Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China (mainland).
The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China (mainland).
Med Sci Monit. 2017 Sep 23;23:4559-4566. doi: 10.12659/msm.905206.
BACKGROUND Acute cerebral infarction is a major clinical subtype of ischemic stroke that has become a leading cause of death and disability worldwide. Aldehyde dehydrogenase 2 (ALDH2) is an important oxidative enzyme in alcohol metabolism. The polymorphism of ALDH2 Glu504Lys polymorphism modifies the activity of this enzyme. However, the potential association between the allelic variation of ALDH2 Glu504Lys with collateral circulation and short-term prognosis of acute cerebral infarction remains unclear. MATERIAL AND METHODS A total of 394 patients with acute cerebral infarction were recruited for ALDH2 genotyping using direct sequencing. Cerebrovascular stenosis and collateral circulation were evaluated by digital subtraction angiography (DSA). Short-term prognosis was assessed in accordance with the modified Ranking Scale (mRS). RESULTS We identified 297 as EAS and 394 as IAS. There were more patients with occluded blood vessel in the opened group and far fewer in the unopened group. ALDH2 polymorphism was significantly different among the primary, secondary, and tertiary opened groups. ALDH2 gene Glu504Lys was significantly associated with short-term prognosis. The genotype GA+AA of ALDH2 gene Glu504Lys locus was an independent risk factor of poor 90-day prognosis. CONCLUSIONS ALDH2 Glu504Lys could be a risk factor for collateral circulation and a negative predictor for short-term prognosis in acute cerebral infarction in Han Chinese. ALDH2 Glu504Lys could be a new therapeutic target for patients with acute cerebral infarction.
急性脑梗死是缺血性脑卒中的主要临床亚型,已成为全球范围内死亡和残疾的主要原因。乙醛脱氢酶 2(ALDH2)是酒精代谢中的一种重要氧化酶。ALDH2 Glu504Lys 多态性改变了该酶的活性。然而,ALDH2 Glu504Lys 等位基因变异与侧支循环和急性脑梗死短期预后之间的潜在关联尚不清楚。
采用直接测序法对 394 例急性脑梗死患者进行 ALDH2 基因分型。数字减影血管造影(DSA)评估脑血管狭窄和侧支循环。采用改良 Rankin 量表(mRS)评估短期预后。
我们发现 297 例为 EAS,394 例为 IAS。开放组的闭塞血管患者更多,未开放组的闭塞血管患者更少。ALDH2 多态性在原发性、继发性和三级开放组之间存在显著差异。ALDH2 基因 Glu504Lys 与短期预后显著相关。ALDH2 基因 Glu504Lys 座的 GA+AA 基因型是 90 天预后不良的独立危险因素。
ALDH2 Glu504Lys 可能是急性脑梗死侧支循环的危险因素和短期预后的负性预测因子。ALDH2 Glu504Lys 可能是急性脑梗死患者的一个新的治疗靶点。