Department of Neurology, Beijing Children's Hospital, The Capital Medical University, Beijing, China.
Dev Med Child Neurol. 2010 Nov;52(11):1028-32. doi: 10.1111/j.1469-8749.2010.03746.x. Epub 2010 Aug 16.
Adrenocorticotropic hormone (ACTH) has been used as the major therapy for infantile spasms since 1958 because it effectively suppresses seizures; it also normalizes the electroencephalogram in the short-term treatment of infantile spasms. G protein-regulated inducer of neurite outgrowth 1 (GRIN1, also known as N-methyl-D-aspartate receptor 1, NMDAR1), a glutamate receptor, is the main component of functional N-methyl-D-aspartic acid receptors that are involved in the glucocorticoid-induced neuronal damage. Thus, it may be a candidate gene to be tested for responsiveness to ACTH in infantile spasms. In the present study, polymorphisms in the GRIN1 gene in infantile spasms were investigated using a case-control design.
Twelve single nucleotide polymorphisms in the GRIN1 gene were genotyped in a Chinese case-control set consisting of 97 unrelated patients with infantile spasms (60 males, 37 females; mean age 6.4 mo, SD 2.7) and 96 healthy individuals (63 males, 33 females; mean age 7.3 mo, SD 3.8). Association analysis was performed on the genotyped data.
Five estimated haplotypes with a frequency of more than 3% were detected. Results of the study showed that responsiveness to treatment with ACTH in homozygous carriers of the CTA haplotype was higher than that in heterozygous carriers and non-carriers (p=0.022). Furthermore, CTG, a rare haplotype, was strongly associated with infantile spasms (p=0.013).
The results suggest that haplotypes of GRIN1 may influence responsiveness to ACTH. The findings necessitate further study for confirmation.
自 1958 年以来,促肾上腺皮质激素(ACTH)一直被用作婴儿痉挛的主要治疗方法,因为它能有效抑制癫痫发作;它还能在婴儿痉挛的短期治疗中使脑电图正常化。G 蛋白调节的神经突生长诱导因子 1(GRIN1,也称为 N-甲基-D-天冬氨酸受体 1,NMDAR1),一种谷氨酸受体,是功能性 N-甲基-D-天冬氨酸受体的主要组成部分,参与糖皮质激素诱导的神经元损伤。因此,它可能是婴儿痉挛对 ACTH 反应性的候选基因。本研究采用病例对照设计,研究了 GRIN1 基因中的多态性与婴儿痉挛的关系。
在一个由 97 例无亲缘关系的婴儿痉挛患者(60 例男性,37 例女性;平均年龄 6.4 个月,标准差 2.7)和 96 例健康个体(63 例男性,33 例女性;平均年龄 7.3 个月,标准差 3.8)组成的中国病例对照组中,对 GRIN1 基因的 12 个单核苷酸多态性进行了基因分型。对基因分型数据进行了关联分析。
检测到 5 种频率超过 3%的估计单倍型。研究结果表明,在 CTA 单倍型纯合子携带者中,对 ACTH 治疗的反应性高于杂合子携带者和非携带者(p=0.022)。此外,罕见的 CTG 单倍型与婴儿痉挛强烈相关(p=0.013)。
结果表明,GRIN1 单倍型可能影响对 ACTH 的反应性。这些发现需要进一步研究证实。