偏头痛的分子机制研究进展

Progress in molecular mechanism of migraine

偏头痛是一种常见的神经系统疾病,影响全球11%的成年人。先兆偏头痛(MA)和无先兆偏头痛(MO)是两种主要的临床亚型。偏头痛的发病机制尚未完全阐明,普遍认为这一病理过程涉及遗传因素和环境因素。偏头痛的遗传学研究集中在罕见的MA亚型-家族性偏瘫偏头痛(FHM),家族性和散发性偏头痛的基因分析发现有MTHFR、KCNK18、HCRTR1、SLC6A4、STX1A、GRIA1和GRIA3基因,因此认为偏头痛可能是一种多基因影响的多因素疾病。最近研究表明,偏头痛的发病机制包括免疫反应和氧化应激两个因素,如细胞因子、酪氨酸代谢、同型半胱氨酸;与疼痛传递和情绪相关的因素如5羟色胺、下丘脑分泌素/食欲素、降钙素基因相关肽、谷氨酸等。已发现HCRTR1基因遗传变异与5-HTTLPR和食欲素多态性之间的关系,已知5-羟色胺能抑制下丘脑神经元的活动,并可能影响偏头痛先兆期。

Migraine is a common neurological disease affecting 11% of adults worldwide. Threatened migraine （MA） and migraine without aura （MO） are the two major clinical subtypes. The pathogenesis of migraine has not been fully elucidated. It is generally believed that this pathological process involves genetic and environmental factors. Genetic studies of migraine are concen trated in the rare MA subtype familial hemiplegic migraine （FHM）. The genetic analysis of familial and sporadic migraine has been found to have MTHFR,KCNK18, HCRTR1,SLC6A4,STX1A,GRIA1 and GRIA3 genes. Therefore, migraine may be a multi fac tot disease with multiple genes. Recent studies have shown that the pathogenesis of migraine includes two factors such as immune response and oxidative stress,such as cytokines,tyrosine metabolism, homocysteine,and pain transfer and emotional factors such as 5 serotonin,hypothalamus / orexin,calcitonin gene phase peptide,glutamic acid and so on. The relationship between the genetic variation of the HCRTR1 gene and the polymorphism of 5 HTTLPR and orexin has been found. It is known that 5 serotonin can inhibit the activity of hypothalamic neurons and may affect the migraine precursor.