海马硬化致耐药性颞叶内侧癫痫的耐药基因蛋白表达及意义  

Expressions of drug-resistance related genes and the significance in sclerotic hippocampi from patients with drug-resistant mesial temporal lobe epilepsy

作　　者：许尚臣[1] 庞琦[1] 董勇[1] 赵光宇[1] 邢毅[1] 

机构地区：[1]山东大学附属省立医院神经外科,济南250021

出　　处：《立体定向和功能性神经外科杂志》2009年第1期6-9,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的观察耐药性颞叶内侧癫痫硬化海马中有关耐药基因蛋白的表达并探讨其临床意义。方法对经手术治疗取自16例颞叶内侧癫痫的硬化海马标本进行免疫组化染色观察p-糖蛋白170(p-gp170)、谷胱甘肽硫转移酶-π(GST-π)、拓扑酶II(TOPII)、胸苷合成酶(TS)及O-6-甲基鸟嘌呤-DNA-甲基转移酶(MGMT)的表达。结果p-gp170和GST-π在硬化海马组织中神经细胞、血管内皮细胞及胶质细胞均有表达,而以血管内皮细胞和胶质细胞阳性表达尤为突出。TOPII、TS和MGMG在硬化海马中无明显阳性表达。结论长期应用抗癫痫药物可能诱导p-gp170和GST-π表达增强,促进抗癫痫药物的排出与代谢,引起耐药。TOPII、TS和MGMG可能与癫痫耐药机制无关。Objective To observe the expressions of drug--resistance related genes in sclerotic hippocampi from patients with drug--resistant mesial temporal lobe epilepsy in order to insight into mechanisms with drug--resistance in epilepsy. Methods The expressions of glycoprorein p 170（ p--gp170）, glutathione-- S-- transferase π （GST-- π）, topoisomerase II （TOP II ）, Thymidylate Synthase（TS）, and O6--methylguanine DNA methyltransferase （MGMT）in the sclerotic hippocampi operatively taken from 16 patients with refractory mesial temporal lobe epilepsy were detected using immunohistochemieal staining. Results Apparent expressions of p-- gp170 and GST--π were observed in neurons, vascular endothelial cells and glial cells in the sclerotic hippocampi, especially more remarkable in vascular endothelial cells and glial cells. TOPII, TH and MGMG were not expressed apparently in the sclerotic hippocampi. Conclusion Long-- term usage of antiepileptic drugs could promote the expressions of p--gp170 and GST--π ,which in turn enhance the excretion and metabolism of the drugs used, leading to the phenomenon of drug--resistance. TOPII.TS and MGMG could possibly be unrelated with the drug--resistance phenomenon in chronic epilepsy.

关 键 词：颞叶内侧癫痫 海马硬化 P-糖蛋白170 谷胱甘肽硫转移酶-π 

分 类 号：R742.1[医药卫生—神经病学与精神病学]