BDNF Val66Me(trs6265)单核苷酸多态性与针刺个体疗效差异的相关性研究  

Study on Correlation Between Single Nucleotide Polymorphism of BDNF Val66Met(rs6265)and Individual Differences in Efficacy of Acupuncture

作　　者：王越月 赖小燕[1] 张宇叶 吴双[1] 武平[1] 兰蕾[1] Wang Yueyue;Lai Xiaoyan;Zhang Yuye;Wu Shuang;Wu Ping;Lan Lei(School of Acupuncture and Tuina,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)

机构地区：[1]成都中医药大学针灸推拿学院,成都610075

出　　处：《世界科学技术-中医药现代化》2020年第9期3393-3399,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委员会青年基金项目(81503664):针刺治疗偏头痛疗效差异的单核苷酸多态性相关脑功能网络研究,负责人:兰蕾;成都中医药大学“杏林学者”学科人才提升计划(030/030041055):针刺敏化穴干预膝骨关节炎的中枢机制研究,负责人:兰蕾。

摘　　要：目的本试验借助单核苷酸多态性分析技术,从脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)Val66Met(rs6265)切入,从表观遗传角度来探讨针刺所产生不同疗效背后的遗传学影响因素。方法以月经性偏头痛患者为研究对象,采用经典的少阳经穴进行针刺治疗,治疗前后分别进行1次临床观察指标评价,并按照头痛缓解天数是否小于50%来区分针刺有效者与针刺无效者。治疗前采集所有受试者血液,提取DNA并保存,进行BDNF基因多态性位点的检测,采用实时荧光定量PCR TapMan探针法对针刺受试者BDNF Val66Met的基因型进行测定。结果针刺有效受试者26例,针刺无效受试者41例;针刺有效组治疗后头痛天数及各临床评价指标显著改善,具有统计学意义(P<0.01);针刺有效组与无效组不同BDNF Va166Met基因型的分布未发现明显差异(P>0.05),但在不同BDNF Va166Met基因型两组的偏头痛特异性生活质量问卷(migraine-specific questionnaire,MSQ)评分中有统计学差异(P<0.05):针刺有效组Met/Met基因型在MSQ-功能受限的情况优于Val/Val和Val/Met基因型(P<0.05),但是在其他的结局指标以及针刺无效组中里无差异;针刺有效组Val/Met基因型在MSQ-功能丧失和情感功能的功能情况远不及Val/Val和Met/Met基因型(P<0.01),但与此同时在针刺无效组的这2个评价指标中,Val/Met基因型的功能情况却明显优于Val/Val基因型(P<0.05),同时与Met/Met基因型相比功能情况略好,但差异没有统计学意义。结论不同BDNF Val66Met基因型在针刺有效组和无效组的分布无明显差异;但不同BDNF Val66Met基因型在2组中的MSQ评分的有差异性,即针刺疗效在不同疗效差异群体中可能会呈现出基因型差异的趋势。Objective To explore genetic factors behind the different efficacy of acupuncture from the perspective of epigenetics,starting from brain-derived neurotrophic factor(BDNF)Val66 Met(rs6265)by using analytical technique of single nucleotide polymorphism(SNP).Methods Taking patients with menstrual migraine as study subjects,classic acupoints on Shaoyang meridians were used for acupuncture treatment.Before and after the treatment,an evaluation on clinical observation indexes was conducted respectively,and according to whether headache relief days were less than50%,subjects with effective acupuncture and subjects with ineffective acupuncture were distinguished.Before the treatment,blood samples were collected from all subjects,DNA was extracted and preserved,BDNF gene polymorphic sites were detected,and genotypes of BDNF Val66 Met in the subjects were determined by a real-time fluorescence quantitative PCR TapMan probe method.Results There were 26 subjects with effective acupuncture and 41 subjects with ineffective acupuncture.Headache days and clinical evaluation indexes in the effective acupuncture group were significantly improved after the treatment,with statistical significance(P<0.01).There was no significant difference in distribution of different BDNF Va166 Met genotypes between the effective acupuncture group and the ineffective acupuncture group(P>0.05),but there were statistical differences in migraine-specific questionnaire(MSQ)scores between the 2 groups with different BDNF Val66 Met genotypes(P<0.05).That of the Met/Met genotype was better than those of Val/Val and Val/Met genotypes in MSQ function limitation in the effective acupuncture group(P<0.05),but there was no difference in other outcome indexes and in the ineffective acupuncture group.That of the Val/Met genotype was far less than those of the Val/Val and Met/Met genotypes in MSQ function loss and emotional function in the effective acupuncture group(P<0.01),but at the same time in these 2 evaluation indexes in the ineffective acupuncture group,

关 键 词：月经性偏头痛 脑源性神经营养因子Val66Met 单核苷酸多态性 针刺个体疗效差异 

分 类 号：R246.9[医药卫生—针灸推拿学]