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Anak-anak
dengan autism memiliki tambahan sinapsis otak: mungkin untuk memangkas sinapsis
dengan obat setelah diagnosis
Anak-anak
dan remaja dengan autisme memiliki surplus sinapsis di otak, dan kelebihan ini
karena perlambatan dalam proses "pemangkasan" otak normal selama
pengembangan, menurut sebuah studi baru. Karena poin sinapsis mana neuron terkoneksi dan berkomunikasi satu
sama lain, sinapsis berlebihan mungkin memiliki efek mendalam pada bagaimana
fungsi otak....................
Children with autism have extra synapses in brain: May be possible to
prune synapses with drug after diagnosis
Date:
August 21,
2014
Source:
Columbia University Medical Center
Summary:
Children and adolescents with autism
have a surplus of synapses in the brain, and this excess is due to a slowdown
in a normal brain “pruning” process during development, according to a new
study. Because synapses are the points where neurons connect and communicate
with each other, the excessive synapses may have profound effects on how the
brain functions.
...................
Children and adolescents with autism have a surplus of
synapses in the brain, and this excess is due to a slowdown in a normal brain
"pruning" process during development, according to a study by
neuroscientists at Columbia University Medical Center (CUMC). Because synapses
are the points where neurons connect and communicate with each other, the
excessive synapses may have profound effects on how the brain functions. The
study was published in the August 21 online issue of the journal Neuron.
A drug that
restores normal synaptic pruning can improve autistic-like behaviors in mice,
the researchers found, even when the drug is given after the behaviors have
appeared.
"This
is an important finding that could lead to a novel and much-needed therapeutic
strategy for autism," said Jeffrey Lieberman, MD, Lawrence C. Kolb
Professor and Chair of Psychiatry at CUMC and director of New York State
Psychiatric Institute, who was not involved in the study.
Although the
drug, rapamycin, has side effects that may preclude its use in people with
autism, "the fact that we can see changes in behavior suggests that autism
may still be treatable after a child is diagnosed, if we can find a better
drug," said the study's senior investigator, David Sulzer, PhD, professor
of neurobiology in the Departments of Psychiatry, Neurology, and Pharmacology
at CUMC.
During
normal brain development, a burst of synapse formation occurs in infancy,
particularly in the cortex, a region involved in autistic behaviors; pruning
eliminates about half of these cortical synapses by late adolescence. Synapses
are known to be affected by many genes linked to autism, and some researchers
have hypothesized that people with autism may have more synapses.
To test this
hypothesis, co-author Guomei Tang, PhD, assistant professor of neurology at
CUMC, examined brains from children with autism who had died from other causes.
Thirteen brains came from children ages two to 9, and thirteen brains came from
children ages 13 to 20. Twenty-two brains from children without autism were
also examined for comparison.
Dr. Tang
measured synapse density in a small section of tissue in each brain by counting
the number of tiny spines that branch from these cortical neurons; each spine
connects with another neuron via a synapse.
By late
childhood, she found, spine density had dropped by about half in the control
brains, but by only 16 percent in the brains from autism patients.
"It's
the first time that anyone has looked for, and seen, a lack of pruning during
development of children with autism," Dr. Sulzer said, "although
lower numbers of synapses in some brain areas have been detected in brains from
older patients and in mice with autistic-like behaviors."
Clues to
what caused the pruning defect were also found in the patients' brains; the
autistic children's brain cells were filled with old and damaged parts and were
very deficient in a degradation pathway known as "autophagy." Cells
use autophagy (a term from the Greek for self-eating) to degrade their own
components.
Using mouse
models of autism, the researchers traced the pruning defect to a protein called
mTOR. When mTOR is overactive, they found, brain cells lose much of their
"self-eating" ability. And without this ability, the brains of the
mice were pruned poorly and contained excess synapses. "While people
usually think of learning as requiring formation of new synapses, "Dr.
Sulzer says, "the removal of inappropriate synapses may be just as
important."
The
researchers could restore normal autophagy and synaptic pruning -- and reverse
autistic-like behaviors in the mice -- by administering rapamycin, a drug that
inhibits mTOR. The drug was effective even when administered to the mice after
they developed the behaviors, suggesting that such an approach may be used to
treat patients even after the disorder has been diagnosed.
Because
large amounts of overactive mTOR were also found in almost all of the brains of
the autism patients, the same processes may occur in children with autism.
"What's
remarkable about the findings," said Dr. Sulzer, "is that hundreds of
genes have been linked to autism, but almost all of our human subjects had
overactive mTOR and decreased autophagy, and all appear to have a lack of
normal synaptic pruning. This says that many, perhaps the majority, of genes
may converge onto this mTOR/autophagy pathway, the same way that many
tributaries all lead into the Mississippi River. Overactive mTOR and reduced
autophagy, by blocking normal synaptic pruning that may underlie learning
appropriate behavior, may be a unifying feature of autism."
Alan Packer,
PhD, senior scientist at the Simons Foundation, which funded the research, said
the study is an important step forward in understanding what's happening in the
brains of people with autism.
"The
current view is that autism is heterogeneous, with potentially hundreds of
genes that can contribute. That's a very wide spectrum, so the goal now is to
understand how those hundreds of genes cluster together into a smaller number
of pathways; that will give us better clues to potential treatments," he
said.
"The
mTOR pathway certainly looks like one of these pathways. It is possible that
screening for mTOR and autophagic activity will provide a means to diagnose
some features of autism, and normalizing these pathways might help to treat
synaptic dysfunction and treat the disease."
The paper is
titled, "Loss of mTOR-dependent macroautophagy causes autistic-like
synaptic pruning deficits." Other authors are: Kathryn Gudsnuk, Sheng-Han
Kuo, Marisa L. Cotrina, Gorazd Rosoklija, Alexander Sosunov, Mark S. Sonders,
Ellen Kanter, Candace Castagna, Ai Yamamoto, Ottavio Arancio, Bradley S.
Peterson, Frances Champagne, Andrew J. Dwork, and James Goldman from CUMC; and
Zhenyu Yue (Icahn School of Medicine at Mount Sinai). Marisa Cotrina is now at
the University of Rochester.
Story
Source:
The above
story is based on materials provided by Columbia University Medical Center. Note: Materials may be edited
for content and length.
Journal
Reference:
- Guomei Tang, Kathryn Gudsnuk, Sheng-Han Kuo, Marisa L. Cotrina, Gorazd Rosoklija, Alexander Sosunov, Mark S. Sonders, Ellen Kanter, Candace Castagna, Ai Yamamoto, Zhenyu Yue, Ottavio Arancio, Bradley S. Peterson, Frances Champagne, Andrew J. Dwork, James Goldman, David Sulzer. Loss of mTOR-Dependent Macroautophagy Causes Autistic-like Synaptic Pruning Deficits. Neuron, 2014; DOI: 10.1016/j.neuron.2014.07.040
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