Johns Hopkins University School of Medicine, Baltimore, MD, USA.
J Neurochem. 2012 Apr;121(1):28-35. doi: 10.1111/j.1471-4159.2012.07670.x. Epub 2012 Feb 7.
Seizures that are resistant to standard medications remain a major clinical problem. One underutilized option for patients with medication-resistant seizures is the high-fat, low-carbohydrate ketogenic diet. The diet received its name based on the observation that patients consuming this diet produce ketone bodies (e.g., acetoacetate, β-hydroxybutyrate, and acetone). Although the exact mechanisms of the diet are unknown, ketone bodies have been hypothesized to contribute to the anticonvulsant and antiepileptic effects. In this review, anticonvulsant properties of ketone bodies and the ketogenic diet are discussed (including GABAergic and glutamatergic effects). Because of the importance of ketone body metabolism in the early stages of life, the effects of ketone bodies on developing neurons in vitro also are discussed. Understanding how ketone bodies exert their effects will help optimize their use in treating epilepsy and other neurological disorders.
抗癫痫药物治疗无效的癫痫仍然是一个主要的临床问题。对于抗癫痫药物治疗无效的患者，有一种未充分利用的选择，即高脂肪、低碳水化合物生酮饮食。这种饮食的名称来源于这样一个观察结果，即食用这种饮食的患者会产生酮体（例如乙酰乙酸、β-羟丁酸和丙酮）。尽管这种饮食的确切机制尚不清楚，但酮体被认为有助于发挥抗惊厥和抗癫痫作用。在这篇综述中，讨论了酮体和生酮饮食的抗惊厥特性（包括 GABA 能和谷氨酸能作用）。由于酮体代谢在生命早期的重要性，还讨论了酮体对体外发育神经元的影响。了解酮体如何发挥作用将有助于优化其在治疗癫痫和其他神经疾病中的应用。
