与星形细胞瘤中耐药性癫痫相关的基因突变。

Gene mutations linked to drug-resistant epilepsy in astrocytoma.

作者信息

Phabphal Kanitpong, Kaewborisutsakul Anukoon, Leetanaporn Kittinun, Choochuen Pongsakorn, Tunthanathip Thara, Navakanitworakul Raphatphorn, Sangkhathat Surasak

机构信息

Unit of Neurology, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

Unit of Neurological Surgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

出版信息

Front Neurol. 2025 Mar 4;16:1523468. doi: 10.3389/fneur.2025.1523468. eCollection 2025.

Abstract

INTRODUCTION

Epilepsy is common in gliomas, particularly astrocytomas, even in patients who have undergone total tumor resection. Resistance to antiseizure drugs presents a significant challenge in managing epilepsy. Seizure outcomes after brain surgery for drug-resistant epilepsy (DRE) are heterogeneous and difficult to predict using models that evaluate current clinical, imaging, and electrophysiological variables. This study aimed to investigate possible correlations between genetic mutations and antiseizure resistance using whole-exome sequencing.

METHODS

Tumor samples from a medical biobank were subjected to whole-exome sequencing, and the contribution of 64 genes from a previous report was analyzed.

RESULTS

Fifteen patients had DRE. Compared to the patients who showed drug responsiveness, patients in the DRE group exhibited mutations in glutamate receptor genes (, , , or ), , and the glutamate-S-transferase gene. No significant differences were found between the groups in terms of mutations in , , Ki-67, IDH, PIK3CA, p, , or .

DISCUSSION

These findings suggest that somatic gene mutations are closely linked to DRE. Identifying the molecular basis of antiseizure drug resistance is crucial for improving the management of DRE.

摘要

引言

癫痫在胶质瘤中很常见,尤其是星形细胞瘤,即使在已经接受肿瘤全切的患者中也是如此。对抗癫痫药物的耐药性给癫痫的治疗带来了重大挑战。药物难治性癫痫(DRE)患者脑手术后的癫痫发作结果存在异质性,使用评估当前临床、影像学和电生理变量的模型难以预测。本研究旨在通过全外显子组测序调查基因突变与抗癫痫耐药性之间可能存在的相关性。

方法

对一个医学生物样本库中的肿瘤样本进行全外显子组测序,并分析先前报告中64个基因的作用。

结果

15例患者患有药物难治性癫痫。与表现出药物反应性的患者相比,药物难治性癫痫组患者的谷氨酸受体基因(、、、或)、以及谷胱甘肽-S-转移酶基因存在突变。两组之间在、、Ki-67、异柠檬酸脱氢酶(IDH)、磷脂酰肌醇-3激酶催化亚基α(PIK3CA)、磷酸化(p)、、或的突变方面未发现显著差异。

讨论

这些发现表明体细胞基因突变与药物难治性癫痫密切相关。确定抗癫痫药物耐药性的分子基础对于改善药物难治性癫痫的治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c62/11913685/62349255a8a3/fneur-16-1523468-g001.jpg

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