Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Avenue East, 3rd f, Boston, MA 02215-1204, USA.
Cephalalgia. 2011 Oct;31(13):1381-404. doi: 10.1177/0333102411419022.
Data on the association between TNFα and TNFβ gene polymorphisms and migraine are conflicting.
We performed a systematic review and meta-analysis of studies published until January 2011. We used data from published papers and as provided after contact with the authors. We calculated study specific odds ratios (OR) and 95% confidence intervals (CI) assuming additive, dominant, and recessive genetic models as well as pooled effect estimates.
Among the ten studies identified, the best evidence is available for the TNFα -308G>A and TNFβ 252A > G polymorphisms indicating no overall association with migraine. Subgroup analyses suggested that the A allele of the TNFα -308G > A variant more than doubles the risk for migraine among populations with a heterogeneous ethnic background, which was driven by associations for migraine without aura (additive model: pooled OR = 2.87, 95% CI 1.86-4.43). Further, the risk for migraine with aura was increased among Asian populations (additive model: pooled OR = 1.71, 95% CI 1.07-2.71). Both observed effects were stronger among females than males.
Our results indicate no overall association between TNFα and TNFβ gene variants and migraine. However, associations differed among specific populations. Our findings need to be treated with caution and further targeted research is warranted to evaluate population-specific effects including population stratification.
关于 TNFα 和 TNFβ 基因多态性与偏头痛之间的关联的数据存在冲突。
我们对截至 2011 年 1 月发表的研究进行了系统回顾和荟萃分析。我们使用了已发表论文中的数据以及与作者联系后提供的数据。我们根据加性、显性和隐性遗传模型计算了研究特异性的比值比（OR）和 95%置信区间（CI），并汇总了效应估计值。
在确定的十项研究中，TNFα-308G>A 和 TNFβ252A>G 多态性的最佳证据表明与偏头痛之间没有总体关联。亚组分析表明，TNFα-308G>A 变体的 A 等位基因使具有异质种族背景的人群患偏头痛的风险增加了一倍以上，这主要归因于无先兆偏头痛（加性模型：汇总 OR=2.87，95%CI 1.86-4.43）。此外，亚洲人群患有先兆偏头痛的风险增加（加性模型：汇总 OR=1.71，95%CI 1.07-2.71）。这两种观察到的效应在女性中比男性中更强。
我们的结果表明 TNFα 和 TNFβ 基因变异与偏头痛之间没有总体关联。然而，特定人群之间存在关联差异。我们的研究结果需要谨慎对待，需要进一步进行有针对性的研究，以评估包括人群分层在内的特定人群的效应。
