Stroke Clinic, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Insurgentes Sur 3877 Col. La Fama, C.P. 14269, Mexico, Mexico.
Genetics Department, National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico, Mexico.
J Neurol. 2016 Jun;263(6):1066-73. doi: 10.1007/s00415-016-8101-8. Epub 2016 Mar 26.
Spontaneous cervico-cerebral artery dissection (CCAD) is a common condition found among young patients with ischemic stroke. We examined the possible association between the polymorphism of methylenetetrahydrofolate reductase (MTHFR)-C677T and the gene mutation in transforming growth factor beta receptor II (TGFBR2) in a cohort of CCAD patients. One-hundred CCAD cases (65 males; mean age: 38.08 ± 10.68 years) and 100 matching controls were included. Ancestry informative markers (AIMs) were used to increase internal validity of the genetic analysis. Genotypes of the C677T polymorphism in the MTHFR gene were determined by polymerase chain reaction and restriction fragment length polymorphism; direct sequencing was used for a mutation analysis of the TGFBR2 gene. Associations were evaluated using a multivariate statistics, and Hardy-Weinberg equilibrium was analyzed. We also incorporated our data into a meta-analysis of the MTHFR-C677T. Sixty-three patients presented with vertebral and 37 with carotid artery dissection. Ancestry markers found a call rate on each over 95 %. All AIMs did not deviate from Hardy-Weinberg equilibrium (p > 0.05). The homozygous TT genotype was more frequent in cases (OR 2.04, CI 95 % 1.53-2.72, p = 0.005), whereas no significant difference was found on heterozygous CT genotype. TGFBR2 mutation was not present in our samples. In the meta-analysis of MTHFR/C677T variant, a total 613 cases and 1547 controls were analyzed; we found a moderate association for the recessive model genotype (OR 2.04, CI 95 % 1.53-2.72; p = 0.342; Z = 4.83; I (2) = 11.3). This study supports a positive association between the MTHFR-C677T polymorphism and genetically confirmed Mexican mestizo CCAD patients.
自发性颈内动脉夹层(CCAD)是年轻缺血性脑卒中患者常见的病症。我们研究了亚甲基四氢叶酸还原酶(MTHFR)-C677T 多态性与转化生长因子β受体 II(TGFBR2)基因突变之间的可能关联,研究对象为一组 CCAD 患者。该研究纳入了 100 例 CCAD 患者(65 例男性;平均年龄:38.08±10.68 岁)和 100 例匹配对照。采用遗传分析的辅助信息标志(AIMs)提高了基因分析的内部有效性。通过聚合酶链反应和限制性片段长度多态性确定 MTHFR 基因中 C677T 多态性的基因型;直接测序用于 TGFBR2 基因突变分析。采用多变量统计评估关联,并用 Hardy-Weinberg 平衡分析。我们还将我们的数据纳入 MTHFR-C677T 的荟萃分析。63 例患者为椎动脉夹层,37 例为颈动脉夹层。每个标记的检出率都超过 95%。所有 AIMs 均未偏离 Hardy-Weinberg 平衡(p>0.05)。TT 纯合基因型在病例中更为常见(OR 2.04,95%CI 1.53-2.72,p=0.005),而杂合 CT 基因型无显著差异。我们的样本中未发现 TGFBR2 突变。在 MTHFR/C677T 变体的荟萃分析中,共分析了 613 例病例和 1547 例对照;我们发现隐性模型基因型存在中度关联(OR 2.04,95%CI 1.53-2.72;p=0.342;Z=4.83;I (2)=11.3)。这项研究支持 MTHFR-C677T 多态性与经基因证实的墨西哥混血 CCAD 患者之间存在正相关。