Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 4 uppsatser.

Thesis (Ph.D.). / Written for the Dept. of Human Genetics. Title from title page of PDF (viewed 2008/07/23). Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 6 uppsatser.

Lau Hoi Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 134-157). / Abstracts in English and Chinese. / PUBLICATIONS BASED ON WORK IN THIS THESIS --- p.I / ABSTRACT --- p.II / ACKNOWLEDGEMENTS --- p.VI / TABLE OF CONTENTS --- p.VIII / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- General Introduction --- p.1 / Chapter 1.2 --- Emesis --- p.3 / Chapter 1.2.1 --- Introduction --- p.3 / Chapter 1.2.2 --- Retching & Vomiting --- p.3 / Chapter 1.2.3 --- Nausea --- p.4 / Chapter 1.2.4 --- Motor Components of Emetic Reflex --- p.5 / Chapter 1.2.4.1 --- Pre-ejection Phase --- p.5 / Chapter 1.2.4.2 --- Ejection Phase --- p.5 / Chapter 1.2.4.3 --- Post-ejection Phase --- p.6 / Chapter 1.2.5 --- Components of Emetic Reflex --- p.6 / Chapter 1.2.5.1 --- Area Postrema (AP) --- p.6 / Chapter 1.2.5.2 --- Nucleus Tractus Solitarius (NTS) --- p.7 / Chapter 1.2.5.3 --- Vomiting Centre --- p.8 / Chapter 1.2.5.4 --- Vestibular System --- p.10 / Chapter 1.2.5.5 --- Abdominal Visceral Afferents --- p.10 / Chapter 1.2.5.6 --- Forebrain --- p.11 / Chapter 1.2.6 --- Neurotransmitters & Receptors --- p.12 / Chapter 1.2.7 --- Anti-emetics --- p.13 / Chapter 1.3 --- Models of Nausea --- p.16 / Chapter 1.3.1 --- Introduction --- p.16 / Chapter 1.3.2 --- Conditioned Taste Aversion --- p.18 / Chapter 1.3.3 --- Pica Behaviour --- p.20 / Chapter 1.3.4 --- Studies of the Involvement of Vasopressin --- p.21 / Chapter 1.3.5 --- Tachygastria --- p.24 / Chapter 1.3.6 --- Locomotor Activity --- p.26 / Chapter 1.4 --- Markers of Neuronal Activity --- p.27 / Chapter 1.4.1 --- General Comments --- p.27 / Chapter 1.4.2 --- c-fos Expression as a Marker of Neuronal Activity --- p.28 / Chapter 1.4.2.1 --- What is c-fos? --- p.28 / Chapter 1.4.2.2 --- Regulation of c-fos Expression --- p.30 / Chapter 1.4.2.2.1 --- Calcium Response Element --- p.31 / Chapter 1.4.2.2.2 --- Serum Response Element --- p.32 / Chapter 1.4.2.3 --- Types of Receptors Involved in c-fos Expression --- p.32 / Chapter 1.4.2.4 --- Feasibility of Using c-fos Expression as Marker of Cellular Activity --- p.36 / Chapter 1.4.2.5 --- Identification of Emetic Pathway by c-fos Immunohistochemistry --- p.36 / Chapter 1.5 --- Aims & Objectives --- p.37 / Chapter CHAPTER 2 --- METHODS --- p.42 / Chapter 2.1 --- Animals --- p.42 / Chapter 2.1.1 --- Ferrets --- p.42 / Chapter 2.1.2 --- Suncus murinus --- p.42 / Chapter 2.2 --- Measurement of Animal Behaviour --- p.43 / Chapter 2.2.1 --- Experiment Design --- p.43 / Chapter 2.2.2 --- Recording of Animal Behaviour --- p.43 / Chapter 2.2.3 --- Calibration of Equipment Used to Record Spontaneous Locomotor Activity --- p.44 / Chapter 2.2.4 --- Behaviour Recorded by the Observer --- p.45 / Chapter 2.3 --- Administration of Drugs --- p.46 / Chapter 2.3.1 --- Ferrets --- p.46 / Chapter 2.3.1.1 --- General Comments --- p.46 / Chapter 2.3.1.2 --- Drug Antagonism Studies --- p.47 / Chapter 2.3.2 --- Suncus murinus --- p.47 / Chapter 2.3.2.1 --- General Comments --- p.47 / Chapter 2.3.2.2 --- Dose-Response Studies --- p.48 / Chapter 2.3.2.3 --- Drug Antagonism Studies --- p.48 / Chapter 2.4 --- c-fos Expression Studies in Ferret Brainstems --- p.50 / Chapter 2.4.1 --- Animals and Anaesthesia --- p.50 / Chapter 2.4.2 --- Perfusion and fixation --- p.50 / Chapter 2.4.3 --- Dehydration of brains --- p.51 / Chapter 2.4.4 --- Embedding of tissue --- p.52 / Chapter 2.4.5 --- Sectioning --- p.52 / Chapter 2.4.6 --- Staining --- p.52 / Chapter 2.4.7 --- Antibodies used --- p.55 / Chapter 2.4.8 --- Positive Control Slides --- p.55 / Chapter 2.5 --- Experimental Design and Statistics --- p.56 / Chapter 2.5.1 --- Randomization of Treatments --- p.56 / Chapter 2.5.2 --- Statistics --- p.57 / Chapter 2.5.2.1 --- Ferrets --- p.57 / Chapter 2.5.2.2 --- Suncus murinus --- p.59 / Chapter 2.6 --- Drugs and Chemicals Used --- p.60 / Chapter 2.6.1 --- Drugs Used --- p.60 / Chapter 2.6.2 --- Chemicals Used --- p.62 / Chapter CHAPTER 3 --- RESULTS --- p.63 / Chapter 3.1 --- Ferret --- p.63 / Chapter 3.1.1 --- "The Effect of Ondansetron and CP-99,994 on Emesis and Locomotor Activity Changes Induced by Cisplatin in the Ferret" --- p.63 / Chapter 3.1.2 --- The Effect of Domperidone on Emesis and Locomotor Activity Changes Induced by Apomorphine in the Ferret --- p.69 / Chapter 3.1.3 --- "The Effect of CP-99,994 on Emesis and Locomotor Activity Changes Induced by Apomorphine in the Ferret" --- p.74 / Chapter 3.1.4 --- c-fos Expression Studies in Ferret Brainstems --- p.79 / Chapter 3.1.4.1 --- Cisplatin-treated Ferrets --- p.79 / Chapter 3.1.4.2 --- Positive Control Slides --- p.84 / Chapter 3.2 --- Suncus murinus --- p.88 / Chapter 3.2.1 --- The Emetic Potential of Nicotine and its Effects on the Spontaneous Locomotor Activity of Suncus murinus --- p.88 / Chapter 3.2.2 --- "The Effect of CP-99,994 on Emesis and Locomotor Activity Changes Induced by Nicotine in Suncus murinus" --- p.92 / Chapter 3.2.3 --- The Emetic Potential of Copper Sulphate and its Effects on the Spontaneous Locomotor Activity of Suncus murinus --- p.95 / Chapter 3.2.4 --- "The Effect of CP-99,994 on Emesis and Locomotor Activity Changes Induced by Copper Sulphate in Suncus murinus" --- p.98 / Chapter 3.2.5 --- The Emetic Potential of Cisplatin and its Effects on the Spontaneous Locomotor Activity of Suncus murinus --- p.101 / Chapter 3.2.6 --- The Effect of Ondansetron on Emesis and Locomotor Activity Changes Induced by Cisplatin in Suncus murinus --- p.104 / Chapter 3.2.7 --- "The Effect of CP-99,994 on Emesis and Locomotor Activity Changes Induced by Cisplatin in Suncus murinus" --- p.107 / Chapter 3.2.8 --- "The Effects of Ondansetron and CP-99,994 on Locomotor Activity in Suncus murinus" --- p.110 / Chapter CHAPTER 4 --- DISCUSSION --- p.113 / Chapter CHAPTER 5 --- GENERAL SUMMARY --- p.130 / REFERENCES --- p.134

A epilepsia do lobo temporal causada por esclerose hipocampal é a epilepsia farmacorresistente mais frequente em adultos. Os transtornos de humor são a comorbidade psiquiátrica mais comuns nesses pacientes. Os mecanismos fisiopatológicos comuns entre a epilepsia e as comorbidades psiquiátricas incluem alterações na via serotoninérgica. Os polimorfismos de genes relacionados à via serotoninérgica (receptores, monoamino oxidase A, transportador de serotonina) podem estar relacionadas à coexistência destas condições. O objetivo principal deste estudo foi o de determinar a possível associação entre os polimorfismos dos genes que codificam os receptores de serotonina 5HT1A (rs6295), 5HT1B (rs6296), e 5HT2C(rs6318); a monoamino oxidase A (MAOA-uVNTR); e o transportador de serotonina (5-HTTLPR e 5-HTTVNTR) e a presença de depressão nesses pacientes, em comparação à pacientes sem epilepsia com depressão, voluntários saudáveis sem epilepsia e sem transtornos psiquiátricos. O objetivo secundário foi o de avaliar a possível associação entre essas variantes genéticas e a susceptibilidade ao desenvolvimento de crises epilépticas assim como sua influência sobre as características clínicas da epilepsia. Foram avaliados 119 pacientes com epilepsia do lobo temporal causada por esclerose hipocampal com (56 pacientes) e sem (63 pacientes) depressão; 146 pacientes com transtorno depressivo maior, sem características psicóticas e 113 controles saudáveis. Os indivíduos foram genotipados para os polimorfismos rs6295, rs6296, rs6318, MAOA-uVNTR, 5-HTTLPR e 5-HTTVNTR. Em relação ao polimorfismo rs6295, não houve diferença na distribuição dos genótipos entre epilepsia e depressão sem epilepsia (p = 1.000) e epilepsia e controles (p = 1.000). Não foi observada diferença entre o polimorfismo rs6296 e os grupos epilepsia e depressão sem epilepsia (p = 0,838) e epilepsia e controles (p = 0,838). Não houve diferença entre o polimorfismo rs6318 e os grupos epilepsia e depressão sem epilepsia (p = 0,207) e epilepsia e controles (p = 0,296). Não foi observada diferença entre o polimorfismo MAOA-uVNTR e os grupos epilepsia e depressão (p = 0,799) e epilepsia e controles (p = 1,000). Não houve diferença entre o polimorfismo 5-HTTLPR e os grupos epilepsia e depressão sem epilepsia (p = 1.000) e epilepsia e controles (p = 0,626). Não foi observada diferença entre o polimorfismo 5-HTTVNTR e epilepsia e depressão sem epilepsia (p = 1.000) e epilepsia e controles (p = 0.790). No grupo de pacientes com epilepsia, não houve diferença entre os polimorfismos estudados e a presença de depressão. Foi observada correlação entre alelos de alta atividade transcricional em homozigose ou hemizigose (3,5 e 4 repetições) do polimorfismo MAOA-uVNTR e ocorrência de crises epilépticas diárias/semanais (p=0,032) e crises tônico-clônicas bilaterais (p=0,016). Também houve relação entre o alelo de 12 repetições em homozigose (alelo relacionados a maior produção de RNA mensageiro) do polimorfismo 5-HTTVNTR e história familiar de epilepsia nos pacientes com epilepsia (p=0,013). Alelos de alta atividade transcricional do polimorfismo MAOA-uVNTR estão relacionados a maior eficiência transcricional do gene da monoamino oxidase A e maior atividade enzimática, levando a aumento na metabolização da serotonina. Portanto, é possível que a redução na concentração de serotonina possa levar a um aumento na hiperexcitabilidade neuronal, tendo como consequência um aumento na frequência de crises e ocorrência de crises tônico-clônicas bilaterais. O alelo de 12 repetições do 5-HTTVNTR relaciona-se a maior produção de RNA mensageiro, levando a maior eficiência transcricional do gene do 5-HTTVNTR. Este achado sugere a presença de um subgrupo de pacientes com predisposição familiar para a ocorrência de crises epilépticas devido a um estado de hiperexcitabilidade neuronal determinado pela maior expressão do transportador de serotonina. Este estudo sugere que os polimorfismos avaliados não estão relacionados com a presença de epilepsia ou de comorbidades psiquiátricas nesses pacientes, mas sim com aspectos clínicos da epilepsia (frequência de crises epilépticas, presença de crises tônico-clônicas bilaterais e história familiar de epilepsia) nos pacientes com epilepsia do lobo temporal causada por esclerose hipocampal / Temporal lobe epilepsy caused by hippocampal sclerosis is the most common drug-resistant epilepsy in adults. Mood disorders are the most common psychiatric comorbidity in these patients. Common pathophysiological mechanisms between epilepsy and psychiatric comorbidities include changes in the serotonergic pathway. Polymorphisms of genes related to the serotoninergic pathway (receptors, monoamine oxidase A, serotonin transporter) may be associated with the coexistence of these conditions. The primary objective of this study was to determine the possible association between polymorphisms of the genes encoding serotonin 5HT1A receptors (rs6295), 5HT1B (rs6296), and 5HT2C (rs6318); monoamine oxidase A (MAOA-uVNTR); and the serotonin transporter (5-HTTLPR and 5-HTTVNTR) and the presence of depression in these patients compared to patients without epilepsy with depression, and healthy volunteers without epilepsy and psychiatric disorders. The secondary objective was to evaluate the possible association between these variants and the susceptibility to the development of epileptic seizures and their influence on the clinical characteristics of epilepsy. We evaluated 119 patients with temporal lobe epilepsy caused by hippocampal sclerosis with (56 patients) and without (63 patients) depression, 146 patients with major depressive disorder, without psychotic characteristics, and 113 healthy controls. The individuals were genotyped for polymorphisms rs6295, rs6296, rs6318, MAOA-uVNTR, 5-HTTLPR and 5-HTTVNTR. Regarding the rs6295 polymorphism, no difference was observed in the distribution of genotypes between epilepsy and depression without epilepsy groups (p = 1,000) and epilepsy and controls (p = 1,000). No difference was observed for the rs6296 polymorphism between epilepsy and depression without epilepsy groups (p = 0.838) and epilepsy and controls (p = 0.838). There was no difference for the rs6318 polymorphism between epilepsy and depression without epilepsy groups (p = 0.207) and epilepsy and controls (p = 0.296). No difference was observed for the MAOA-uVNTR polymorphism between epilepsy and depression without epilepsy groups (p = 0.799) and epilepsy and controls (p = 1,000). There was no difference between the polymorphism 5-HTTLPR and epilepsy and depression groups without epilepsy (p = 1,000) and epilepsy and controls (p = 0.626). No difference was observed between the 5-HTTVNTR polymorphism and epilepsy and depression without epilepsy groups (p = 1,000) and epilepsy and controls (p = 0.790). In the group of patients with epilepsy, there was no difference between the polymorphisms studied and the history of psychiatric comorbidities. A correlation was observed between alleles with high transcriptional activity in homozygosis or hemizygosis (3.5 and 4 repeats) of the MAOA-uVNTR polymorphism and occurrence of daily /weekly epileptic seizures (p = 0.032) and bilateral tonic-clonic seizures (p = 0.016). There was also a relationship between the allele of 12 repeats in homozygosis (allele related to higher messenger RNA production) of the 5-HTTVNTR polymorphism and family history of epilepsy in patients with epilepsy (p = 0.013). High transcriptional activity alleles of MAOA-uVNTR are related to the higher transcriptional efficiency of the monoamine oxidase A gene and higher enzymatic activity, leading to increased serotonin metabolism. Therefore, it is possible that the reduction in serotonin concentration may lead to an increase in neuronal hyperexcitability, increasing the frequency of seizures and occurrence of bilateral tonic-clonic seizures. The 12-repeat allele of 5-HTTVNTR is related to increased messenger RNA production, leading to increased transcriptional efficiency of the 5-HTTVNTR gene. This finding suggests the presence of a subgroup of patients with a familial predisposition for the occurrence of epileptic seizures due to a state of neuronal hyperexcitability determined by the higher expression of the serotonin transporter. This study suggests that the polymorphisms evaluated are not related to the presence of epilepsy or psychiatric comorbidities in these patients, but rather to clinical aspects of epilepsy (frequency of epileptic seizures, the presence of bilateral tonic-clonic seizures, and family history of epilepsy) in patients with temporal lobe epilepsy and hippocampal sclerosis