Worrall Bradford B, Brott Thomas G, Brown Robert D, Brown W Mark, Rich Stephen S, Arepalli Sampath, Wavrant-De Vrièze Fabienne, Duckworth Jaime, Singleton Andrew B, Hardy John, Meschia James F
Department of Neurology, University of Virginia Health System, Charlottesville, VA, USA.
Stroke. 2007 Apr;38(4):1189-96. doi: 10.1161/01.STR.0000260099.42744.b0. Epub 2007 Mar 1.
Genetic factors influence risk for ischemic stroke and likely do so at multiple steps in the pathogenic process. Variants in genes related to inflammation contribute to risk of stroke. The purpose of this study was to confirm our earlier finding of an association between allele 2 of a variable number tandem repeat of the IL-1 receptor antagonist gene (IL1RN) and cerebrovascular disease.
An association study of the variable number tandem repeat genotype with ischemic stroke and stroke subtypes was performed on samples from a North American study of affected sibling pairs concordant for ischemic stroke and 2 North American cohorts of prospectively ascertained ischemic stroke cases and unrelated controls. DNA analysis was performed on cases and controls, stratified by race.
After adjustment for age, sex, and stroke risk factors, the odds ratio for association of allele 2 and ischemic stroke was 2.80 (95% confidence interval, 1.29 to 6.11; P=0.03) for the white participants. The effect of allele 2 of IL1RN on stroke risk most closely fits a recessive genetic model (P=0.009). For the smaller sample of nonwhite participants, the results were not significant.
Allele 2 of IL1RN, present in nearly one-quarter of stroke patients, may contribute to genetic risk for ischemic stroke and confirm the previously identified association with cerebrovascular disease. These results are driven by the association in the white participants. Further exploration in a larger nonwhite sample is warranted.
遗传因素影响缺血性中风的风险,并且可能在致病过程的多个环节发挥作用。与炎症相关的基因变异会增加中风风险。本研究的目的是证实我们之前发现的白细胞介素-1受体拮抗剂基因(IL1RN)可变数目串联重复序列的2等位基因与脑血管疾病之间的关联。
对来自一项北美缺血性中风同胞对研究的样本,以及两个北美前瞻性确定的缺血性中风病例和非相关对照队列,进行可变数目串联重复序列基因型与缺血性中风及中风亚型的关联研究。对病例和对照进行DNA分析,并按种族分层。
在对年龄、性别和中风风险因素进行校正后,白人参与者中,2等位基因与缺血性中风关联的比值比为2.80(95%置信区间为1.29至6.11;P=0.03)。IL1RN的2等位基因对中风风险的影响最符合隐性遗传模型(P=0.009)。对于样本量较小的非白人参与者,结果不显著。
IL1RN的2等位基因存在于近四分之一的中风患者中,可能是缺血性中风遗传风险的一个因素,并证实了之前确定的与脑血管疾病的关联。这些结果是由白人参与者中的关联驱动的。有必要在更大的非白人样本中进行进一步探索。