KCNA1 gain-of-function epileptic encephalopathy treated with 4-aminopyridine.

KCNA1 gain-of-function epileptic encephalopathy treated with 4-aminopyridine.
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DOI:
10.1002/acn3.51742
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发表时间:
2023-04
影响因子:
5.3
通讯作者:
Cooper, Edward C.
Cooper, Edward C.
中科院分区:
医学2区
文献类型:
--
作者:
Mueller, Peter;Takacs, Danielle S.;Hedrich, Ulrike B. S.;Coorg, Rohini;Masters, Laura;Glinton, Kevin E.;Dai, Hongzheng;Cokley, Jon A.;Riviello, James J.;Lerche, Holger;Cooper, Edward C.

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孟德尔癫痫的精准医学正在迅速发展。我们描述一例严重耐药的多灶性癫痫的早期婴儿。外显子组测序发现KCNA1基因中有从头变异P.(Leu296Phe),编码电压门控K+通道亚基KV1.1。到目前为止,KCNA1的功能丧失变异与发作性共济失调1型或癫痫有关。对卵母细胞中突变的亚基的功能研究表明,电压依赖的超极化转变导致了功能的获得。Leu296Phe通道对4-氨基吡啶敏感。临床使用4-氨基吡啶与减少癫痫负担、简化联合用药和防止再次住院有关。
Precision medicine for Mendelian epilepsy is rapidly developing. We describe an early infant with severely pharmacoresistant multifocal epilepsy. Exome sequencing revealed the de novo variant p.(Leu296Phe) in the gene KCNA1, encoding the voltage‐gated K+ channel subunit KV1.1. So far, loss‐of‐function variants in KCNA1 have been associated with episodic ataxia type 1 or epilepsy. Functional studies of the mutated subunit in oocytes revealed a gain‐of‐function caused by a hyperpolarizing shift of voltage dependence. Leu296Phe channels are sensitive to block by 4‐aminopyridine. Clinical use of 4‐aminopyridine was associated with reduced seizure burden, enabled simplification of co‐medication and prevented rehospitalization.
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