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结节性硬化症的脑部症状:发病机制与治疗。

Brain Symptoms of Tuberous Sclerosis Complex: Pathogenesis and Treatment.

机构信息

Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

Department of Pediatrics, National Rehabilitation Center for Children with Disabilities, Itabashi-ku, Tokyo 173-0037, Japan.

出版信息

Int J Mol Sci. 2021 Jun 22;22(13):6677. doi: 10.3390/ijms22136677.

Abstract

The mammalian target of the rapamycin (mTOR) system plays multiple, important roles in the brain, regulating both morphology, such as cellular size, shape, and position, and function, such as learning, memory, and social interaction. Tuberous sclerosis complex (TSC) is a congenital disorder caused by a defective suppressor of the mTOR system, the TSC1/TSC2 complex. Almost all brain symptoms of TSC are manifestations of an excessive activity of the mTOR system. Many children with TSC are afflicted by intractable epilepsy, intellectual disability, and/or autism. In the brains of infants with TSC, a vicious cycle of epileptic encephalopathy is formed by mTOR hyperactivity, abnormal synaptic structure/function, and excessive epileptic discharges, further worsening epilepsy and intellectual/behavioral disorders. Molecular target therapy with mTOR inhibitors has recently been proved to be efficacious for epilepsy in human TSC patients, and for autism in TSC model mice, indicating the possibility for pharmacological treatment of developmental synaptic disorders.

摘要

哺乳动物雷帕霉素靶蛋白(mTOR)系统在大脑中发挥着多种重要作用,调节形态,如细胞大小、形状和位置,以及功能,如学习、记忆和社交互动。结节性硬化症(TSC)是一种由 mTOR 系统的缺陷抑制剂 TSC1/TSC2 复合物引起的先天性疾病。几乎所有 TSC 的大脑症状都是 mTOR 系统过度活跃的表现。许多患有 TSC 的儿童患有难治性癫痫、智力障碍和/或自闭症。在 TSC 婴儿的大脑中,mTOR 过度活跃、异常的突触结构/功能和过度的癫痫发作形成了一个恶性循环,进一步加重了癫痫和智力/行为障碍。最近的研究证明,mTOR 抑制剂的分子靶向治疗对人类 TSC 患者的癫痫和 TSC 模型小鼠的自闭症有效,这表明对发育性突触障碍进行药物治疗是可能的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91f1/8268912/c9f2d541fe57/ijms-22-06677-g001.jpg

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