6. Epub 2012 Feb 25.
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Purines and the Anti-Epileptic Actions of Ketogenic Diets.嘌呤与生酮饮食的抗癫痫作用
Open Neurosci J. 2010 Jan 1;4(1):58-63. doi: 10.2174/1874082001004010058.
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A ketogenic diet reduces long-term potentiation in the dentate gyrus of freely behaving rats.生酮饮食可降低自由活动大鼠齿状回的长期增强现象。
J Neurophysiol. 2011 Aug;106(2):662-6. doi: 10.1152/jn.00001.2011. Epub 2011 May 25.

本文引用的文献

1
Fructose-1,6-bisphosphate has anticonvulsant activity in models of acute seizures in adult rats.1,6-二磷酸果糖在成年大鼠急性癫痫发作模型中具有抗惊厥活性。
J Neurosci. 2007 Oct 31;27(44):12007-11. doi: 10.1523/JNEUROSCI.3163-07.2007.
2
The neuropharmacology of the ketogenic diet.生酮饮食的神经药理学
Pediatr Neurol. 2007 May;36(5):281-92. doi: 10.1016/j.pediatrneurol.2007.02.008.
3
2-Deoxy-D-glucose reduces epilepsy progression by NRSF-CtBP-dependent metabolic regulation of chromatin structure.2-脱氧-D-葡萄糖通过NRSF-CtBP依赖性染色质结构代谢调节减少癫痫进展。
Nat Neurosci. 2006 Nov;9(11):1382-7. doi: 10.1038/nn1791. Epub 2006 Oct 15.
4
Mitochondrial biogenesis in the anticonvulsant mechanism of the ketogenic diet.生酮饮食抗惊厥机制中的线粒体生物合成
Ann Neurol. 2006 Aug;60(2):223-35. doi: 10.1002/ana.20899.
5
Low-glycemic-index treatment: a liberalized ketogenic diet for treatment of intractable epilepsy.低血糖指数治疗:一种用于治疗难治性癫痫的宽松生酮饮食。
Neurology. 2005 Dec 13;65(11):1810-2. doi: 10.1212/01.wnl.0000187071.24292.9e.
6
The use of diet in the treatment of epilepsy.饮食在癫痫治疗中的应用。
Epilepsy Behav. 2005 Feb;6(1):4-8. doi: 10.1016/j.yebeh.2004.10.006.
7
Non-invasive detection of ketosis and its application in refractory epilepsy.
Prostaglandins Leukot Essent Fatty Acids. 2004 Mar;70(3):329-35. doi: 10.1016/j.plefa.2003.08.025.
8
Brain uptake and metabolism of ketone bodies in animal models.动物模型中酮体的脑摄取与代谢
Prostaglandins Leukot Essent Fatty Acids. 2004 Mar;70(3):265-75. doi: 10.1016/j.plefa.2003.07.006.
9
Anticonvulsant properties of acetone, a brain ketone elevated by the ketogenic diet.丙酮的抗惊厥特性,一种由生酮饮食升高的脑酮。
Ann Neurol. 2003 Aug;54(2):219-26. doi: 10.1002/ana.10634.
10
Perspectives on the metabolic management of epilepsy through dietary reduction of glucose and elevation of ketone bodies.通过饮食减少葡萄糖和提高酮体对癫痫进行代谢管理的观点。
J Neurochem. 2003 Aug;86(3):529-37. doi: 10.1046/j.1471-4159.2003.01862.x.