Zhang Bin, Li Rui, Zhang Yufan, Gao Xia
Department of Neurology, the First Hospital of Yulin, Yulin, Shaanxi.
Department of Geriatrics, Dazhou Central Hospital, Dazhou, Sichuan, China.
Medicine (Baltimore). 2020 Jan;99(5):e18921. doi: 10.1097/MD.0000000000018921.
Recent studies have suggested that the potential functional polymorphism R47H in triggering receptors expressed on myeloid cells 2 (TREM2) is associated with several neurodegenerative diseases, however, the results remain inconclusive. This meta-analysis aimed to investigate the association between TREM2 R47H and the risk for 3 typical neurodegenerative diseases: Alzheimer disease (AD), Parkinson disease (PD), and amyotrophic lateral sclerosis (ALS).
A literature review was carried out using PubMed, Medline, and Embase. Data analysis was conducted using Stata 15.0 software. The pooled odds ratio (ORs) and 95% confidence interval (CIs) were calculated.
A total of 35 articles were identified as eligible: 22 on AD, 3 on ALS, 7 on PD, 2 on AD and ALS, and 1 on ALS and PD. The AD set included 23,092 cases and 30,920 controls, the ALS set included 7391 cases and 12,442 controls, and the PD set included 8498 patients and 9161 controls. We found that R47H was associated with an increased risk of AD in the total pooled population (P < .001, OR = 4.02, 95% CI = 3.15-5.13). However, this significant difference existed for Caucasian people (OR = 4.16, 95% CI = 3.24-5.33) but not for Asian or African people. Moreover, we did not find any significant differences in minor allele frequency distribution between the PD and control groups or between the ALS and control groups, not only for the total pooled population but also for the subgroups of different ethnicities.
Our study suggested that R47H in the TREM2 gene leads to an increased risk for developing AD, but not for ALS and PD, which adds evidence to the notion that diverse pathogenesis may be involved in different neurogenerative diseases.
近期研究表明,髓系细胞触发受体2(TREM2)中潜在的功能性多态性R47H与多种神经退行性疾病相关,但结果仍无定论。本荟萃分析旨在研究TREM2 R47H与3种典型神经退行性疾病:阿尔茨海默病(AD)、帕金森病(PD)和肌萎缩侧索硬化症(ALS)风险之间的关联。
使用PubMed、Medline和Embase进行文献综述。使用Stata 15.0软件进行数据分析。计算合并比值比(OR)和95%置信区间(CI)。
共确定35篇文章符合要求:22篇关于AD,3篇关于ALS,7篇关于PD,2篇关于AD和ALS,1篇关于ALS和PD。AD组包括23092例病例和30920例对照,ALS组包括7391例病例和12442例对照,PD组包括8498例患者和9161例对照。我们发现,在总合并人群中,R47H与AD风险增加相关(P<0.001,OR = 4.02,95%CI = 3.15 - 5.13)。然而,这种显著差异仅存在于白种人(OR = 4.16,95%CI = 3.24 - 5.33)中,亚洲或非洲人群中未发现。此外,我们发现,不仅在总合并人群中,而且在不同种族亚组中,PD组与对照组之间或ALS组与对照组之间的次要等位基因频率分布均无显著差异。
我们的研究表明,TREM2基因中的R47H会增加患AD的风险,但不会增加患ALS和PD的风险,这为不同神经退行性疾病可能涉及多种发病机制的观点提供了证据。