偏头痛的遗传学研究:全基因组关联研究时代。
Genetics of migraine in the age of genome-wide association studies.
机构信息
Department of Neurology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany.
出版信息
J Headache Pain. 2012 Jan;13(1):1-9. doi: 10.1007/s10194-011-0399-0. Epub 2011 Nov 11.
Genetic factors importantly contribute to migraine. However, unlike for rare monogenic forms of migraine, approaches to identify genes for common forms of migraine have been of limited success. Candidate gene association studies were often negative and positive results were often not replicated or replication failed. Further, the significance of positive results from linkage studies remains unclear owing to the inability to pinpoint the genes under the peaks that may be involved in migraine. Problems hampering these studies include limited sample sizes, methods of migraine ascertainment, and the heterogeneous clinical phenotype. Three genome-wide association studies are available now and have successfully identified four new genetic variants associated with migraine. One new variant (rs1835740) modulates glutamate homeostasis, thus integrates well with current concepts of neurotransmitter disturbances. This variant may be more specific for severe forms of migraine such as migraine with aura than migraine without aura. Another variant (rs11172113) implicates the lipoprotein receptor LRP1, which may interact with neuronal glutamate receptors, thus also providing a link to the glutamate pathway. In contrast, rs10166942 is in close proximity to TRPM8, which codes for a cold and pain sensor. For the first time this links a gene explicitly implicated in pain related pathways to migraine. The potential function of the fourth variant rs2651899 (PRDM16) in migraine is unclear. All these variants only confer a small to moderate change in risk for migraine, which concurs with migraine being a heterogeneous disorder. Ongoing large international collaborations will likely identify additional gene variants for migraine.
遗传因素对偏头痛有重要影响。然而,与罕见的单基因偏头痛形式不同,识别常见偏头痛形式基因的方法一直收效甚微。候选基因关联研究的结果往往是否定的,阳性结果往往无法复制或复制失败。此外,由于无法确定可能与偏头痛有关的峰下基因,连锁研究的阳性结果的意义仍不清楚。阻碍这些研究的问题包括样本量有限、偏头痛确定方法以及异质的临床表型。现在有三项全基因组关联研究,成功地确定了四个与偏头痛相关的新遗传变异。一个新的变异(rs1835740)调节谷氨酸稳态,因此与当前神经递质紊乱的概念很好地结合在一起。与无先兆偏头痛相比,该变异可能更特异于偏头痛伴先兆等严重形式的偏头痛。另一个变异(rs11172113)涉及脂蛋白受体 LRP1,它可能与神经元谷氨酸受体相互作用,因此也与谷氨酸途径有关。相比之下,rs10166942 与编码冷和疼痛传感器的 TRPM8 接近。这是首次将明确涉及与疼痛相关途径的基因与偏头痛联系起来。变异 rs2651899(PRDM16)在偏头痛中的潜在功能尚不清楚。所有这些变异仅使偏头痛的风险发生微小到中度的变化,这与偏头痛是一种异质性疾病一致。正在进行的大型国际合作可能会确定偏头痛的其他基因变异。