Nieto-Estévez Vanesa, Hsieh Jenny
Department of Biology and Brain Health Consortium, 414492The University of Texas at San Antonio, TX, USA.
Epilepsy Curr. 2020 Sep;20(5):282-290. doi: 10.1177/1535759720949254. Epub 2020 Sep 10.
Epilepsy is a common neurological disorder characterized by recurrent and unprovoked seizures due to neuronal hyperactivity. A large proportion of epilepsy cases begin during childhood. Causes of epilepsy include stroke, infections, brain injury, genetic factors, or other factors that alter brain structure and development, but in up to 50% of cases the cause is unknown. Approximately 35% of patients have refractory seizures that do not respond to medication. Animal models and in vitro cultures have contributed to our understanding of epilepsy, but there is a clear need for better models to explore the human brain in normal and pathological conditions. Human pluripotent stem cell (PSC) technologies opened the door for new models for analyzing brain development and disease, especially conditions with a genetic component. Initially, PSCs were differentiated into 2-dimensional cultures of a homogenous population of neural cells, such as glutamatergic excitatory or γ-aminobutyric acidergic inhibitory neurons, as well as glial cells. Nevertheless, these cultures lacked the structure and complexity of a human brain. In the last decade, PSC technology has advanced to the next level through the development of 3-dimensional culture, called organoids. These organoids recapitulate features of the human brain that are missing in animal models, enabling a deeper study of the human brain. In this review, we will summarize the current status of organoid research and its application to epilepsy.
癫痫是一种常见的神经系统疾病,其特征是由于神经元活动亢进导致反复出现无端发作。很大一部分癫痫病例始于儿童期。癫痫的病因包括中风、感染、脑损伤、遗传因素或其他改变脑结构和发育的因素,但在高达50%的病例中病因不明。约35%的患者有难治性癫痫发作,对药物治疗无反应。动物模型和体外培养有助于我们对癫痫的理解,但显然需要更好的模型来探索正常和病理状态下的人类大脑。人类多能干细胞(PSC)技术为分析脑发育和疾病,特别是具有遗传成分的疾病的新模型打开了大门。最初,PSC被分化为神经细胞同质群体的二维培养物,如谷氨酸能兴奋性或γ-氨基丁酸能抑制性神经元以及神经胶质细胞。然而,这些培养物缺乏人类大脑的结构和复杂性。在过去十年中,PSC技术通过三维培养(称为类器官)的发展提升到了一个新水平。这些类器官概括了动物模型中所没有的人类大脑特征,从而能够对人类大脑进行更深入的研究。在本综述中,我们将总结类器官研究的现状及其在癫痫中的应用。