GABRB3

基因产物:γ-氨基丁酸A受体β3亚单位。

蛋白功能:属于配体门控型氯离子通道,是脑内主要抑制性神经递质GABAA异源五聚体受体的组成部分(示意图1)[1]。

相关疾病:儿童失神癫痫(AD)[2];青少年失神癫痫(AD)[4];遗传性癫痫伴热性惊厥附加症(AD)[3];热性惊厥(AD)[3];发育性癫痫性脑病43型(部分可表现为癫痫伴肌阵挛-失张力发作(Doose 综合征)West 综合征Lennox-Gastaut综合征Dravet 综合征婴儿癫痫伴游走性局灶性发作)(AD)[3-6]。

突变数据库:ClinVar数据库

相关临床研究:PubMed数据库(PMID:31435640 (Brain. 2019);PMID: 28053010 (Neurology. 2017)

用药提醒该基因突变所致疾病表型谱较广,可根据不同癫痫综合征选择用药(整体从机理上讲,可首先考虑选择主要可影响γ-氨基丁酸浓度的药物如丙戊酸钠,部分难治性且以肌阵挛为主的发作时可考虑选择氯硝西泮氯巴占作为添加或单独使用,司替戊醇也可考虑作为添加),从该基因可导致的这些综合征总体来看,卡马西平或奥卡西平这类的尽可能避开,部分病人可能无效甚至加重。以上用药提醒仅为个人观点,仅供参考,针对该基因目前尚未查到有相关用药的大型临床研究文献。

讨论版块点击进入GABRB3基因突变讨论版块

 

示意图1

gabaar示意图

 

参考文献

  1. Whiting, P.J., et al., Molecular and functional diversity of the expanding GABA-A receptor gene family. Ann N Y Acad Sci, 1999. 868: p. 645-53.
  2. Tanaka, M., et al., Hyperglycosylation and reduced GABA currents of mutated GABRB3 polypeptide in remitting childhood absence epilepsy. Am J Hum Genet, 2008. 82(6): p. 1249-61.
  3. Moller, R.S., et al., Mutations in GABRB3: From febrile seizures to epileptic encephalopathies. Neurology, 2017. 88(5): p. 483-492.
  4. Shi, Y.W., et al., Synaptic clustering differences due to different GABRB3 mutations cause variable epilepsy syndromes. Brain, 2019. 142(10): p. 3028-3044.
  5. Sterbova, K., et al., Neonatal Onset of Epilepsy of Infancy with Migrating Focal Seizures Associated with a Novel GABRB3 Variant in Monozygotic Twins. Neuropediatrics, 2018. 49(3): p. 204-208.
  6. Pavone, P., et al., A novel GABRB3 variant in Dravet syndrome: Case report and literature review. Mol Genet Genomic Med, 2020. 8(11): p. e1461.