生酮饮食抗癫痫治疗的机制研究进展
Research Progress on the Mechanism of Ketogenic Diet in Antiepilepsy
DOI: 10.12677/ACM.2022.126846, PDF,   
作者: 王贞芸:青海大学研究生院,青海 西宁;王兰桂:青海大学附属医院,青海 西宁
关键词: 生酮饮食癫痫研究进展Ketogenic Diet Epilepsy Research Progress
摘要: 癫痫是慢性神经系统疾病,对患者的神经功能造成严重损害,目前抗癫痫主要包括药物及手术治疗,但部分难治性癫痫患者经手术治疗或两种以上抗癫痫药物治疗后仍然无法有效控制癫痫发作,目前国外提倡用生酮饮食治疗难治性癫痫,并且取得了良好的临床效果,在1998年对51名患有耐药性癫痫的儿童进行的一项多中心研究显示坚持生酮饮食一年的患儿中43%无癫痫发作,39%控制了50%~90%的癫痫发作,但生酮饮食抗癫痫治疗的机制尚不完全明确,本文就生酮饮食抗癫痫治疗机制的目前的研究进展进行综述。
Abstract: Epilepsy is a chronic nervous system disease, which causes serious damage to the neurological function of patients. At present, antiepileptic drug treatment and surgical treatment are the main treatment options, but some patients with refractory epilepsy still can not control epilepsy after surgical treatment or more than two kinds of antiepileptic drugs. At present, ketogenic diet is ad-vocated in foreign countries, and good clinical results have been achieved, a multi center study of 51 children with drug-resistant epilepsy in 1998 showed that 43% of the children who insisted on ke-togenic diet for one year had no seizures, and 39% controlled 50%~90% of the seizures. However, the mechanism of ketogenic diet antiepileptic therapy is not completely clear. This paper reviews the current research progress on the mechanism of ketogenic diet antiepileptic therapy.
文章引用:王贞芸, 王兰桂. 生酮饮食抗癫痫治疗的机制研究进展[J]. 临床医学进展, 2022, 12(6): 5849-5855. https://doi.org/10.12677/ACM.2022.126846

参考文献

[1] Sourbron, J., Klinkenberg, S., van Kuijk, S.M.J., et al. (2020) Ketogenic Diet for the Treatment of Pediatric Epilepsy: Review and Meta-Analysis. Child’s Nervous System, 36, 1099-1109. [Google Scholar] [CrossRef] [PubMed]
[2] Ułamek-Kozioł, M., Czuczwar, S.J., Januszewski, S., et al. (2019) Ketogenic Diet and Epilepsy. Nutrients, 11, 2510. [Google Scholar] [CrossRef] [PubMed]
[3] Neves, G.S., Lunardi, M.S., Lin, K., et al. (2021) Ketogenic Diet, Seizure Control, and Cardiometabolic Risk in Adult Patients with Pharmacoresistant Epilepsy: A Review. Nutrition Reviews, 79, 931-944. [Google Scholar] [CrossRef] [PubMed]
[4] Zarnowska, I.M. (2020) Therapeutic Use of the Ketogenic Diet in Re-fractory Epilepsy: What We Know and What Still Needs to Be Learned. Nutrients, 12, 2616. [Google Scholar] [CrossRef] [PubMed]
[5] D’Andrea Meira, I., Romão, T.T., Pires Do Prado, H.J., et al. (2019) Ketogenic Diet and Epilepsy: What We Know So Far. Frontiers in Neuroscience, 13, Article No. 5. [Google Scholar] [CrossRef] [PubMed]
[6] Lambrechts, D.A.J.E., de Kinderen, R.J.A., Vles, J.S.H., et al. (2018) A Randomized Controlled Trial of the Ketogenic Diet in Refractory Childhood Epilepsy. Acta Neurologica Scan-dinavica, 137, 152-154. [Google Scholar] [CrossRef] [PubMed]
[7] Kim, D.Y., Abdelwahab, M.G., Lee, S.H., et al. (2015) Ketones Prevent Oxidative Impairment of Hippocampal Synaptic Integrity through KATP Channels. PLOS ONE, 10, e119316. [Google Scholar] [CrossRef] [PubMed]
[8] Grigolon, R.B., Gerchman, F., Schöffel, A.C., et al. (2020) Mental, Emotional, and Behavioral Effects of Ketogenic Diet for Non-Epileptic Neuropsychiatric Conditions. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 102, Article ID: 109947. [Google Scholar] [CrossRef] [PubMed]
[9] Calderón, N., Betancourt, L., Hernández, L., et al. (2017) A Ke-togenic Diet Modifies Glutamate, Gamma-Aminobutyric Acid and Agmatine Levels in the Hippocampus of Rats: A Mi-crodialysis Study. Neuroscience Letters, 642, 158-162. [Google Scholar] [CrossRef] [PubMed]
[10] Ricci, A., Idzikowski, M.A., Soares, C.N., et al. (2020) Explor-ing the Mechanisms of Action of the Antidepressant Effect of the Ketogenic Diet. Reviews in the Neurosciences, 31, 637-648. [Google Scholar] [CrossRef] [PubMed]
[11] Verrotti, A., Iapadre, G., Di Francesco, L., et al. (2020) Diet in the Treatment of Epilepsy: What We Know So Far. Nutrients, 12, 2645. [Google Scholar] [CrossRef] [PubMed]
[12] Barry, D., Ellul, S., Watters, L., et al. (2018) The Ketogenic Diet in Dis-ease and Development. International Journal of Developmental Neuroscience, 68, 53-58. [Google Scholar] [CrossRef] [PubMed]
[13] Augustin, K., Khabbush, A., Williams, S., et al. (2018) Mech-anisms of Action for the Medium-Chain Triglyceride Ketogenic Diet in Neurological and Metabolic Disorders. The Lan-cet Neurology, 17, 84-93. [Google Scholar] [CrossRef
[14] Chen, Y. and Zhou, X. (2020) Research Progress of mTOR Inhibitors. European Journal of Medicinal Chemistry, 208, Article ID: 112820. [Google Scholar] [CrossRef] [PubMed]
[15] Switon, K., Kotulska, K., Janusz-Kaminska, A., et al. (2017) Molecular Neurobiology of mTOR. Neuroscience, 341, 112-153. [Google Scholar] [CrossRef] [PubMed]
[16] Ko, A., Sim, N.S., Choi, H.S., et al. (2022) Efficacy of the Ketogenic Diet for Pediatric Epilepsy According to the Presence of Detectable Somatic mTOR Pathway Mutations in the Brain. Journal of Clinical Neurology (Seoul, Korea), 18, 71-78. [Google Scholar] [CrossRef] [PubMed]
[17] Murugan, M. and Boison, D. (2020) Ketogenic Diet, Neuroprotection, and Antiepileptogenesis. Epilepsy Research, 167, Article ID: 106444. [Google Scholar] [CrossRef] [PubMed]
[18] Zhao, M., Huang, X., Cheng, X., et al. (2017) Ketogenic Diet Improves the Spatial Memory Impairment Caused by Exposure to Hypobaric Hypoxia through Increased Acetyla-tion of Histones in Rats. PLOS ONE, 12, e174477. [Google Scholar] [CrossRef] [PubMed]
[19] Simeone, T.A., Simeone, K.A. and Rho, J.M. (2017) Ketone Bodies as Anti-Seizure Agents. Neurochemical Research, 42, 2011-2018. [Google Scholar] [CrossRef] [PubMed]
[20] Ni, H., Zhao, D.J. and Tian, T. (2016) Ketogenic Diet Change cPLA2/Clusterin and Autophagy Related Gene Expression and Correlate with Cognitive Deficits and Hippocampal MFs Sprouting Following Neonatal Seizures. Epilepsy Research, 120, 13-18. [Google Scholar] [CrossRef] [PubMed]
[21] Wang, J., Huang, J., Yao, S., et al. (2021) The Ketogenic Diet Increases Neuregulin 1 Expression via Elevating Histone Acetylation and Its Anti-Seizure Effect Requires ErbB4 Kinase Activity. Cell & Bioscience, 11, 93. [Google Scholar] [CrossRef] [PubMed]
[22] Genzer, Y., Dadon, M., Burg, C., et al. (2016) Effect of Dietary Fat and the Circadian Clock on the Expression of Brain-Derived Neurotrophic Factor (BDNF). Molecular and Cellular Endocrinology, 430, 49-55. [Google Scholar] [CrossRef] [PubMed]
[23] Li, R.J., Liu, Y., Liu, H.Q., et al. (2020) Ketogenic Diets and Pro-tective Mechanisms in Epilepsy, Metabolic Disorders, Cancer, Neuronal Loss, and Muscle and Nerve Degeneration. Journal of Food Biochemistry, 44, e13140. [Google Scholar] [CrossRef] [PubMed]
[24] Greco, T., Glenn, T.C., Hovda, D.A., et al. (2016) Ketogenic Diet De-creases Oxidative Stress and Improves Mitochondrial Respiratory Complex Activity. Journal of Cerebral Blood Flow & Metabolism, 36, 1603-1613. [Google Scholar] [CrossRef
[25] Knowles, S., Budney, S., Deodhar, M., et al. (2018) Ketogenic Diet Regulates the Antioxidant Catalase via the Transcription Factor PPARgamma2. Epilepsy Research, 147, 71-74. [Google Scholar] [CrossRef] [PubMed]
[26] Napolitano, A., Longo, D., Lucignani, M., et al. (2020) The Ketogenic Diet Increases in Vivo Glutathione Levels in Patients with Epilepsy. Metabolites, 10, 504. [Google Scholar] [CrossRef] [PubMed]
[27] Rogawski, M.A., Löscher, W. and Rho, J.M. (2016) Mechanisms of Action of Antiseizure Drugs and the Ketogenic Diet. Cold Spring Harbor Perspectives in Medicine, 6, a22780. [Google Scholar] [CrossRef] [PubMed]
[28] Pittman, Q.J. (2020) A Gut Feeling about the Ketogenic Diet in Epilepsy. Epilepsy Research, 166, Article ID: 106409. [Google Scholar] [CrossRef] [PubMed]
[29] Fan, Y., Wang, H., Liu, X., et al. (2019) Crosstalk between the Ketogenic Diet and Epilepsy: From the Perspective of Gut Microbiota. Mediators of Inflammation, 2019, Article ID: 8373060. [Google Scholar] [CrossRef] [PubMed]