ABCG2 c.421C>A 与严重创伤性脑损伤后的结局相关。
ABCG2 c.421C>A Is Associated with Outcomes after Severe Traumatic Brain Injury.
机构信息
1 Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh , Pittsburgh, Pennsylvania.
2 Health Promotion and Development, School of Nursing, University of Pittsburgh , Pittsburgh, Pennsylvania.
出版信息
J Neurotrauma. 2018 Jan 1;35(1):48-53. doi: 10.1089/neu.2017.5000. Epub 2017 Sep 19.
Traumatic brain injury (TBI) is a leading cause of death with no pharmacological treatments that improve outcomes. Transporter proteins participate in TBI recovery by maintaining the central nervous system (CNS) biochemical milieu. Genetic variations in transporters that alter expression and/or function have been associated with TBI outcomes. The ATP-binding cassette transporter, ABCG2, is a uric acid (UA) transporter that effluxes UA from cells in the CNS and is responsible for systemic UA clearance. Uric acid is a CNS antioxidant and/or a biomarker that might support TBI recovery. Our objective was to investigate the impact of ABCG2 SNP: c.421C>A on TBI outcomes. Two cohorts (discovery [N = 270] and replication [N = 166]) were genotyped for ABCG2 c.421C>A. Glasgow Outcome Scale (GOS) scores were collected at 3, 6, 12, and 24 months post-injury and compared with mixed-effects multiple ordinal regression controlled for time post-injury, age, sex, time, post-injury imaging determined hemorrhage types, and Glasgow Coma Scale score. Variant alleles (genotype) were associated with better GOS scores (p = 0.01 [discovery] and p = 0.02 [replication]), whereas genotype*age interaction was associated with worse GOS scores (p = 0.03 [discovery] and p = 0.01 [replication]). Reversed coefficient directionality suggests variant allele(s) are protective up to approximately age 34 years. Overall, variant alleles at ABCG2 c.421C>A associate with better GOS scores post-injury in two independently sampled cohorts. This finding is mitigated by increasing subject age. This suggests that ABCG2 might have an age-dependent effect on TBI recovery and should be explored in future mechanistic studies.
创伤性脑损伤(TBI)是导致死亡的主要原因,目前尚无改善预后的药物治疗方法。转运蛋白通过维持中枢神经系统(CNS)生化环境参与 TBI 的恢复。转运蛋白的表达和/或功能发生改变的基因变异与 TBI 结果有关。三磷酸腺苷结合盒转运蛋白 ABCG2 是一种尿酸(UA)转运蛋白,可将 UA 从 CNS 细胞中排出,并负责全身 UA 清除。尿酸是一种 CNS 抗氧化剂和/或生物标志物,可能支持 TBI 的恢复。我们的目的是研究 ABCG2 SNP:c.421C>A 对 TBI 结果的影响。两个队列(发现[N=270]和复制[N=166])对 ABCG2 c.421C>A 进行了基因分型。在损伤后 3、6、12 和 24 个月收集格拉斯哥结局量表(GOS)评分,并与混合效应多序贯回归进行比较,该回归控制了损伤后时间、年龄、性别、时间、损伤后影像学确定的出血类型和格拉斯哥昏迷量表评分。变异等位基因(基因型)与更好的 GOS 评分相关(p=0.01[发现]和 p=0.02[复制]),而基因型*年龄相互作用与更差的 GOS 评分相关(p=0.03[发现]和 p=0.01[复制])。相反的系数方向表明,变异等位基因在大约 34 岁之前具有保护作用。总体而言,在两个独立采样的队列中,ABCG2 c.421C>A 的变异等位基因与损伤后更好的 GOS 评分相关。随着受试者年龄的增加,这种发现的影响会减弱。这表明 ABCG2 对 TBI 恢复可能有年龄依赖性影响,应在未来的机制研究中进行探索。
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