Dardiotis Efthimios, Paterakis Konstantinos, Tsivgoulis Georgios, Tsintou Magdalini, Hadjigeorgiou Georgios F, Dardioti Maria, Grigoriadis Savas, Simeonidou Constantina, Komnos Apostolos, Kapsalaki Eftychia, Fountas Kostas, Hadjigeorgiou Georgios M
1 Department of Neurology, Laboratory of Neurogenetics, University of Thessaly , University Hospital of Larissa, Larissa, Greece .
J Neurotrauma. 2014 Dec 1;31(23):1920-6. doi: 10.1089/neu.2014.3347. Epub 2014 Oct 10.
Accumulating evidence suggests that the extent of brain injury and the clinical outcome after traumatic brain injury (TBI) are modulated, to some degree, by genetic variants. Aquaporin-4 (AQP4) is the predominant water channel in the central nervous system and plays a critical role in controlling the water content of brain cells and the development of brain edema after TBI. We sought to investigate the influence of the AQP4 gene region on patient outcome after TBI by genotyping tag single nucleotide polymorphisms (SNPs) along AQP4 gene. A total of 363 patients with TBI (19.6% female) were prospectively evaluated. Data including the Glasgow Coma Scale (GCS) scores at admission, the presence of intracranial hemorrhage, and the 6-month Glasgow Outcome Scale (GOS) scores were collected. Seven tag SNPs across the AQP4 gene were identified based on the HapMap data. Using logistic regression analyses, SNPs and haplotypes were tested for associations with 6-month GOS after adjusting for age, GCS score, and sex. Significant associations with TBI outcome were detected for rs3763043 (OR [95% confidence interval (CI)]: 5.15 [1.60-16.5], p=0.006, for recessive model), rs3875089 (OR [95% CI]: 0.18 [0.07-0.50] p=0.0009, for allele difference model), and a common haplotype of AQP4 tag SNPs (OR [95% CI]: 2.94, [1.34-6.36], p=0.0065). AQP4 tag SNPs were not found to influence the initial severity of TBI or the presence of intracranial hemorrhages. In conclusion, the present study provides evidence for possible involvement of genetic variations in AQP4 gene in the functional outcome of patients with TBI.
越来越多的证据表明,创伤性脑损伤(TBI)后的脑损伤程度和临床结局在一定程度上受基因变异的调节。水通道蛋白4(AQP4)是中枢神经系统中主要的水通道,在控制脑细胞含水量和TBI后脑水肿的发展中起关键作用。我们试图通过对AQP4基因沿线的标签单核苷酸多态性(SNP)进行基因分型,来研究AQP4基因区域对TBI患者结局的影响。对总共363例TBI患者(19.6%为女性)进行了前瞻性评估。收集了包括入院时的格拉斯哥昏迷量表(GCS)评分、颅内出血情况以及6个月时的格拉斯哥预后量表(GOS)评分等数据。基于HapMap数据确定了AQP4基因上的7个标签SNP。使用逻辑回归分析,在调整年龄、GCS评分和性别后,测试SNP和单倍型与6个月GOS的关联。对于rs3763043(隐性模型的比值比[95%置信区间(CI)]:5.15[1.60 - 16.5],p = 0.006)、rs3875089(等位基因差异模型的比值比[95% CI]:0.18[0.07 - 0.50],p = 0.0009)以及AQP4标签SNP的一个常见单倍型(比值比[95% CI]:2.94,[1.34 - 6.36],p = 0.0065),检测到与TBI结局有显著关联。未发现AQP4标签SNP影响TBI的初始严重程度或颅内出血的存在。总之,本研究为AQP4基因的遗传变异可能参与TBI患者的功能结局提供了证据。