Department of Neurology, Institute of Medical Sciences, 30117Banaras Hindu University, Varanasi, India.
Department of community medicine, NDMC Medical College and 56888Hindu Rao Hospital, New Delhi, India.
J Geriatr Psychiatry Neurol. 2023 Mar;36(2):98-106. doi: 10.1177/08919887221103580. Epub 2022 May 22.
Long-term levodopa therapy for Parkinson's disease (PD) can cause levodopa induced dyskinesia (LID). Genetic predisposition has a significant role to play in inter-individual heterogeneity in the clinical manifestation of LID. Despite accumulating evidence for the role of COMT gene polymorphism (rs4680) as a genetic basis for LID, to date results have been inconsistent. Early assessment of the Catechol-O-Methyltransferase (COMT) genotype might be helpful to stratify PD patients concerning their individual risk for LID.
In this meta-analysis, we have used 9 studies, which were selected through online databases. Statistical analysis was performed using R (v-3.6) software. 5 genetic models have been used in the present study: Allele model (A vs. G), Dominant model (AA+AG vs. GG), Homozygote model (AA vs. GG), Co-dominant/heterozygote model (AG vs. GG), and Recessive model (AA vs. AG + GG).
The results indicated a significant association between COMT rs4680 (Val158Met) polymorphism and LID risk. The genotype AA of COMT rs4680 is a risk factor for LID in PD patients under the recessive model (AA vs GG+AG) in the random-effect model. Analysis based on ethnicity showed that COMT rs4680 SNP allele A is a risk factor for LID development in Asian PD patients, while GG genotype is a risk factor for LID development in non-Asian PD patients using different genetic models.
The results of the present meta-analysis support that the COMT Val158Met polymorphism is a risk factor for the development of LID in PD patients having ethnic variations.
长期左旋多巴治疗帕金森病(PD)可引起左旋多巴诱导的运动障碍(LID)。遗传易感性在 LID 临床表现的个体间异质性中起着重要作用。尽管越来越多的证据表明 COMT 基因多态性(rs4680)是 LID 的遗传基础,但迄今为止结果并不一致。早期评估儿茶酚-O-甲基转移酶(COMT)基因型可能有助于根据 LID 的个体风险对 PD 患者进行分层。
在这项荟萃分析中,我们使用了通过在线数据库选择的 9 项研究。使用 R(v-3.6)软件进行统计分析。本研究采用了 5 种遗传模型:等位基因模型(A 对 G)、显性模型(AA+AG 对 GG)、纯合子模型(AA 对 GG)、共显性/杂合子模型(AG 对 GG)和隐性模型(AA 对 AG+GG)。
结果表明,COMT rs4680(Val158Met)多态性与 LID 风险之间存在显著关联。COMT rs4680 的基因型 AA 是 PD 患者在隐性模型(AA 对 GG+AG)下发生 LID 的危险因素。基于种族的分析表明,COMT rs4680 SNP 等位基因 A 是亚洲 PD 患者发生 LID 发展的危险因素,而 GG 基因型是亚洲以外 PD 患者发生 LID 发展的危险因素。
本荟萃分析的结果支持 COMT Val158Met 多态性是具有种族差异的 PD 患者发生 LID 的危险因素。