GABRG2基因介绍

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基因产物:γ-氨基丁酸A受体γ2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)[6]。

相关疾病: 遗传性癫痫伴热性惊厥附加症 (AD)[1];热性惊厥(AD)[2]; 儿童失神癫痫 [2]; 青少年失神癫痫 [7];发育性癫痫性脑病74型(部分可表现为 婴儿癫痫伴游走性局灶性发作 Dravet 综合征 )(AD)[3-5]。

相关临床研究:PubMed数据库(PMID:  27367160 (JAMA Neurol. 2016) ;PMID:  27864268 (Brain. 2017) ;PMID:  31004928 (Seizure. 2019)

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。 


示意图1
 


参考文献
  1. Harkin, L.A., et al., Truncation of the GABA(A)-receptor gamma2 subunit in a family with generalized epilepsy with febrile seizures plus.Am J Hum Genet, 2002. 70(2): p. 530-6.
  2. Wallace, R.H., et al., Mutant GABA(A) receptor gamma2-subunit in childhood absence epilepsy and febrile seizures.Nat Genet, 2001. 28(1): p. 49-52.
  3. Komulainen-Ebrahim, J., et al., Novel variants and phenotypes widen the phenotypic spectrum of GABRG2-related disorders. Seizure, 2019. 69: p. 99-104.
  4. Kang, J.Q. and R.L. Macdonald, Molecular Pathogenic Basis for GABRG2 Mutations Associated With a Spectrum of Epilepsy Syndromes, From Generalized Absence Epilepsy to Dravet Syndrome. JAMA Neurol, 2016. 73( 8 ): p. 1009-16.
  5. Shen, D., et al., De novo GABRG2 mutations associated with epileptic encephalopathies.Brain, 2017. 140(1): p. 49-67.
  6. 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.
  7. International League Against Epilepsy. juvenile absence epilepsy (Accessed March 14, 2021).
25 May 2022 17:32 #1

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