Background The pathogenic mechanism of brain arteriovenous malformation (bAVM) is poorly understood. A growing body of evidence indicates that genetic factors play crucial roles in bAVM. This study examined genetic variants associated with bAVM through quantitative synthesis and qualitative description of literature.
Methods Five databases were searched to gather potentially relevant articles published up to January 2022. STATA 14.0 software was used for statistical analyses. Pooled odds ratios and 95% confidence intervals were calculated with random effect models, and heterogeneity was assessed using the Cochran Q test and quantified with the I2 test. Sensitivity and publication bias were analyzed to test the robustness of the associations. Variants identified in only one study or with great heterogeneity were not suitable for pooling association analysis, and therefore a qualitative systematic review was performed.
Results In total, 30 papers were included in a systematic review involving 4709 cases and 7832 controls, where 17 papers were in a meta-analysis. A suggested association of bAVM was observed with ACVRL1 rs2071219 in the additive model and CDKN2B-AS1 rs1333040 in the recessive and additive models. Other variants of genes that could not be analyzed were summarized by qualitative description. These genes were mostly involved in bone morphogenic protein/transforming growth factor beta (BMP/TGF-β), vascular endothelial growth factor/vascular endothelial growth factor receptor (VEGF/VEGFR), and RAS-mitogen activated protein kinase (MAPK) signaling and inflammation.
Conclusions According to our meta-analysis, ACVRL1 rs2071219 and CDKN2B-AS1 rs1333040 were potentially associated with bAVM. Multiple pathological signaling pathways could affect disease development. Future studies should aim to determine the interaction of candidate genes with environmental risk factors and to elucidate detailed mechanisms of action of variants and genes.
- Arteriovenous Malformation
Data availability statement
Data are available upon reasonable request. Data not included in this article will be shared when other investigators request to replicate procedures and results. Researchers can contact corresponding author for data access.
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JY and YL contributed equally.
Contributors JL: data curation, statistic analysis, investigation, validation, resources and software, writing the original draft, and review and editing. YL: data curation, investigation, validation, resources and software, and funding acquisition. HZ and DY: data curation and investigation. CL: statistic analysis. WJ: project administration and supervision, and funding acquisition. JY: guarantor, project administration and supervision, methodology, funding acquisition, statistic analysis, and writing, review, and editing.
Funding This study was supported by grants from the Hunan Province Nature Science Foundation, China (2021JJ30911, 2021JJ31077, 2021JJ31121) and the Financial Science and Technology Project of Hunan Province, China (422000008).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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