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Carnwath TP, Demel SL, Prestigiacomo CJ. Genetics of ischemic stroke functional outcome. J Neurol 2024; 271:2345-2369. [PMID: 38502340 PMCID: PMC11055934 DOI: 10.1007/s00415-024-12263-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/21/2024]
Abstract
Ischemic stroke, which accounts for 87% of cerebrovascular accidents, is responsible for massive global burden both in terms of economic cost and personal hardship. Many stroke survivors face long-term disability-a phenotype associated with an increasing number of genetic variants. While clinical variables such as stroke severity greatly impact recovery, genetic polymorphisms linked to functional outcome may offer physicians a unique opportunity to deliver personalized care based on their patient's genetic makeup, leading to improved outcomes. A comprehensive catalogue of the variants at play is required for such an approach. In this review, we compile and describe the polymorphisms associated with outcome scores such as modified Rankin Scale and Barthel Index. Our search identified 74 known genetic polymorphisms spread across 48 features associated with various poststroke disability metrics. The known variants span diverse biological systems and are related to inflammation, vascular homeostasis, growth factors, metabolism, the p53 regulatory pathway, and mitochondrial variation. Understanding how these variants influence functional outcome may be helpful in maximizing poststroke recovery.
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Affiliation(s)
- Troy P Carnwath
- University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA.
| | - Stacie L Demel
- Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Charles J Prestigiacomo
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
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Chai J, Cao XL, Lu F. Association of Interleukin-6-174G/C Polymorphism With Ischemic Stroke: An Updated Meta-Analysis. Front Neurol 2022; 12:799022. [PMID: 35069427 PMCID: PMC8770401 DOI: 10.3389/fneur.2021.799022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/02/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Although numerous epidemiological studies have investigated the association between −174G/C(rs1800795) polymorphism in the interleukin-6 (IL-6) gene-stimulatory region and the risk of ischemic stroke (IS), they failed to reach a unified conclusion. The true relationship between −174G/C(rs1800795) polymorphism and IS remains controversial and unclear. Therefore, in this meta-analysis, we aimed to analyze more precisely the association between −174G/C(rs1800795) single-nucleotide polymorphism (SNP) of IL-6 gene and IS in a larger pooled population. Methods: A comprehensive literature search was performed in PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials until June 30, 2021. A fixed or random-effects model was utilized based on heterogeneity between studies. The odds ratios (ORs) and 95% confidence intervals (Cis) were calculated in the models of allele comparison (G vs. C), homozygote comparison (GG vs. CC) and (GC vs. CC), dominant (GG vs. GC + CC), hyper dominant (GG + CC vs. GC), and recessive (GG + GC vs. CC) to determine the strength of associations. Results: This meta-analysis included 13 case-control studies in 35 articles with 5,548 individuals. Overall, no significant associations between IL-6 −174G/C(rs1800795) and IS were identified (G vs. C:OR [95% CI] = 0.99 [0.81, 1.21], P = 0.91; GG + CC vs. GC:0.97 [0.85, 1.11], P = 0.66; GG vs. GC + CC: 1.01 [0.81, 1.25], P = 0.94; GC vs. CC: OR [95% CI] = 1.01 [0.68, 1.5], P = 0.96; GG vs. CC:0.93 [0.57, 1.51], P = 0.76; GG + GC vs. CC:0.97 [0.64, 1.47], P = 0.89). In the subgroup analyses by ethnicity or HWE P-value, there was a statistically significant association between IL-6 −174G/C(rs1800795) polymorphisms and IS in the alleles model; (G vs. C: LogOR [95% CI] = 0.14 [−0.16,.45], P = 0.00), homozygote model (GG vs. CC: LogOR [95% CI] = 0.18 [−0.58,.95], P = 0.00) and (GC vs. CC: LogOR [95% CI] = 0.2 [−0.46,.85], P = 0.00), dominant model (GG vs. GC + CC: OR [95% CI] = 0.02 [−0.72, 0.77], P = 0.00), and recessive model (GG + GC vs. CC: OR [95% CI]= −0.17 [−0.86,.52], P = 0.00) of the European population and in the dominant model (GG vs. GC + CC: OR [95% CI] = −0.13 [−0.51, 0.24]) of the Asian population. No statistical significance was identified in both six models of HWE p ≥ 0.2 group (both P ≥ 0.05). Conclusion: This meta-analysis revealed no correlation between IL-6 −174G/C(rs1800795) polymorphism and IS, whereas the subgroup analysis indicated that the relationship between IL-6 −174G/C(rs1800795) polymorphism and IS susceptibility varied significantly according to ethnicity and geography.
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Affiliation(s)
- Jie Chai
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.,Cardiovascular Internal Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xian-Ling Cao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Feng Lu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.,Cardiovascular Internal Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Data inclusion in the article: A meta-analysis on associations of IL-6 and IL-10 polymorphisms with susceptibility to ischemic stroke. J Neuroimmunol 2019; 339:577141. [PMID: 31884259 DOI: 10.1016/j.jneuroim.2019.577141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 02/05/2023]
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Wei LK, Quan LS. Biomarkers for ischemic stroke subtypes: A protein-protein interaction analysis. Comput Biol Chem 2019; 83:107116. [PMID: 31561071 DOI: 10.1016/j.compbiolchem.2019.107116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/10/2019] [Accepted: 08/26/2019] [Indexed: 01/21/2023]
Abstract
According to the Trial of Org 10172 in Acute Stroke Treatment, ischemic stroke is classified into five subtypes. However, the predictive biomarkers of ischemic stroke subtypes are still largely unknown. The utmost objective of this study is to map, construct and analyze protein-protein interaction (PPI) networks for all subtypes of ischemic stroke, and to suggest the predominant biological pathways for each subtypes. Through 6285 protein data retrieved from PolySearch2 and STRING database, the first PPI networks for all subtypes of ischemic stroke were constructed. Notably, F2 and PLG were identified as the critical proteins for large artery atherosclerosis (LAA), lacunar, cardioembolic, stroke of other determined etiology (SOE) and stroke of undetermined etiology (SUE). Gene ontology and DAVID analysis revealed that GO:0030193 regulation of blood coagulation and GO:0051917 regulation of fibrinolysis were the important functional clusters for all the subtypes. In addition, inflammatory pathway was the key etiology for LAA and lacunar, while FOS and JAK2/STAT3 signaling pathways might contribute to cardioembolic stroke. Due to many risk factors associated with SOE and SUE, the precise etiology for these two subtypes remained to be concluded.
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Affiliation(s)
- Loo Keat Wei
- Department of Biological Science, Faculty of Science, Universiti Tunku Abdul Rahman, Bandar Barat, 31900 Kampar, Perak, Malaysia.
| | - Leong Shi Quan
- Department of Biological Science, Faculty of Science, Universiti Tunku Abdul Rahman, Bandar Barat, 31900 Kampar, Perak, Malaysia
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Math N, Han TS, Lubomirova I, Hill R, Bentley P, Sharma P. Influences of genetic variants on stroke recovery: a meta-analysis of the 31,895 cases. Neurol Sci 2019; 40:2437-2445. [PMID: 31359356 PMCID: PMC6848040 DOI: 10.1007/s10072-019-04024-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 07/20/2019] [Indexed: 02/07/2023]
Abstract
Background The influences of genetic variants on functional clinical outcomes following stroke are unclear. In order to reliably quantify these influences, we undertook a comprehensive meta-analysis of outcomes after acute intracerebral haemorrhage (ICH) or ischaemic stroke (AIS) in relation to different genetic variants. Methods PubMed, PsycInfo, Embase and Medline electronic databases were searched up to January 2019. Outcomes, defined as favourable or poor, were assessed by validated scales (Barthel index, modified Rankin scale, Glasgow outcome scale and National Institutes of Health stroke scale). Results Ninety-two publications comprising 31,895 cases met our inclusion criteria. Poor outcome was observed in patients with ICH who possessed the APOE4 allele: OR =2.60 (95% CI = 1.25–5.41, p = 0.01) and in AIS patients with the GA or AA variant at the BDNF-196 locus: OR = 2.60 (95% CI = 1.25–5.41, p = 0.01) or a loss of function allele of CYP2C19: OR = 2.36 (95% CI = 1.56–3.55, p < 0.0001). Poor outcome was not associated with APOE4: OR = 1.02 (95% CI = 0.81–1.27, p = 0.90) or IL6-174 G/C: OR = 2.21 (95% CI = 0.55–8.86, p = 0.26) in patients with AIS. Conclusions We demonstrate that recovery of AIS was unfavourably associated with variants of BDNF and CYP2C19 genes whilst recovery of ICH was unfavourably associated with APOE4 gene. Electronic supplementary material The online version of this article (10.1007/s10072-019-04024-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nikhil Math
- Department of Neuroscience, Imperial College London, South Kensington, London, SW7 2AZ, UK
| | - Thang S Han
- Institute of Cardiovascular Research Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK.
- Department of Endocrinology, Ashford & St Peter's NHS Foundation Trust, Chertsey, England.
| | - Irina Lubomirova
- Department of Neuroscience, Imperial College London, South Kensington, London, SW7 2AZ, UK
| | - Robert Hill
- Department of Neuroscience, Imperial College London, South Kensington, London, SW7 2AZ, UK
| | - Paul Bentley
- Department of Neuroscience, Imperial College London, South Kensington, London, SW7 2AZ, UK
- Imperial College Healthcare NHS Trust, London, W2 1NY, UK
| | - Pankaj Sharma
- Institute of Cardiovascular Research Royal Holloway, University of London, Egham, Surrey, TW20 0EX, UK.
- Department of Endocrinology, Ashford & St Peter's NHS Foundation Trust, Chertsey, England.
- Imperial College Healthcare NHS Trust, London, W2 1NY, UK.
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Akhter MS, Biswas A, Abdullah SM, Hobani Y, Ranjan R, Behari M, Saxena R. Influence of Interleukin-6 (IL-6) Promoter Gene Polymorphisms (-174G>C, -572G>C, and -597G>A) on IL-6 Plasma Levels and Their Impact in the Development of Acute Ischemic Stroke in Young Indians. Clin Appl Thromb Hemost 2019; 25:1076029619854136. [PMID: 31215220 PMCID: PMC6714995 DOI: 10.1177/1076029619854136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
This study aimed to determine whether there is an influence of interleukin 6 (IL-6) gene promoter polymorphisms on IL-6 plasma levels and its role in the development of ischemic stroke in young Indians. One hundred young patients with ischemic stroke (age ≥ 45 years) and equal number of age- and sex-matched controls were genotyped for 174G>C, −572G>C, and −597G>A promoter polymorphisms by polymerase chain reaction–restriction fragment length polymorphism. Plasma IL-6 levels were measured by enzyme-linked immunosorbent assay. Plasma IL-6 levels were significantly higher in patients as compared to controls (patients: 28.61 ± 8.61 pg/mL, controls: 7.60 ± 4.10 pg/mL, P = .001). Both −174G>C (allelic χ2/P value: 4.79/.028, genotypic χ2/P value: 5.3/.021) and −572G>C (allelic χ2/P value: 9.63/.00113 Genotypic χ2/P value: 74/.0002) polymorphisms exhibited genotypic as well as allelic significant association with the disease phenotype. Comparison was made between patients and controls for all 3 polymorphisms using a recessive model with respect to plasma IL-6 levels; no polymorphism showed any significant correlative association with the increased IL-6 levels (P = .31, .51, .32). Interleukin 6 is an inflammatory marker that is considerably influenced by nongenetic factors and is not a good candidate gene for studying genetic components associated with ischemic stroke. It seems that the variability in IL-6 levels is an integrated effect of nongenetic influences and the inflammatory events that follow ischemic stroke instead of being its cause. It is suggested that there is no direct association between −174G>C, −572G>C, and −597G>A polymorphisms and elevated IL-6 levels in the development of ischemic stroke.
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Affiliation(s)
- Mohammad Suhail Akhter
- 1 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.,2 Applied Medical Sciences, Jazan University, Jazan University, Jazan, Saudi Arabia
| | - Arijit Biswas
- 3 Institute of Experimental Hematology and Transfusion Medicine, Sigmund Freud, Germany
| | | | - Yahya Hobani
- 2 Applied Medical Sciences, Jazan University, Jazan University, Jazan, Saudi Arabia
| | - Ravi Ranjan
- 1 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Madhuri Behari
- 1 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Renu Saxena
- 1 Department of Hematology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Ou M, Liu S, Ma X, Xing X, He W, Gao H. IL‐6 promoter polymorphism increased risks of recurrent stroke in the young patients with moderate internal carotid artery stenosis. J Cell Biochem 2017; 119:2886-2890. [DOI: 10.1002/jcb.26467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 10/31/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Minghui Ou
- Department of Vascular SurgeryPeople's Hospital of Ningxia Hui autonomous regionsYinchuanNingxiaChina
| | - Shunda Liu
- Department of NeurologyPeople's Hospital of Ningxia Hui Autonomous RegionsYinchuanNingxiaChina
- The First Affiliated Hospital of Northwest University for NationalitiesYinchuanNingxiaChina
| | - Xiaoping Ma
- Department of NeurologyPeople's Hospital of Ningxia Hui Autonomous RegionsYinchuanNingxiaChina
- The First Affiliated Hospital of Northwest University for NationalitiesYinchuanNingxiaChina
| | - Xiangluan Xing
- Department of NeurologyPeople's Hospital of Ningxia Hui Autonomous RegionsYinchuanNingxiaChina
- The First Affiliated Hospital of Northwest University for NationalitiesYinchuanNingxiaChina
| | - Wenting He
- Department of NeurologyPeople's Hospital of Ningxia Hui Autonomous RegionsYinchuanNingxiaChina
- The First Affiliated Hospital of Northwest University for NationalitiesYinchuanNingxiaChina
| | - Huanmin Gao
- Department of NeurologyPeople's Hospital of Ningxia Hui Autonomous RegionsYinchuanNingxiaChina
- The First Affiliated Hospital of Northwest University for NationalitiesYinchuanNingxiaChina
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Chen Z, Zheng J, Liu W, Yang K, Li K, Huang B, Zhu R, Lu X, Li L. The SG13S114 polymorphism of the ALOX5AP gene is associated with ischemic stroke in Europeans: a meta-analysis of 8062 subjects. Neurol Sci 2017; 38:579-587. [PMID: 28101761 DOI: 10.1007/s10072-016-2804-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
Abstract
The association between ALOX5AP SG13S114 polymorphism and ischemic stroke (IS) susceptibility has extensively been investigated, especially in white populations; however, the results were inconclusive. Here, we perform a meta-analysis to clarify the effect of SG13S114 variant on the IS risk in Europeans. The Web of Science, PubMed, EMBASE, and Medline were searched up to August 1st, 2016. Data were extracted and the odd ratios (ORs) and 95% confidence intervals (CIs) were calculated by a fixed-effects or random-effects model. In total, 8 case control studies involved 8062 subjects were finally included in this meta-analysis. We observed a significantly decreased IS risk in persons carrying an A allele at the SG13S114 polymorphism compared with those with a T allele (A vs T, OR = 0.856, 95% CI = 0.797-0.919, p < 0.001). In addition, the results of sensitivity and cumulative meta-analysis indicated the robustness of our results. In addition, the publication bias was not detected using the funnel plot and Egger's tests. In summary, the present meta-analysis suggested that the A allele at the ALOX5AP SG13S114 polymorphism is a protective factor for the IS in the Europeans. In addition, further studies with large sample size are needed to validate the association, as well as in other ethnic groups.
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Affiliation(s)
- Zhongjun Chen
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.,Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical College, No. 62 South Huaihai Road, Huai'an, 223002, China
| | - Jinyu Zheng
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical College, No. 62 South Huaihai Road, Huai'an, 223002, China
| | - Wenguang Liu
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical College, No. 62 South Huaihai Road, Huai'an, 223002, China
| | - Kun Yang
- Department of Neurosurgery, Nanjing Brain Hospital Affiliated with Nanjing Medical University, 264 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Kai Li
- Department of Neurosurgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210011, Jiangsu, China
| | - Baosheng Huang
- Department of Neurosurgery, Sir Shaw Hospital, Nanjing Medical University, Nanjing, 211100, Jiangsu, China
| | - Ronglan Zhu
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China
| | - Xiaocheng Lu
- Department of Neurosurgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Lixin Li
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
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