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颅内动脉瘤形成与蛛网膜下腔出血的遗传关联。

Genetic associations of intracranial aneurysm formation and sub-arachnoid hemorrhage.

作者信息

Theodotou Christian B, Snelling Brian M, Sur Samir, Haussen Diogo C, Peterson Eric C, Elhammady Mohamed Samy

机构信息

Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA.

Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, FL, USA.

出版信息

Asian J Neurosurg. 2017 Jul-Sep;12(3):374-381. doi: 10.4103/1793-5482.180972.

Abstract

Risk factors for cerebral aneurysms typically include age, hypertension, smoking, and alcohol usage. However, the possible connection of aneurysms with genetic conditions such as Marfan's syndrome, polycystic kidney disease, and neurofibromatosis raises the question of possible genetic risk factors for aneurysm, and additionally, genetic risk factors for rupture. We conducted a literature review using the PubMed database for studies regarding genetic correlation with cerebral aneurysm formation as well as rupture from December 2008 to Jun 2015. Twenty-one studies related to IA formation and 10 concerning IA rupture that met our criteria were found and tabulated. The most studied gene and the strongest association was 9p21/CDKN2, which is involved in vessel wall remodelling. Other possible genes that may contribute to IA formation include EDNRA and SOX17; however, these factors were not studied as robustly as CDKN2. Multiple factors contribute to aneurysm formation and rupture and the contributions of blood flow dynamics and comorbidities as mentioned previously, cannot be ignored. While these elements are important to development and rupture of aneurysms, genetic influence may predispose certain patients to formation of aneurysms and eventual rupture.

摘要

脑动脉瘤的风险因素通常包括年龄、高血压、吸烟和饮酒。然而,动脉瘤与马方综合征、多囊肾病和神经纤维瘤病等遗传疾病之间的可能联系,引发了关于动脉瘤可能的遗传风险因素的问题,此外,还有破裂的遗传风险因素。我们使用PubMed数据库进行了一项文献综述,以查找2008年12月至2015年6月期间有关脑动脉瘤形成以及破裂的遗传相关性的研究。发现并列出了21项与颅内动脉瘤形成相关的研究以及10项符合我们标准的关于颅内动脉瘤破裂的研究。研究最多且关联最强的基因是9p21/CDKN2,它参与血管壁重塑。其他可能与颅内动脉瘤形成有关的基因包括EDNRA和SOX17;然而,对这些因素的研究不如对CDKN2的研究充分。多种因素导致动脉瘤的形成和破裂,如前所述,血流动力学和合并症的作用也不容忽视。虽然这些因素对动脉瘤的发展和破裂很重要,但遗传影响可能使某些患者易患动脉瘤并最终破裂。

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