Che Fengyuan, Fu Qingxi, Li Xuesong, Gao Naiyong, Qi Faying, Sun Zhiqing, Du Yifeng, Li Ming
Department of Neurology, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, PR China; Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, PR China.
Department of Neurology, Linyi People's Hospital, Linyi, Shandong 276003, PR China.
Seizure. 2015 Feb;25:178-80. doi: 10.1016/j.seizure.2014.09.014. Epub 2014 Oct 5.
Insulin/insulin receptor (INSR) signaling plays diverse roles in the central nervous system, including regulation of blood glucose, synaptic plasticity, dendritic growth, modulation of electrophysiological activity, proliferation of astrocytes and neuronal apoptosis. Interestingly, many of these and/or related processes represent biological mechanisms associated with temporal lobe epilepsy (TLE). Thus, insulin signaling may play a role in the development of TLE and its therapeutic responses. We hypothesized that functional polymorphisms in the insulin pathway genes INSR, insulin receptor substrate 1 (IRS1), and IRS2 may be associated with the therapeutic responses of TLE. Therefore, in this study we analyzed the association of three single nucleotide polymorphisms (SNPs) showing a risk for TLE drug resistance using a hospital-based case-control design.
Two hundred and one patients with refractory TLE and one hundred and seventy-five drug-responsive TLE patients were recruited for the study. Polymerase chain reaction-restriction fragment length polymorphism was used to detect the genotypes of INSR His1085His, IRS1 G972R and IRS2 1057G/A.
No significant differences between refractory and drug-responsive TLE patients were observed for the IRS1 G972R and IRS2 1057G/A polymorphisms (P>0.05), but a significant association was found for the INSR His1085His polymorphism for both genotypes (P=0.035) and alleles (P=0.011). IRS2 1057G/A combined with the INSR His 1085 His polymorphism increased the odds ratio of drug resistance in TLE (P=0.011, OR=2.263, 95% CI: 1.208-4.239).
These results suggest that a genetic variation in the insulin signaling pathway genes may affect the therapeutic response of TLE.
胰岛素/胰岛素受体(INSR)信号通路在中枢神经系统中发挥多种作用,包括调节血糖、突触可塑性、树突生长、电生理活动调节、星形胶质细胞增殖和神经元凋亡。有趣的是,其中许多和/或相关过程代表了与颞叶癫痫(TLE)相关的生物学机制。因此,胰岛素信号通路可能在TLE的发生发展及其治疗反应中发挥作用。我们推测胰岛素通路基因INSR、胰岛素受体底物1(IRS1)和IRS2中的功能多态性可能与TLE的治疗反应相关。因此,在本研究中,我们采用基于医院的病例对照设计,分析了三个显示TLE耐药风险的单核苷酸多态性(SNP)的关联性。
招募了201例难治性TLE患者和175例药物反应性TLE患者进行研究。采用聚合酶链反应-限制性片段长度多态性方法检测INSR His1085His、IRS1 G972R和IRS2 1057G/A的基因型。
在IRS1 G972R和IRS2 1057G/A多态性方面,难治性和药物反应性TLE患者之间未观察到显著差异(P>0.05),但在INSR His1085His多态性的基因型(P=0.035)和等位基因(P=0.011)方面发现了显著关联。IRS2 1057G/A与INSR His 1085 His多态性相结合增加了TLE患者耐药的比值比(P=0.011,OR=2.263,95%CI:1.208-4.239)。
这些结果表明,胰岛素信号通路基因的遗传变异可能影响TLE的治疗反应。