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解析癫痫的遗传学基础:最新进展及其对诊断和治疗的影响。

Unraveling the genetic basis of epilepsy: Recent advances and implications for diagnosis and treatment.

机构信息

Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.

Department of Anatomy, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.

出版信息

Brain Res. 2024 Nov 15;1843:149120. doi: 10.1016/j.brainres.2024.149120. Epub 2024 Jul 18.

Abstract

Epilepsy, affecting approximately 1% of the global population, manifests as recurring seizures and is heavily influenced by genetic factors. Recent advancements in genetic technologies have revolutionized our understanding of epilepsy's genetic landscape. Key studies, such as the discovery of mutations in ion channels (e.g., SCN1A and SCN2A), neurotransmitter receptors (e.g., GABRA1), and synaptic proteins (e.g., SYNGAP1, KCNQ2), have illuminated critical pathways underlying epilepsy susceptibility and pathogenesis. Genome-wide association studies (GWAS) have identified specific genetic variations linked to epilepsy risk, such as variants near SCN1A and PCDH7, enhancing diagnostic accuracy and enabling personalized treatment strategies. Moreover, epigenetic mechanisms, including DNA methylation (e.g., MBD5), histone modifications (e.g., HDACs), and non-coding RNAs (e.g., miR-134), play pivotal roles in altering gene expression and synaptic plasticity, contributing to epileptogenesis. These discoveries offer promising avenues for therapeutic interventions aimed at improving outcomes for epilepsy patients. Genetic testing has become essential in clinical practice, facilitating precise diagnosis and tailored management approaches based on individual genetic profiles. Furthermore, insights into epigenetic regulation suggest novel therapeutic targets for developing more effective epilepsy treatments. In summary, this review highlights significant progress in understanding the genetic and epigenetic foundations of epilepsy. By integrating findings from key studies and specifying genes involved in epigenetic modifications, we underscore the potential for advanced therapeutic strategies in this complex neurological disorder, emphasizing the importance of personalized medicine approaches in epilepsy management.

摘要

癫痫影响全球约 1%的人口,表现为反复发作,受遗传因素的影响很大。最近遗传技术的进步彻底改变了我们对癫痫遗传图谱的理解。关键研究,如离子通道(例如 SCN1A 和 SCN2A)、神经递质受体(例如 GABRA1)和突触蛋白(例如 SYNGAP1、KCNQ2)突变的发现,阐明了癫痫易感性和发病机制的关键途径。全基因组关联研究(GWAS)已经确定了与癫痫风险相关的特定遗传变异,例如 SCN1A 和 PCDH7 附近的变异,提高了诊断准确性,并为个性化治疗策略提供了依据。此外,表观遗传机制,包括 DNA 甲基化(例如 MBD5)、组蛋白修饰(例如 HDACs)和非编码 RNA(例如 miR-134),在改变基因表达和突触可塑性方面发挥着重要作用,有助于癫痫发生。这些发现为旨在改善癫痫患者预后的治疗干预提供了有前途的途径。遗传测试在临床实践中变得至关重要,有助于根据个体遗传谱进行精确诊断和定制管理方法。此外,对表观遗传调控的深入了解为开发更有效的癫痫治疗方法提供了新的治疗靶点。总之,这篇综述强调了理解癫痫遗传和表观遗传基础的重大进展。通过整合关键研究的发现并指定涉及表观遗传修饰的基因,我们强调了在这种复杂的神经疾病中采用先进治疗策略的潜力,强调了个性化医学方法在癫痫管理中的重要性。

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