Della-Morte David, Pacifici Francesca, Rundek Tatjana
aDepartment of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, USA bDepartment of Systems Medicine, School of Medicine, University of Rome Tor Vergata cIRCCS San Raffaele Pisana, Rome, Italy.
Curr Opin Lipidol. 2016 Apr;27(2):187-95. doi: 10.1097/MOL.0000000000000275.
Cerebrovascular disease (CeVD) remains a major cause of death and a leading cause of disability worldwide. CeVD is a complex and multifactorial disease caused by the interaction of vascular risk factors, environment, and genetic factors. In the present article, we discussed genetic susceptibility to CeVD, with particular emphasis on genetic studies of the associations between lipid traits and CeVD.
Several animal and clinical studies clearly defined genetic predisposition to atherosclerosis and CeVD, and particularly to ischemic stroke. Recent evidence has shown that traditional vascular risk factors explain only a small proportion of variance in atherosclerosis, suggesting that additional nontraditional factors and novel genetic determinants impact CeVD. With the help of genome-wide technology, novel genetic variants have been implicated in CeVD and lipid metabolism such as those in protein convertase subtilisin/kexin type 9 (PCSK9) gene in stroke and familial hypercholesterolemia. These studies are important as they contribute to our understanding of the genetic mechanisms underlying CeVD and to developing more effective CeVD prevention strategies.
CeVD is a complex and multifactorial disease and genetics likely plays an important role in its pathogenesis. The gene-gene and gene-environment interactions of genes involved in biology of vascular disease, including the lipid metabolism are important factors for individual susceptibility to CeVD. Accounting for individual variation in genes, environment and lifestyle will bring us closer to precision medicine, which is an emerging and recently introduced new approach for disease treatment and prevention in clinical practice.
脑血管疾病(CeVD)仍然是全球主要的死亡原因和致残的主要原因。CeVD是一种由血管危险因素、环境和遗传因素相互作用引起的复杂多因素疾病。在本文中,我们讨论了CeVD的遗传易感性,特别强调了脂质性状与CeVD之间关联的遗传研究。
多项动物和临床研究明确了动脉粥样硬化和CeVD,尤其是缺血性中风的遗传易感性。最近的证据表明,传统的血管危险因素仅能解释动脉粥样硬化中一小部分的变异,这表明其他非传统因素和新的遗传决定因素对CeVD有影响。借助全基因组技术,新的遗传变异已被发现与CeVD和脂质代谢有关,例如中风和家族性高胆固醇血症中蛋白转化酶枯草杆菌蛋白酶/kexin 9型(PCSK9)基因中的变异。这些研究很重要,因为它们有助于我们理解CeVD的遗传机制,并有助于制定更有效的CeVD预防策略。
CeVD是一种复杂的多因素疾病,遗传学可能在其发病机制中起重要作用。参与血管疾病生物学过程(包括脂质代谢)的基因的基因-基因和基因-环境相互作用是个体对CeVD易感性的重要因素。考虑到基因、环境和生活方式的个体差异将使我们更接近精准医学,这是临床实践中一种新兴且最近引入的疾病治疗和预防新方法。