Genomic expression patterns in medication overuse headaches.
Genomic expression patterns in medication overuse headaches.
复制标题
药物过度使用的基因组表达模式。
DOI：
10.1177/0333102410373155
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发表时间：
2011-01
期刊：
影响因子：
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通讯作者：
Powers SW
中科院分区：
文献类型：
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作者：
Hershey AD;Burdine D;Kabbouche MA;Powers SW
慢性每日头痛（CDH）和慢性偏头痛（CM）是神经病学中最常见的问题之一，通常难以治疗，并且经常并发药物过度使用头痛（MOH）。正确认识MOH可能会改变治疗结果，防止长期残疾。这项研究确定了独特的基因组表达模式MOH响应停止过度使用的药物。从大型数据库中测量了MOH的基线发生率和对停药的典型反应模式。从有或没有MOH的CM患者获得全血样品，并评估其基因组谱。在治疗前和治疗6-12周后，使用Affytron人U133 plus 2阵列检查基因组表达模式。根据头痛频率和功能障碍比较头痛特征和治疗反应。在1311例报告每日或持续头痛的患者中，513例（39.1%）报告过度使用镇痛药物。在随访时，44.5%的患者头痛频率减少了50%或更多，而41.6%的患者没有变化。获得了33例患者的血液基因组表达模式，其中19例（57.6%）过度使用止痛药，MOH中有一种独特的基因组表达模式，对停止止痛药有反应。这些样本的基因本体表明，相当数量的参与脑和免疫组织，包括多个信号通路和细胞凋亡。血液基因组模式可以准确地识别MOH患者对停药的反应。这些结果表明，MOH涉及一个独特的分子生物学途径，可以用特定的生物标志物来识别。
Chronic daily headache (CDH) and chronic migraine (CM) are one of the most frequent problems encountered in neurology, are often difficult to treat, and frequently complicated by medication-overuse headache (MOH). Proper recognition of MOH may alter treatment outcome and prevent long term disability. This study identifies the unique genomic expression pattern MOH that respond to cessation of the overused medication. Baseline occurrence of MOH and typical pattern of response to medication cessation were measured from a large database. Whole blood samples from patients with CM with or without MOH were obtained and their genomic profile was assessed. Affymetrix human U133 plus2 arrays were used to examine the genomic expression patterns prior to treatment and 6–12 weeks later. Headache characterisation and response to treatment based on headache frequency and disability were compared. Of 1311 patients reporting daily or continuous headaches, 513 (39.1%) reported overusing analgesic medication. At follow-up, 44.5% had a 50% or greater reduction in headache frequency, while 41.6% had no change. Blood genomic expression patterns were obtained on 33 patients with 19 (57.6%) overusing analgesic medication with a unique genomic expression pattern in MOH that responded to cessation of analgesics. Gene ontology of these samples indicated a significant number were involved with brain and immunological tissues, including multiple signalling pathways and apoptosis. Blood genomic patterns can accurately identify MOH patients that respond to medication cessation. These results suggest that MOH involves a unique molecular biology pathway that can be identified with a specific biomarker.