Bychkova Ekaterina, Dorofeeva Marina, Levov Aleksandr, Kislyakov Alexey, Karandasheva Kristina, Strelnikov Vladimir, Anoshkin Kirill
Research Centre for Medical Genetics, Moskvorechye Street 1, 115522 Moscow, Russia.
Faculty of Biomedicine, Pirogov Russian National Research Medical University, Ostrovityanova Street 1, 117997 Moscow, Russia.
Curr Issues Mol Biol. 2023 May 3;45(5):3977-3996. doi: 10.3390/cimb45050254.
Patients with tuberous sclerosis complex present with cognitive, behavioral, and psychiatric impairments, such as intellectual disabilities, autism spectrum disorders, and drug-resistant epilepsy. It has been shown that these disorders are associated with the presence of cortical tubers. Tuberous sclerosis complex results from inactivating mutations in the or genes, resulting in hyperactivation of the mTOR signaling pathway, which regulates cell growth, proliferation, survival, and autophagy. and are classified as tumor suppressor genes and function according to Knudson's two-hit hypothesis, which requires both alleles to be damaged for tumor formation. However, a second-hit mutation is a rare event in cortical tubers. This suggests that the molecular mechanism of cortical tuber formation may be more complicated and requires further research. This review highlights the issues of molecular genetics and genotype-phenotype correlations, considers histopathological characteristics and the mechanism of morphogenesis of cortical tubers, and also presents data on the relationship between these formations and the development of neurological manifestations, as well as treatment options.
结节性硬化症患者存在认知、行为和精神障碍,如智力残疾、自闭症谱系障碍和耐药性癫痫。研究表明,这些障碍与皮质结节的存在有关。结节性硬化症是由TSC1或TSC2基因的失活突变引起的,导致mTOR信号通路的过度激活,该信号通路调节细胞生长、增殖、存活和自噬。TSC1和TSC2被归类为肿瘤抑制基因,并根据Knudson的双击假说发挥作用,该假说要求两个等位基因都受损才能形成肿瘤。然而,二次打击突变在皮质结节中是罕见事件。这表明皮质结节形成的分子机制可能更为复杂,需要进一步研究。本综述重点介绍了分子遗传学问题和基因型-表型相关性,考虑了皮质结节的组织病理学特征和形态发生机制,还展示了这些病变与神经学表现发展之间关系的数据以及治疗选择。