Genetics of migraine and pharmacogenomics: some considerations

Abstract

Migraine is a complex disorder caused by a combination of genetic and environmental factors.Although family and twin studies show that there is a genetic component in migraine, no genes predisposing to common forms of the disorder, migraine with and without aura, have been identified. Patients with migraine respond differently to a given drug administered. The efficacy of therapy and the occurrence of adverse drug response are a consequence of individual variability. Genetic profiling of predisposition to migraine should facilitate the development of more effective diagnostic and therapeutic applications. The development of International Hap Map project could provide a powerful tool for identification of the candidate genes in this complex disease and pharmacogenomics research could be the promise for individualized treatments and prevention of adverse drug response.

Is Helicobacter Pylori Associated with a Migraine?

“…These studies recruited patients who mainly suffered from migraine without aura because this subtype of migraine seems to be caused by a combination of genetic and environmental factors, whereas migraine with aura is probably determined largely, or exclusively, by genetic factors [28,29]. It has been suggested that the pathogenic role of the H. pylori infection in migraine, is based on a relationship between the host immune response against the bacterium and the chronic release of vasoactive substances.…”

Pharmacogenomics in migraine: catching biomarkers for a predictable disease control

“…Several data suggest that the transcriptional level in these genes and also the role played by environmental factors are important aspects to consider unless assessing a drug's response [2,[10][11][12]. However, since these enzymes act mainly at the hepatic level, analysis of their expression through functional genomics or epigenetic analysis seems unrealistic.…”

“…The fact that only 50% of migraine patients adequately respond to acute and prophylaxis therapies always suggested questions that only pharmacogenomics (PGx) is able to clarify. The great expectations held by researchers in the field of migraine genetics turned into a widespread disenchantment, since the application goal has been missing [2]. Indeed, after a decade of brilliant genetic evidence on rare forms of migraine, such as familial hemiplegic migraine, very little or almost nothing has been translated to therapeutic management of the most common migraine forms [2][3][4][5][6].…”

“…Moreover, it is evident that migraine patients react differently to given drugs. A patient's efficacy for a therapeutic substance are subject to its interaction with DNA/ RNA variations of the patient themselves and might produce significant relapses, not only in terms efficacy but also according to a safe reduction for what concerns global risk of adverse events and a certain profit in terms of health expenses [2,7,8].…”

Clinical implications of neuropharmacogenetics

“…The positive associations found with genetic variants in the serotonin transporter have recently not been replicated [142]. A few studies have also considered medication overuse headache as a potential pharmaco-genetic interaction and have found association between this disorder and genetic polymorphisms in the dopamine neurotransmitter system (DAT, MAOA, DRD4, DRD2) and the BDNF [143][144][145] known to predispose patients to drug abuse behaviour. Monoamine oxidase A (MAOA) has also been associated with triptan overuse [146].…”