Florey Neuroscience Institutes, University of Melbourne, Melbourne, Victoria, Australia.
Epilepsia. 2012 Nov;53(11):1849-59. doi: 10.1111/j.1528-1167.2012.03631.x. Epub 2012 Aug 20.
Voltage-gated sodium channels (VGSCs) are integral membrane proteins. They are essential for normal neurologic function and are, currently, the most common recognized cause of genetic epilepsy. This review summarizes the neurobiology of VGSCs, their association with different epilepsy syndromes, and the ways in which we can experimentally interrogate their function. The most important sodium channel subunit of relevance to epilepsy is SCN1A, in which over 650 genetic variants have been discovered. SCN1A mutations are associated with a variety of epilepsy syndromes; the more severe syndromes are associated with truncation or complete loss of function of the protein. SCN2A is another important subtype associated with epilepsy syndromes, across a range of severe and less severe epilepsies. This subtype is localized primarily to excitatory neurons, and mutations have a range of functional effects on the channel. SCN8A is the other main adult subtype found in the brain and has recently emerged as an epilepsy gene, with the first human mutation discovered in a severe epilepsy syndrome. Mutations in the accessory β subunits, thought to modulate trafficking and function of the α subunits, have also been associated with epilepsy. Genome sequencing is continuing to become more affordable, and as such, the amount of incoming genetic data is continuing to increase. Current experimental approaches have struggled to keep pace with functional analysis of these mutations, and it has proved difficult to build associations between disease severity and the precise effect on channel function. These mutations have been interrogated with a range of experimental approaches, from in vitro, in vivo, to in silico. In vitro techniques will prove useful to scan mutations on a larger scale, particularly with the advance of high-throughput automated patch-clamp techniques. In vivo models enable investigation of mutation in the context of whole brains with connected networks and more closely model the human condition. In silico models can help us incorporate the impact of multiple genetic factors and investigate epistatic interactions and beyond.
电压门控钠离子通道(VGSCs)是一种整合膜蛋白。它们对于正常的神经功能至关重要,目前是最常见的遗传性癫痫的公认原因。本文综述了 VGSCs 的神经生物学、它们与不同癫痫综合征的关联,以及我们可以用来实验性研究其功能的方法。与癫痫最相关的最重要的钠离子通道亚基是 SCN1A,其中已发现超过 650 种遗传变异。SCN1A 突变与多种癫痫综合征有关;更严重的综合征与蛋白质的截断或完全丧失功能有关。SCN2A 是另一种与癫痫综合征相关的重要亚型,涉及一系列严重和不太严重的癫痫。这种亚型主要定位于兴奋性神经元,突变对通道有一系列功能影响。SCN8A 是大脑中另一种主要的成人亚型,最近作为一种癫痫基因出现,在一种严重的癫痫综合征中发现了第一个人类突变。认为调节 α 亚基运输和功能的辅助β亚基的突变也与癫痫有关。基因组测序的费用不断降低,因此传入的遗传数据量继续增加。目前的实验方法一直难以跟上对这些突变的功能分析的步伐,并且很难在疾病严重程度和对通道功能的确切影响之间建立关联。已经使用一系列实验方法,包括体外、体内和计算机模拟方法来研究这些突变。体外技术将有助于大规模扫描突变,特别是随着高通量自动膜片钳技术的进步。体内模型能够在具有连接网络的整个大脑的背景下研究突变,并更接近地模拟人类状况。计算机模拟模型可以帮助我们纳入多个遗传因素的影响,并研究上位性相互作用等。