Epilepsy Research Laboratory, Department of Neurological Surgery, University of California, San Francisco, California, USA.
Dev Neurobiol. 2011 Jan 1;71(1):107-17. doi: 10.1002/dneu.20813.
Of the nearly 3 million Americans diagnosed with epilepsy, approximately 30% are unresponsive to current medications. Recent data has shown that early postnatal transplantation of interneuronal precursor cells increases GABAergic inhibition in the host brain and dramatically suppresses seizure activity in epileptic mice. In this review, we will highlight findings from seizure-prone mice and humans that demonstrate the link between dysfunctional GABAergic inhibition and hyperexcitability. In particular, we will focus on rodent models of temporal lobe epilepsy, the most common and difficult to treat form of the disease, and interneuronopathies, an emerging classification. A wealth of literature showing a causal link between reduced GABA-mediated inhibition and seizures has directed our efforts to recover the loss of inhibition via transplantation of interneuronal precursors. Numerous related studies have explored the anticonvulsant potential of cell grafts derived from a variety of brain regions, yet the mechanism underlying the effect of such heterogeneous cell transplants is unknown. In discussing our recent findings and placing them in context with what is known about epilepsy, and how related transplant approaches have progressed, we hope to initiate a frank discussion of the best path toward the translation of this approach to patients with intractable forms of epilepsy.
在近 300 万被诊断患有癫痫的美国人中,大约有 30%的人对现有药物没有反应。最近的数据表明,神经元前体细胞的早期产后移植会增加宿主大脑中的 GABA 能抑制,并显著抑制癫痫小鼠的癫痫发作活动。在这篇综述中,我们将重点介绍易发生癫痫的小鼠和人类的研究结果,这些结果表明 GABA 能抑制功能障碍与过度兴奋之间存在关联。特别是,我们将重点关注颞叶癫痫的啮齿动物模型,这是最常见和最难治疗的疾病形式,以及神经前体细胞病变,这是一种新兴的分类。大量文献表明,减少 GABA 介导的抑制与癫痫之间存在因果关系,这促使我们努力通过移植神经元前体细胞来恢复抑制作用的丧失。许多相关研究已经探索了源自各种脑区的细胞移植物的抗惊厥潜力,但这种异质细胞移植的作用机制尚不清楚。在讨论我们最近的发现,并将其置于已知的癫痫知识背景下,以及相关的移植方法的进展情况,我们希望能够就将这种方法转化为治疗难治性癫痫患者的最佳途径展开坦诚的讨论。