Although Mendelian diseases are rare, when considered one by one, overall they constitute a significant social burden. Besides the medical aspects, they propose us one of the most general biological problems. Given the simplest physiological perturbation of an organism, that is, a single gene mutation, how do its effects percolate through the hierarchical biological levels to determine the pathogenesis? And how robust is the physiological system to this perturbation? To solve these problems, the study of genetic epilepsies caused by mutant ion channels presents special advantages, as it can exploit the full range of modern experimental methods. These allow to extend the functional analysis from single channels to whole brains. An instructive example is autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE), which can be caused by mutations in neuronal nicotinic acetylcholine receptors. In vitro, such mutations often produce hyperfunctional receptors, at least in heterozygous condition. However, understanding how this leads to sleep-related frontal epilepsy is all but straightforward. Several available animal models are helping us to determine the effects of ADNFLE mutations on the mammalian brain. Because of the complexity of the cholinergic regulation in both developing and mature brains, several pathogenic mechanisms are possible, which also present different therapeutic implications. 1. Introduction Strictly speaking, expressions like “integrative biology” or “system biology” are pleonastic, as the essence of biological processes is the interplay of many elements, even in unicellular organisms. Such locutions serve nonetheless to remind us that fully explaining physiological and pathological processes requires taking into account the organism context, which is easy to forget in a time that offers very powerful molecular methods. The pathogenesis of any disease is determined by a concourse of genetic, environmental, and developmental factors that produce their effects in a setting characterized by continuous interplay between cell groups, tissues, and organs. Understanding the conditions that predispose an individual to undergo such a course of events is thus a central problem of biology. Adopting a pathophysiological standpoint should considerably facilitate the task of gaining better integrative insight, because the experimental evidence related to pathology greatly exceeds the results available in other fields devoted to the organism biology. Therefore, although it seems unlikely that these issues will ever turn out to present general
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