Johnson Matthew P, Fernandez Francesca, Colson Natalie J, Griffiths Lyn R
Griffith University, Genomics Research Centre, School of Medical Science, PMB 50 GCMC Gold Coast, Queensland, Australia.
Expert Opin Pharmacother. 2007 Aug;8(12):1821-35. doi: 10.1517/14656566.8.12.1821.
Migraine is a common idiopathic primary headache disorder with significant mental, physical and social health implications. Accompanying an intense unilateral pulsating head pain other characteristic migraine symptoms include nausea, emesis, phonophobia, photophobia and in approximately 20-30% of migraine cases, neurologic disturbances associated with the aura phase. Although selective serotonin (5-HT) receptor agonists (i.e., 5-HT(1B/1D)) are successful in alleviating migrainous symptoms in < or = 70% of known sufferers, for the remaining 30%, additional migraine abortive medications remain unsuccessful, not tested or yet to be identified. Genetic characterization of the migrainous disorder is making steady progress with an increasing number of genomic susceptibility loci now identified on chromosomes 1q, 4q, 5q, 6p, 11q, 14q, 15q, 17p, 18q, 19p and Xq. The 4q, 5q, 17p and 18q loci involve endophenotypic susceptibility regions for various migrainous symptoms. In an effort to develop individualized pharmacotherapeutics, the identification of these migraine endophenotypic loci may well be the catalyst needed to aid in this goal. In this review the authors discuss the present treatment of migraine, known genomic susceptibility regions and results from migraine (genetic) association studies. The authors also discuss pharmacogenomic considerations for more individualized migraine prophylactic treatments.
偏头痛是一种常见的特发性原发性头痛疾病，对精神、身体和社会健康有重大影响。伴随剧烈的单侧搏动性头痛，偏头痛的其他典型症状包括恶心、呕吐、恐声症、畏光症，在大约20%-30%的偏头痛病例中，还会出现与先兆期相关的神经功能障碍。尽管选择性5-羟色胺（5-HT）受体激动剂（即5-HT(1B/1D)）能使70%或更少的已知患者的偏头痛症状得到缓解，但对于其余30%的患者，其他偏头痛终止药物仍未取得成功、未经过测试或有待确定。偏头痛疾病的基因特征研究正在稳步推进，目前已在1号染色体、4号染色体、5号染色体、6号染色体短臂、11号染色体、14号染色体、15号染色体、17号染色体短臂、18号染色体、19号染色体短臂和X染色体上发现了越来越多的基因组易感位点。4号染色体、5号染色体、17号染色体短臂和18号染色体上的位点涉及各种偏头痛症状的内表型易感区域。为了开发个体化药物治疗方法，确定这些偏头痛内表型位点很可能是实现这一目标所需的催化剂。在这篇综述中，作者讨论了偏头痛的现有治疗方法、已知的基因组易感区域以及偏头痛（基因）关联研究的结果。作者还讨论了药物基因组学在更个体化偏头痛预防性治疗中的应用。
