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Hao J, Liu H, Ma J, Liu G, Dong G, Liu P, Xiao F. SCN1A IVS5N+5 G>A Polymorphism and Risk of Febrile Seizure and Epilepsy: A Systematic Review and Meta-Analysis. Front Neurol 2021; 11:581539. [PMID: 33391151 PMCID: PMC7773848 DOI: 10.3389/fneur.2020.581539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/30/2020] [Indexed: 01/11/2023] Open
Abstract
Background: Previous studies had investigated the association between polymorphism of IVS5N+5 G>A in SCN1A and the risk of febrile seizure and epilepsy. However, the results were inconsistent. We aimed to conduct a systematic review and meta-analysis to evaluate the association between SCN1A IVS5N+5 G>A polymorphism and risk of febrile seizures and epilepsy. Methods: We searched Embase, Medline, Scopus, and CNKI for studies on the association between SCN1A IVS5N+5 G>A polymorphism and risk of febrile seizures and epilepsy up to 19 February 2020. We pooled odds ratios (ORs) and 95% confidence intervals (CIs) by different genetic models. To explore the source of heterogeneity, we performed the subgroup analysis by ethnicity and source of control. Results: We included a total of 12 studies in the meta-analysis. We found a significant negative association between G allele SCN1A IVS5N+5 G>A polymorphism, febrile seizures [G vs. A: OR (95% CI): 0.690 (0.530-0.897); GG vs. AA: 0.503 (0.279-0.908); AG vs. AA: 0.581 (0.460-0.733); GG + AG vs. AA: 0.543 (0.436-0.677); AA + GG vs. AG: 1.309 (1.061-1.615)], and epilepsy [G vs. A: 0.822 (0.750-0.902); GG vs. AA: 0.655 (0.515-0.832); AG vs. AA: 0.780 (0.705-0.862); GG vs. AG + AA: 0.769 (0.625-0.947); GG + AG vs. AA: 0.743 (0.663-0.833); AA + GG vs. AG: 1.093 (1.001-1.193)]. The subgroup analysis shows the association varied by type of disease, ethnicity, and source of control. Conclusion: The present meta-analysis suggests that G allele in SCN1A IVS5N+5 G>A polymorphism is a protective factor of febrile seizures and epilepsy. It is possible to determine the vulnerability of each individual to develop febrile seizures or epilepsy genotype by these genetic variants. Future studies with better study designs are needed to confirm the results. Study Registration: This study was registered in the International Prospective register of systematic reviews (PROSPERO, CRD42020163318).
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Affiliation(s)
- Jindou Hao
- Department of Paediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, China.,Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Haiying Liu
- Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Jiying Ma
- Department of Occupational Health Surveillance, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Guosheng Liu
- Department of Paediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guoqing Dong
- Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Peihui Liu
- Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Fei Xiao
- Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
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Zhi H, Wu C, Yang Z. SCN1A rs3812718 polymorphism is associated with epilepsy: An updated meta-analysis. Epilepsy Res 2018; 142:81-87. [DOI: 10.1016/j.eplepsyres.2018.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/10/2018] [Accepted: 03/24/2018] [Indexed: 12/18/2022]
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Ma QL, Wang B, Chen GF, Huang JL, Li Y, Cao DZ, Liu RT. [Association between SCN1A rs3812718 polymorphism and generalized epilepsy with febrile seizures plus]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2018; 20:130-133. [PMID: 29429462 PMCID: PMC7389242 DOI: 10.7499/j.issn.1008-8830.2018.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 12/21/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate the association between SCN1A rs3812718 polymorphism and generalized epilepsy with febrile seizures plus (GEFS+), and to provide potential molecular targets for the diagnosis and treatment of GEFS+. METHODS The iPLEX technique in the MassARRAY system was used to determine SCN1A rs3812718 polymorphism, genotype frequency, and allele frequency in 50 patients with GEFS+ and 50 healthy controls. RESULTS As for the frequencies of CC, CT, and TT genotypes in SCN1A rs3812718, there was a significant difference in the frequency of TT genotype between the GEFS+ group and the control group (P<0.05). There was also a significant difference in the frequency of T allele between the two groups (P<0.05). Compared with those carrying CC genotype or C allele, the individuals with CT genotype , TT genotype or T allele had a higher risk of developing GEFS+ (CT/CC: OR=4.05, 95%CI: 1.04-15.69; TT/CC: OR=30.60, 95%CI: 6.46-144.85; T/C: OR=4.64, 95%CI: 2.54-8.48). CONCLUSIONS SCN1A rs3812718 polymorphism is a risk factor for GEFS+, and the population carrying T allele may have an increased risk of GEFS.
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Affiliation(s)
- Qi-Ling Ma
- Department of Pediatrics, Second People's Hospital of Shenzhen, Shenzhen, Guangdong 518035, China.
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Hessel EVS, van Lith HA, Wolterink-Donselaar IG, de Wit M, Groot Koerkamp MJA, Holstege FCP, Kas MJH, Fernandes C, de Graan PNE. Mapping of aFEB3homologous febrile seizure locus on mouse chromosome 2 containing candidate genesScn1aandScn3a. Eur J Neurosci 2016; 44:2950-2957. [DOI: 10.1111/ejn.13420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/10/2016] [Accepted: 08/09/2016] [Indexed: 01/05/2023]
Affiliation(s)
- Ellen V. S. Hessel
- Brain Center Rudolf Magnus; Department of Translational Neuroscience; University Medical Center Utrecht; Universiteitsweg 100 3584 CG Utrecht The Netherlands
| | - Hein A. van Lith
- Division of Animal Welfare & Laboratory Animal Science; Department of Animals in Science & Society; Faculty of Veterinary Medicine and Brain Center Rudolf Magnus; Utrecht University; Utrecht The Netherlands
| | - Inge G. Wolterink-Donselaar
- Brain Center Rudolf Magnus; Department of Translational Neuroscience; University Medical Center Utrecht; Universiteitsweg 100 3584 CG Utrecht The Netherlands
| | - Marina de Wit
- Brain Center Rudolf Magnus; Department of Translational Neuroscience; University Medical Center Utrecht; Universiteitsweg 100 3584 CG Utrecht The Netherlands
| | | | - Frank C. P. Holstege
- Department of Molecular Cancer Research; University Medical Center Utrecht; Utrecht The Netherlands
| | - Martien J. H. Kas
- Brain Center Rudolf Magnus; Department of Translational Neuroscience; University Medical Center Utrecht; Universiteitsweg 100 3584 CG Utrecht The Netherlands
- Groningen Institute for Evolutionary Life Sciences; University of Groningen; Groningen The Netherlands
| | - Cathy Fernandes
- Social, Genetic & Developmental Psychiatry Centre; Institute of Psychiatry; Psychology and Neuroscience; King's College London; London UK
| | - Pierre N. E. de Graan
- Brain Center Rudolf Magnus; Department of Translational Neuroscience; University Medical Center Utrecht; Universiteitsweg 100 3584 CG Utrecht The Netherlands
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Onwuli DO, Beltran-Alvarez P. An update on transcriptional and post-translational regulation of brain voltage-gated sodium channels. Amino Acids 2015; 48:641-651. [PMID: 26503606 PMCID: PMC4752963 DOI: 10.1007/s00726-015-2122-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 10/16/2015] [Indexed: 11/29/2022]
Abstract
Voltage-gated sodium channels are essential proteins in brain physiology, as they generate the sodium currents that initiate neuronal action potentials. Voltage-gated sodium channels expression, localisation and function are regulated by a range of transcriptional and post-translational mechanisms. Here, we review our understanding of regulation of brain voltage-gated sodium channels, in particular SCN1A (NaV1.1), SCN2A (NaV1.2), SCN3A (NaV1.3) and SCN8A (NaV1.6), by transcription factors, by alternative splicing, and by post-translational modifications. Our focus is strongly centred on recent research lines, and newly generated knowledge.
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Affiliation(s)
- Donatus O Onwuli
- School of Biological, Biomedical and Environmental Sciences, University of Hull, Hardy Building Cottingham Road, Hull, HU6 7RX, UK
| | - Pedro Beltran-Alvarez
- School of Biological, Biomedical and Environmental Sciences, University of Hull, Hardy Building Cottingham Road, Hull, HU6 7RX, UK.
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Menzler K, Hermsen A, Balkenhol K, Duddek C, Bugiel H, Bauer S, Schorge S, Reif PS, Klein KM, Haag A, Oertel WH, Hamer HM, Knake S, Trucks H, Sander T, Rosenow F. A commonSCN1Asplice-site polymorphism modifies the effect of carbamazepine on cortical excitability-A pharmacogenetic transcranial magnetic stimulation study. Epilepsia 2014; 55:362-9. [DOI: 10.1111/epi.12515] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Katja Menzler
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
| | - Anke Hermsen
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
| | | | - Caroline Duddek
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
| | - Hannes Bugiel
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
| | - Sebastian Bauer
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
| | - Stephanie Schorge
- Department of Clinical and Experimental Epilepsy; Institute of Neurology; London United Kingdom
| | - Philipp S. Reif
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
| | - Karl Martin Klein
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
| | - Anja Haag
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
| | | | - Hajo M. Hamer
- Epilepsy Center Erlangen; Department of Neurology; University Hospitals Erlangen; Erlangen Germany
| | - Susanne Knake
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
| | - Holger Trucks
- Cologne Center for Genomics (CCG); Cologne University; Cologne Germany
| | - Thomas Sander
- Cologne Center for Genomics (CCG); Cologne University; Cologne Germany
| | - Felix Rosenow
- Epilepsy Center Hessen; Philipps-University Marburg; Marburg Germany
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Tang L, Lu X, Tao Y, Zheng J, Zhao P, Li K, Li L. SCN1A rs3812718 polymorphism and susceptibility to epilepsy with febrile seizures: A meta-analysis. Gene 2014; 533:26-31. [DOI: 10.1016/j.gene.2013.09.071] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 09/18/2013] [Accepted: 09/19/2013] [Indexed: 01/01/2023]
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Baum L, Haerian BS, Ng HK, Wong VCN, Ng PW, Lui CHT, Sin NC, Zhang C, Tomlinson B, Wong GWK, Tan HJ, Raymond AA, Mohamed Z, Kwan P. Case-control association study of polymorphisms in the voltage-gated sodium channel genes SCN1A, SCN2A, SCN3A, SCN1B, and SCN2B and epilepsy. Hum Genet 2013; 133:651-9. [PMID: 24337656 DOI: 10.1007/s00439-013-1405-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 12/01/2013] [Indexed: 12/19/2022]
Abstract
High-frequency action potentials are mediated by voltage-gated sodium channels, composed of one large α subunit and two small β subunits, encoded mainly by SCN1A, SCN2A, SCN3A, SCN1B, and SCN2B genes in the brain. These play a key role in epilepsy, with the most commonly mutated gene in epilepsy being SCN1A. We examined whether polymorphisms in the above genes affect epilepsy risk in 1,529 epilepsy patients and 1,935 controls from four ethnicities or locations: Malay, Indian, and Chinese, all from Malaysia, and Chinese from Hong Kong. Of patients, 19 % were idiopathic, 42 % symptomatic, and 40 % cryptogenic. We genotyped 43 polymorphisms: 27 in Hong Kong, 28 in Malaysia, and 12 in both locations. The strongest association with epilepsy was rs3812718, or SCN1A IVS5N+5G>A: odds ratio (OR) = 0.85 for allele G (p = 0.0009) and 0.73 for genotype GG versus AA (p = 0.003). The OR was between 0.76 and 0.87 for all ethnicities. Meta-analysis confirmed the association (OR = 0.81 and p = 0.002 for G, and OR = 0.67 and p = 0.007 for GG versus AA), which appeared particularly strong for Indians and for febrile seizures. Allele G affects splicing and speeds recovery from inactivation. Since SCN1A is preferentially expressed in inhibitory neurons, G may decrease epilepsy risk. SCN1A rs10188577 displayed OR = 1.20 for allele C (p = 0.003); SCN2A rs12467383 had OR = 1.16 for allele A (p = 0.01), and displayed linkage disequilibrium with rs2082366 (r (2) = 0.67), whose genotypes tended toward association with SCN2A brain expression (p = 0.10). SCN1A rs2298771 was associated in Indians (OR = 0.56, p = 0.005) and SCN2B rs602594 with idiopathic epilepsy (OR = 0.62, p = 0.002). Therefore, sodium channel polymorphisms are associated with epilepsy.
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Affiliation(s)
- Larry Baum
- School of Pharmacy, The Chinese University of Hong Kong, Shatin, Hong Kong, China,
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Gender-specific profiling in SCN1A polymorphisms and time-to-recurrence in patients with stage II/III colorectal cancer treated with adjuvant 5-fluoruracil chemotherapy. THE PHARMACOGENOMICS JOURNAL 2013; 14:135-41. [PMID: 23752739 DOI: 10.1038/tpj.2013.21] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 04/13/2013] [Accepted: 04/26/2013] [Indexed: 02/06/2023]
Abstract
This study was designed to analyze the gender-related association between SCN1A polymorphisms (voltage-gated sodium channels; α-subunit) and time-to-recurrence (TTR) in patients with colorectal cancer (CRC) treated with 5-fluoruracil (5-FU)-based adjuvant chemotherapy. We enrolled from a prospective database patients with stage II and III CRC treated with adjuvant 5-FU-based chemotherapy. Genotypes for SCN1A rs3812718 and rs229877 were determined by direct DNA sequencing. One hundred twenty-seven males and 107 females were included in the study. In the univariate and multivariate analysis, the shortest TTR was associated with female patients carrying the rs3812718-TT genotype (hazard ratio (HR): 2.26 (95% confidence interval (CI): 0.89, 5.70), P=0.039) but with male patients carrying the rs3812718-CC genotype (HR: 0.49 (95% CI: 0.18, 1.38), P=0.048). For rs229877 the CT genotype was associated with a trend for shorter TTR in both gender populations. The study validated gender-dependent association between genomic SCN1A rs3812718 polymorphism and TTR in CRC patients treated with adjuvant 5-FU-based chemotherapy. This study confirms that voltage-gated Na+ channels may be a potential therapeutic target and a useful predictive biomarker before 5-FU infusion.
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Eckhaus J, Lawrence KM, Helbig I, Bui M, Vadlamudi L, Hopper JL, Scheffer IE, Berkovic SF. Genetics of febrile seizure subtypes and syndromes: a twin study. Epilepsy Res 2013; 105:103-9. [PMID: 23522981 DOI: 10.1016/j.eplepsyres.2013.02.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 12/27/2012] [Accepted: 02/12/2013] [Indexed: 01/30/2023]
Abstract
PURPOSE Febrile seizures (FS) are the most common seizure syndrome. A strong genetic component has been well established through family and twin studies; however, such studies have not examined the genetics of different FS types (simple, complex, febrile status epilepticus) and sub-syndromes (true FS, febrile seizures plus (FS+), 'FS with later epilepsy'). Here we used a community-based twin sample to analyze genetic factors within different FS subtypes and FS syndromes. METHODS Twin pairs were ascertained from the twin database of the Epilepsy Research Centre. A retrospective chart review was conducted and follow-up attempted for all subjects. Casewise concordance values were calculated for the different subgroups and intra-pair variation was analyzed. KEY FINDINGS One hundred and seventy-nine twin pairs with FS were identified. Overall casewise concordance for FS in monozygotic (MZ) twins (0.62) was greater than in dizygotic (DZ) twins (0.16, p<0.0001). A greater concordance amongst MZ pairs than DZ twin pairs was also observed for all FS subtypes and FS sub-syndromes, particularly in twins with FS+. Within concordant MZ pairs, we did not observe the co-occurrence of FS and FS+. SIGNIFICANCE These results suggest a strong genetic contribution to different FS subtypes and sub-syndromes. They also support the existence of distinct genetic factors for different FS subtypes and sub-syndromes, especially FS+. This information is important for the strategic planning of next generation sequencing studies of febrile seizures.
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Affiliation(s)
- Jazmin Eckhaus
- Epilepsy Research Centre and Department of Medicine (Neurology), University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
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Sapio MR, Salzmann A, Vessaz M, Crespel A, Lyons PJ, Malafosse A, Fricker LD. Naturally occurring carboxypeptidase A6 mutations: effect on enzyme function and association with epilepsy. J Biol Chem 2012; 287:42900-9. [PMID: 23105115 DOI: 10.1074/jbc.m112.414094] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Carboxypeptidase A6 (CPA6) is a member of the A/B subfamily of M14 metallocarboxypeptidases that is expressed in brain and many other tissues during development. Recently, two mutations in human CPA6 were associated with febrile seizures and/or temporal lobe epilepsy. In this study we screened for additional CPA6 mutations in patients with febrile seizures and focal epilepsy, which encompasses the temporal lobe epilepsy subtype. Mutations found from this analysis as well as CPA6 mutations reported in databases of single nucleotide polymorphisms were further screened by analysis of the modeled proCPA6 protein structure and the functional role of the mutated amino acid. The point mutations predicted to affect activity and/or protein folding were tested by expression of the mutant in HEK293 cells and analysis of the resulting CPA6 protein. Common polymorphisms in CPA6 were also included in this analysis. Several mutations resulted in reduced enzyme activity or CPA6 protein levels in the extracellular matrix. The mutants with reduced extracellular CPA6 protein levels showed normal levels of 50-kDa proCPA6 in the cell, and this could be converted into 37-kDa CPA6 by trypsin, suggesting that protein folding was not greatly affected by the mutations. Interestingly, three of the mutations that reduced extracellular CPA6 protein levels were found in patients with epilepsy. Taken together, these results provide further evidence for the involvement of CPA6 mutations in human epilepsy and reveal additional rare mutations that inactivate CPA6 and could, therefore, also be associated with epileptic phenotypes.
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Affiliation(s)
- Matthew R Sapio
- Department of Neuroscience, Albert Einstein College of Medicine,Bronx, New York 10461,USA
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Balan S, Vellichirammal NN, Banerjee M, Radhakrishnan K. Failure to find association between febrile seizures and SCN1A rs3812718 polymorphism in south Indian patients with mesial temporal lobe epilepsy and hippocampal sclerosis. Epilepsy Res 2012; 101:288-92. [DOI: 10.1016/j.eplepsyres.2012.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 04/04/2012] [Accepted: 04/08/2012] [Indexed: 10/28/2022]
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Zhou BT, Zhou QH, Yin JY, Li GL, Xu XJ, Qu J, Liu D, Zhou HH, Liu ZQ. Comprehensive analysis of the association of SCN1A gene polymorphisms with the retention rate of carbamazepine following monotherapy for new-onset focal seizures in the Chinese Han population. Clin Exp Pharmacol Physiol 2012; 39:379-84. [PMID: 22292851 DOI: 10.1111/j.1440-1681.2012.05680.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - Qiu-Hong Zhou
- Department ofEndocrinology; Xiang-Ya Hospital of Central South University; Hunan; China
| | - Ji-Ye Yin
- Institute of Clinical Pharmacology; Hunan Key Laboratory of Pharmacogenetics; Central South University Xiang-Ya School of Medicine; Hunan; China
| | - Guo-Liang Li
- Department of Neurology; Xiang-Ya Hospital of Central South University; Hunan; China
| | - Xiao-Jing Xu
- Institute of Clinical Pharmacology; Hunan Key Laboratory of Pharmacogenetics; Central South University Xiang-Ya School of Medicine; Hunan; China
| | - Jian Qu
- Institute of Clinical Pharmacology; Hunan Key Laboratory of Pharmacogenetics; Central South University Xiang-Ya School of Medicine; Hunan; China
| | - Ding Liu
- Department of Neurology; Third Xiang-Ya Hospital of Central South University; Hunan; China
| | - Hong-Hao Zhou
- Institute of Clinical Pharmacology; Hunan Key Laboratory of Pharmacogenetics; Central South University Xiang-Ya School of Medicine; Hunan; China
| | - Zhao-Qian Liu
- Institute of Clinical Pharmacology; Hunan Key Laboratory of Pharmacogenetics; Central South University Xiang-Ya School of Medicine; Hunan; China
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