a Headache Center, Department of Neuroscience "Rita Levi Montalcini" , University of Torino , Torino , Italy.
Expert Opin Ther Targets. 2019 Jan;23(1):29-37. doi: 10.1080/14728222.2019.1549544. Epub 2018 Nov 28.
Migraine is a common neurovascular disorder classified by the World Health Organization as one of the most debilitating diseases. Migraine is a complex disease and is a consequence of an interaction between genetic, epigenetic and environmental factors. The MTHFR gene is one of the few replicated genetic risk factors for migraine and encodes an enzyme that is crucial for the folate and the methionine cycles. Individuals carrying the T allele of the MTHFR C677T polymorphism have increased plasma concentrations of homocysteine which leads to endothelial cell injury and alterations in coagulant properties of blood. Areas covered: This review focuses on the recent advances in genetics and the role of the MTHFR gene and homocysteine metabolism in migraine etiopathogenesis. The article summarizes the potential of targeting MTHFR and homocysteine for disease prevention. Expert opinion: Determination of MTHFR C677T polymorphisms as well as measurement of homocysteine concentrations may be useful to migraine patients, particularly those suffering from migraine with aura. Preliminary studies support the use of folate, vitamin B6 and vitamin B12 for the prevention of migraine. However, the results of these studies await replication in larger randomized controlled clinical trials.
偏头痛是一种常见的神经血管疾病，世界卫生组织将其列为最具致残性的疾病之一。偏头痛是一种复杂的疾病，是遗传、表观遗传和环境因素相互作用的结果。MTHFR 基因是少数几个经过复制的偏头痛遗传风险因素之一，它编码一种对叶酸和蛋氨酸循环至关重要的酶。携带 MTHFR C677T 多态性 T 等位基因的个体，血浆同型半胱氨酸浓度升高，导致内皮细胞损伤和血液凝固特性改变。涵盖领域：本综述重点介绍了偏头痛发病机制中遗传学和 MTHFR 基因及同型半胱氨酸代谢作用的最新进展。本文总结了针对 MTHFR 和同型半胱氨酸进行疾病预防的潜力。专家意见：确定 MTHFR C677T 多态性以及测量同型半胱氨酸浓度可能对偏头痛患者有用，特别是那些有先兆偏头痛的患者。初步研究支持使用叶酸、维生素 B6 和维生素 B12 预防偏头痛。然而，这些研究的结果还需要在更大的随机对照临床试验中得到证实。
