Nguyen Lena H, Bordey Angélique
Department of Neurosurgery, Yale School of Medicine, Yale University, New Haven, CT, United States.
Department of Cellular & Molecular Physiology, Yale School of Medicine, Yale University, New Haven, CT, United States.
Front Neuroanat. 2021 Apr 9;15:664695. doi: 10.3389/fnana.2021.664695. eCollection 2021.
Hyperactivation of the mechanistic target of rapamycin complex 1 (mTORC1) due to mutations in genes along the PI3K-mTOR pathway and the GATOR1 complex causes a spectrum of neurodevelopmental disorders (termed mTORopathies) associated with malformation of cortical development and intractable epilepsy. Despite these gene variants' converging impact on mTORC1 activity, emerging findings suggest that these variants contribute to epilepsy through both mTORC1-dependent and -independent mechanisms. Here, we review the literature on electroporation-based animal models of mTORopathies, which recapitulate the brain mosaic pattern of mTORC1 hyperactivity, and compare the effects of distinct PI3K-mTOR pathway and GATOR1 complex gene variants on cortical development and epilepsy. We report the outcomes on cortical pyramidal neuronal placement, morphology, and electrophysiological phenotypes, and discuss some of the converging and diverging mechanisms responsible for these alterations and their contribution to epileptogenesis. We also discuss potential therapeutic strategies for epilepsy, beyond mTORC1 inhibition with rapamycin or everolimus, that could offer personalized medicine based on the gene variant.
由于PI3K - mTOR通路和GATOR1复合体中的基因突变导致雷帕霉素复合物1(mTORC1)过度激活,会引发一系列与皮质发育畸形和难治性癫痫相关的神经发育障碍(称为mTOR病)。尽管这些基因变异对mTORC1活性有共同影响,但新出现的研究结果表明,这些变异通过mTORC1依赖性和非依赖性机制导致癫痫。在这里,我们回顾了基于电穿孔的mTOR病动物模型的文献,这些模型再现了mTORC1过度活跃的脑镶嵌模式,并比较了不同的PI3K - mTOR通路和GATOR1复合体基因变异对皮质发育和癫痫的影响。我们报告了皮质锥体神经元定位、形态和电生理表型的结果,并讨论了导致这些改变的一些共同和不同机制及其对癫痫发生的作用。我们还讨论了除用雷帕霉素或依维莫司抑制mTORC1之外的癫痫潜在治疗策略,这些策略可以基于基因变异提供个性化医疗。