Waring Stephen C, Rosenberg Roger N
Department of Epidemiology, The University of Texas School of Public Health, 1200 Herman Pressler, RAS-E629, Houston, TX 77030, USA.
Arch Neurol. 2008 Mar;65(3):329-34. doi: 10.1001/archneur.65.3.329.
The genetics of Alzheimer disease (AD) to date support an age-dependent dichotomous model whereby earlier age of disease onset (< 60 years) is explained by 3 fully penetrant genes (APP [NCBI Entrez gene 351], PSEN1 [NCBI Entrez gene 5663], and PSEN2 [NCBI Entrez gene 5664]), whereas later age of disease onset (> or = 65 years) representing most cases of AD has yet to be explained by a purely genetic model. The APOE gene (NCBI Entrez gene 348) is the strongest genetic risk factor for later onset, although it is neither sufficient nor necessary to explain all occurrences of disease. Numerous putative genetic risk alleles and genetic variants have been reported. Although all have relevance to biological mechanisms that may be associated with AD pathogenesis, they await replication in large representative populations. Genome-wide association studies have emerged as an increasingly effective tool for identifying genetic contributions to complex diseases and represent the next frontier for furthering our understanding of the underlying etiologic, biological, and pathologic mechanisms associated with chronic complex disorders. There have already been success stories for diseases such as macular degeneration and diabetes mellitus. Whether this will hold true for a genetically complex and heterogeneous disease such as AD is not known, although early reports are encouraging. This review considers recent publications from studies that have successfully applied genome-wide association methods to investigations of AD by taking advantage of the currently available high-throughput arrays, bioinformatics, and software advances. The inherent strengths, limitations, and challenges associated with study design issues in the context of AD are presented herein.
迄今为止,阿尔茨海默病(AD)的遗传学研究支持一种年龄依赖性二分模型,即疾病发病较早(<60岁)可由3个完全显性的基因(APP[NCBI Entrez基因351]、PSEN1[NCBI Entrez基因5663]和PSEN2[NCBI Entrez基因5664])来解释,而代表大多数AD病例的较晚发病年龄(≥65岁)尚未能用纯遗传模型来解释。APOE基因(NCBI Entrez基因348)是晚发型AD最强的遗传风险因素,尽管它对于解释所有的发病情况既不充分也不必要。已经报道了许多假定的遗传风险等位基因和遗传变异。尽管所有这些都与可能与AD发病机制相关的生物学机制有关,但它们有待在大型代表性人群中得到验证。全基因组关联研究已成为识别复杂疾病遗传因素的一种越来越有效的工具,是推进我们对慢性复杂疾病潜在病因、生物学和病理机制理解的下一个前沿领域。对于黄斑变性和糖尿病等疾病,已经有了成功的案例。尽管早期报告令人鼓舞,但对于像AD这样遗传复杂且异质性的疾病是否如此尚不清楚。本综述考虑了近期的研究出版物,这些研究通过利用当前可用的高通量阵列、生物信息学和软件进展,成功地将全基因组关联方法应用于AD研究。本文介绍了AD背景下与研究设计问题相关的内在优势、局限性和挑战。