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缺血性脑卒中与遗传变异:在巴西人群中探寻与严重程度和复发的关联。

Ischemic Stroke and Genetic Variants: In Search of Association with Severity and Recurrence in a Brazilian Population.

机构信息

Medicine Department, University of Joinville Region-UNIVILLE, Joinville, Brazil.

Medicine Department, University of Joinville Region-UNIVILLE, Joinville, Brazil; Joinville Stroke Biobank, University of Joinville Region-UNIVILLE, Joinville, Brazil.

出版信息

J Stroke Cerebrovasc Dis. 2020 Feb;29(2):104487. doi: 10.1016/j.jstrokecerebrovasdis.2019.104487. Epub 2019 Nov 19.

Abstract

OBJECTIVE

The aim of this study was to investigate the relationship between genetic variants in candidate genes and clinical severity and prognosis (recurrence) of ischemic stroke (IS) in a Brazilian population.

METHODS

This was a retrospective study based on clinical and demographic data retrieved from the JOINVASC cohort-Epidemiological Study on Cerebrovascular Diseases in Joinville and on respective DNA samples available at the Joinville Stroke Biobank, over the period 2010-2015. Four hundred and thirty-five subjects were included. Patients were divided into large artery atherosclerosis (195 cases) and cardioembolic IS (240 cases) subgroups according to Trial of Org 10172 in the Acute Stroke Treatment standards. The severity of the event was established from the score obtained using the National Institutes of Health Stroke Scale. The genotypic and allelic frequencies of each variant were acquired by Real-Time Polymerase Chain Reaction. The codominance model was considered for the analysis of the genotypes' influence.

RESULTS

There was no association between clinical severity and recurrence with variants rs2383207 (CDKN2B-AS1) for atherothrombotic IS and variants rs879324 (ZFHX3), rs966221 (PDE4D), and rs152312 (PDE4D) for cardioembolic IS. The variants rs1396476, rs2910829, rs6843082, and rs2107595 were not in Hardy-Weinberg equilibrium in the evaluated population.

CONCLUSIONS

Although this study failed to identify an association between genetic variants and clinical response variability, the need to carry out related studies with larger number of cases covering other populations and genetic variants remains, which would allow the uncovering of hypothetical genetic factors governing stroke outcomes and recurrence.

摘要

目的

本研究旨在调查候选基因中的遗传变异与巴西人群中缺血性卒中(IS)的临床严重程度和预后(复发)之间的关系。

方法

这是一项基于 2010 年至 2015 年期间从 JOINVASC 队列-若因维利脑血管疾病的流行病学研究和若因维利卒中生物库中可用的相应 DNA 样本中检索到的临床和人口统计学数据的回顾性研究。共纳入 435 例患者。根据试验中的组织学分类,将患者分为大动脉粥样硬化性(195 例)和心源性栓塞性 IS(240 例)亚组。采用国立卫生研究院卒中量表(NIHSS)评分确定事件严重程度。通过实时聚合酶链反应(PCR)获得每个变异的基因型和等位基因频率。采用共显性模型分析基因型的影响。

结果

在与动脉粥样硬化性 IS 相关的 rs2383207(CDKN2B-AS1)和与心源性栓塞性 IS 相关的 rs879324(ZFHX3)、rs966221(PDE4D)和 rs152312(PDE4D)等变异与临床严重程度和复发无关联。在评估人群中,rs1396476、rs2910829、rs6843082 和 rs2107595 等变异不符合哈迪-温伯格平衡。

结论

尽管本研究未能确定遗传变异与临床反应变异性之间的关联,但仍需要开展相关研究,纳入更多病例,涵盖其他人群和遗传变异,以揭示潜在的遗传因素对卒中结局和复发的影响。

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