Solomon Chase, Comi Anne
Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD, United States.
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States.
Front Neurol. 2024 Dec 2;15:1493873. doi: 10.3389/fneur.2024.1493873. eCollection 2024.
Sturge-Weber syndrome (SWS) is a rare congenital neurovascular disorder that initially presents with a facial port-wine birthmark (PWB) and most commonly associated with a R183Q somatic mosaic mutation in the gene . This mutation is enriched in endothelial cells. Contrast-enhanced magnetic resonance imaging (MRI) diagnoses brain abnormalities including leptomeningeal vascular malformation, an enlarged choroid plexus, and abnormal cortical and subcortical blood vessels. Mouse SWS models identify dysregulated proteins important for abnormal vasculogenesis and blood brain barrier permeability. Recent clinical research has focused on early diagnosis, biomarker development, presymptomatic treatment, and development of novel treatment strategies. Prospective pilot clinical drug trials with cannabidiol (Epidiolex) or with sirolimus, an mTOR inhibitor, indicate possible reductions in seizure frequency and improved cognitive outcome. This review connects the most recent molecular research in SWS cell culture and animal models to developing new treatment methods and identifies future areas of research.
斯特奇-韦伯综合征(SWS)是一种罕见的先天性神经血管疾病,最初表现为面部葡萄酒色斑(PWB),最常与该基因中的R183Q体细胞镶嵌突变相关。这种突变在内皮细胞中富集。对比增强磁共振成像(MRI)可诊断脑部异常,包括软脑膜血管畸形、脉络丛增大以及皮质和皮质下血管异常。小鼠SWS模型确定了对异常血管生成和血脑屏障通透性重要的失调蛋白。最近的临床研究集中在早期诊断、生物标志物开发、症状前治疗以及新治疗策略的开发。使用大麻二酚(Epidiolex)或mTOR抑制剂西罗莫司进行的前瞻性试点临床药物试验表明,癫痫发作频率可能降低,认知结果得到改善。本综述将SWS细胞培养和动物模型中的最新分子研究与新治疗方法的开发联系起来,并确定了未来的研究领域。