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Genetic and Demographic Outcomes in a Population of Patients with Headache and Facial Pain

DOI: 10.4236/jbbs.2018.86022, PP. 339-350

Keywords: Headache, Pharmacogenetics, Cytochrome P450, Cerebrovascular Risk, Cardiovascular Risk

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Abstract:

Background: Pharmacogenetics information about cytochrome p450 (CYP450) polymorphism in patients with headaches is limitedly reported. Similarly, the genetic factors linking various headache types and vascular disorders are poorly described. We aimed to characterize the genetic profile of a cohort of headache and facial pain subjects. Methods: Medical records of consecutive headache subjects that underwent PersonaGeneTM testing were reviewed. PersonaGeneTM panel assessed CYP450, apolipoprotein E (ApoE), methylene tetrahydrofolate reductase (MTHFR), Factor II, Factor V Leiden and Vitamin K epoxide reductase complex subunit 1 (VKORC1). Demographic information, headache diagnosis and genetic profiling were analyzed and compared with data obtained from the general population. Results: Out of 130 headache patients, 91.3% were Caucasian and 70.8% had migraine. Compared to the general Caucasian population, our Caucasian headache patients were significantly different for CYP3A4/A5 and CYP2D6 (p < 0.001) and comparable regarding CYP2C9 and CYPC19. Whereas MTHFR genotype was similar, ApoE and Factor V Leiden were different in headache patients (p = 0.001). Less headache patients showed intermediate sensitivity to warfarin (p = 0.009) based on VQORC1 genotyping. No differences were noticed between migraine and other headache type diagnoses for all the genetic tests. Conclusion: Distinctive profiles for CYP450, ApoE, Factor V Leiden and VQORC1 were observed in our Caucasian headache cohort. These results may impact headache subjects’ pharmacological treatment options and vascular risk ascertainment.

References

[1]  Burstein, R., Noseda, R. and Borsook, D. (2015) Migraine: Multiple Processes, Complex Pathophysiology. Journal of Neuroscience, 35, 6619-6629.
https://doi.org/10.1523/JNEUROSCI.0373-15.2015
[2]  Piane, M., et al. (2007) Genetics of Migraine and Pharmacogenomics: Some Considerations. The Journal of Headache and Pain, 8, 334-339.
https://doi.org/10.1007/s10194-007-0427-2
[3]  Bigal, M.E., et al. (2009) Migraine and Cardiovascular Disease: Possible Mechanisms of Interaction. Neurology, 72, 1864-1871.
https://doi.org/10.1212/WNL.0b013e3181a71220
[4]  Monteith, T.S., et al. (2015) Migraine and Risk of Stroke in Older Adults: Northern Manhattan Study. Neurology, 85, 715-721.
https://doi.org/10.1212/WNL.0000000000001854
[5]  Persico, A.M., et al. (2015) Migraine Genetics: Current Findings and Future Lines of Research. Neurogenetics, 16, 77-95.
https://doi.org/10.1007/s10048-014-0433-x
[6]  Sacco, S. and Kurth, T. (2014) Migraine and the Risk for Stroke and Cardiovascular Disease. Current Cardiology Reports, 16, 524.
https://doi.org/10.1007/s11886-014-0524-1
[7]  Samer, C.F., et al. (2013) Applications of CYP450 Testing in the Clinical Setting. Molecular Diagnosis & Therapy, 17, 165-184.
https://doi.org/10.1007/s40291-013-0028-5
[8]  Budd, W.T., et al. (2016) Next Generation Sequencing Reveals Disparate Population Frequencies among Cytochrome P450 Genes: Clinical Pharmacogenomics of the CYP2 Family. International Journal of Computational Biology and Drug Design (IJCBDD), 9, 54-77.
https://doi.org/10.1504/IJCBDD.2016.074984
[9]  Geisen, C., et al. (2005) VKORC1 Haplotypes and Their Impact on the Inter-Individual and Inter-Ethnical Variability of Oral Anticoagulation. Thrombosis and Haemostasis, 94, 773-779.
[10]  Smith, M.T. and Muralidharan, A. (2012) Pharmacogenetics of Pain and Analgesia. Clinical Genetics, 82, 321-330.
https://doi.org/10.1111/j.1399-0004.2012.01936.x
[11]  Trescot, A.M. and Faynboym, S. (2014) A Review of the Role of Genetic Testing in Pain Medicine. Pain Physician, 17, 425-445.
[12]  Zhou, S.F. (2009) Polymorphism of Human Cytochrome P450 2D6 and Its Clinical Significance: Part II. Clinical Pharmacokinetics, 48, 761-804.
https://doi.org/10.2165/11318070-000000000-00000
[13]  Mattsson, P., et al. (2000) Cytochrome P450 2D6 and Glutathione S-Transferase M1 Genotypes and Migraine. European Journal of Clinical Investigation, 30, 367-371.
https://doi.org/10.1046/j.1365-2362.2000.00633.x
[14]  Lamba, J.K., et al. (2002) Genetic Contribution to Variable Human CYP3A-Mediated Metabolism. Advanced Drug Delivery Reviews, 54, 1271-1294.
https://doi.org/10.1016/S0169-409X(02)00066-2
[15]  Sim, S.C., et al. (2006) A Common Novel CYP2C19 Gene Variant Causes Ultrarapid Drug Metabolism Relevant for the Drug Response to Proton Pump Inhibitors and Antidepressants. Clinical Pharmacology & Therapeutics, 79, 103-113.
https://doi.org/10.1016/j.clpt.2005.10.002
[16]  Lindh, J.D., et al. (2009) Influence of CYP2C9 Genotype on Warfarin Dose Requirements—A Systematic Review and Meta-Analysis. European Journal of Clinical Pharmacology, 65, 365-375.
https://doi.org/10.1007/s00228-008-0584-5
[17]  Chan, K.W., et al. (2010) Magnetic Resonance Spectroscopy of the Brain under Mild Hypothermia Indicates Changes in Neuroprotection-Related Metabolites. Neuroscience Letters, 475, 150-155.
https://doi.org/10.1016/j.neulet.2010.03.066
[18]  Rieder, M.J., et al. (2005) Effect of VKORC1 Haplotypes on Transcriptional Regulation and Warfarin Dose. The New England Journal of Medicine, 352, 2285-2293.
https://doi.org/10.1056/NEJMoa044503
[19]  Gage, B.F., et al. (2008) Use of Pharmacogenetic and Clinical Factors to Predict the Therapeutic Dose of Warfarin. Clinical Pharmacology & Therapeutics, 84, 326-331.
https://doi.org/10.1038/clpt.2008.10
[20]  Gupta, R., et al. (2009) Polymorphism in Apolipoprotein E among Migraineurs and Tension-Type Headache Subjects. The Journal of Headache and Pain, 10, 115-120.
https://doi.org/10.1007/s10194-008-0094-y
[21]  Price, D.T. and Ridker, P.M. (1997) Factor V Leiden Mutation and the Risks for Thromboembolic Disease: A Clinical Perspective. Annals of Internal Medicine, 127, 895-903.
https://doi.org/10.7326/0003-4819-127-10-199711150-00007
[22]  Kim, R.J. and Becker, R.C. (2003) Association between Factor V Leiden, Prothrombin G20210A, and Methylenetetrahydrofolate Reductase C677T Mutations and Events of the Arterial Circulatory System: A Meta-Analysis of Published Studies. American Heart Journal, 146, 948-957.
https://doi.org/10.1016/S0002-8703(03)00519-2
[23]  Lippi, G., Mattiuzzi, C. and Cervellin, G. (2015) Meta-Analysis of Factor V Leiden and Prothrombin G20210A Polymorphism in Migraine. Blood Coagulation & Fibrinolysis, 26, 7-12.
https://doi.org/10.1097/MBC.0000000000000188
[24]  Schürks, M., Rist, P.M. and Kurth, T. (2010) MTHFR 677C>T and ACE D/I Polymorphisms in Migraine: A Systematic Review and Meta-Analysis. Headache, 50, 588-599.
https://doi.org/10.1111/j.1526-4610.2009.01570.x
[25]  Nguyen, A. and Prothrombin, G. (2000) A Polymorphism and Thrombophilia. Mayo Clinic Proceedings, 75, 595-604.
https://doi.org/10.4065/75.6.595

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