偏头痛的遗传学。

Genetics of migraine.

机构信息

Neurology Department, Montpellier University Hospital, Montpellier, France.

出版信息

Rev Neurol (Paris). 2021 Sep;177(7):801-808. doi: 10.1016/j.neurol.2021.06.002. Epub 2021 Jul 23.

Abstract

Migraine is a complex brain disorder explained by the interaction of genetic and environmental factors. In monogenic migraines, including familial hemiplegic migraine and migraine with aura associated with hereditary small-vessel disorders, the identified genes encode proteins expressed in neurons, astrocytes or vessels, which all increase the susceptibility to cortical spreading depression. Study of monogenic migraines showed that the neurovascular unit plays a prominent role in migraine. Genome-wide association studies have identified multiple susceptibility variants that only cause a small increase of the global migraine risk. The variants belong to several complex networks of "pro-migraine" molecular abnormalities, which are mainly neuronal or vascular. Genetics has also underscored the importance of genetic factors shared between migraine and its major co-morbidities including depression and high blood pressure. Further studies are still needed to map all of the susceptibility loci for migraine and then to understand how these genomic variants lead to migraine cell phenotypes. Thanks to the advent of new technologies such as induced pluripotent stem cells, genetic data will hopefully finally be able to lead to therapeutic progress.

摘要

偏头痛是一种复杂的脑部疾病,由遗传和环境因素相互作用引起。在单基因偏头痛中,包括家族性偏瘫性偏头痛和伴有遗传性小血管疾病的先兆性偏头痛,已鉴定的基因编码在神经元、星形胶质细胞或血管中表达的蛋白质,这些都会增加皮质扩散抑制的易感性。对单基因偏头痛的研究表明,神经血管单元在偏头痛中起着重要作用。全基因组关联研究已经确定了多个易感变异,这些变异仅导致整体偏头痛风险的微小增加。这些变异属于几个“致偏头痛”分子异常的复杂网络,主要是神经元或血管。遗传学还强调了偏头痛与其主要合并症(包括抑郁症和高血压)之间遗传因素的重要性。仍需要进一步研究以绘制偏头痛的所有易感位点图谱,然后了解这些基因组变异如何导致偏头痛细胞表型。得益于诱导多能干细胞等新技术的出现,遗传数据有望最终能够带来治疗进展。

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