Adenosine, ketogenic diet and epilepsy: the emerging therapeutic relationship between metabolism and brain activity.
Adenosine, ketogenic diet and epilepsy: the emerging therapeutic relationship between metabolism and brain activity.
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DOI：
10.2174/157015909789152164
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发表时间：
2009-09
影响因子：
5.3
通讯作者：
Ruskin DN
中科院分区：
文献类型：
--
作者：
Masino SA;Kawamura M;Wasser CD;Pomeroy LT;Ruskin DN
多年来，神经调节剂腺苷一直被认为是一种内源性抗惊厥分子，并被称为“报复性代谢物”。作为 ATP 的核心分子，腺苷在细胞能量和神经元兴奋性之间形成了独特的联系。与此同时，生酮（高脂肪、低碳水化合物）饮食是一种显着影响神经元活动的代谢疗法，几十年来生酮饮食已成功用于治疗医学难治性癫痫，特别是儿童。迄今为止，饮食疗法成功的关键神经机制尚不清楚，这阻碍了类似药理学解决方案的开发。同样，基于腺苷受体的癫痫和其他多种疾病的治疗方法仍然难以捉摸。在这篇综述中，我们探讨了腺苷作为抗惊厥策略的生理调节，并提出了腺苷在癫痫生酮饮食治疗成功中的关键作用。虽然目前的重点是腺苷、生酮代谢和癫痫的调节，但其治疗意义扩展到各种急性和慢性神经系统疾病，如脑损伤、炎症和神经性疼痛、自闭症和多巴胺能障碍。将讨论腺苷代谢调节的广泛临床相关性的新证据。
For many years the neuromodulator adenosine has been recognized as an endogenous anticonvulsant molecule and termed a “retaliatory metabolite.” As the core molecule of ATP, adenosine forms a unique link between cell energy and neuronal excitability. In parallel, a ketogenic (high-fat, low-carbohydrate) diet is a metabolic therapy that influences neuronal activity significantly, and ketogenic diets have been used successfully to treat medically-refractory epilepsy, particularly in children, for decades. To date the key neural mechanisms underlying the success of dietary therapy are unclear, hindering development of analogous pharmacological solutions. Similarly, adenosine receptor–based therapies for epilepsy and myriad other disorders remain elusive. In this review we explore the physiological regulation of adenosine as an anticonvulsant strategy and suggest a critical role for adenosine in the success of ketogenic diet therapy for epilepsy. While the current focus is on the regulation of adenosine, ketogenic metabolism and epilepsy, the therapeutic implications extend to acute and chronic neurological disorders as diverse as brain injury, inflammatory and neuropathic pain, autism and hyperdopaminergic disorders. Emerging evidence for broad clinical relevance of the metabolic regulation of adenosine will be discussed.
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影响因子：
2.6
作者：
Balietti, Marta;Giorgetti, Belinda;Bertoni-Freddari, Carlo
通讯作者：
Bertoni-Freddari, Carlo
影响因子：
2
作者：
Baranano, Kristin W;Hartman, Adam L
通讯作者：
Hartman, Adam L
DOI：
10.1001/archneurpsyc.1930.02220110066004
发表时间：
1930-05-01
影响因子：
--
作者：
Barborka, CJ
通讯作者：
Barborka, CJ
影响因子：
2
作者：
Caruso, Claire C.
通讯作者：
Caruso, Claire C.
影响因子：
2.6
作者：
Chez, MG;Chang, M;Schwartz, A
通讯作者：
Schwartz, A