A Study of Apolipoprotein E (Apo E) Gene Polymorphisms in Chronic Spinal Cord Compression and their Relation with Cervical Spondylotic Myelopathy | ||||
| Bulletin of Egyptian Society for Physiological Sciences | ||||
| Article 12, Volume 31, Issue 1, December 2011, Page 165-178 PDF (506.9 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/besps.2011.35979 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Eman Badr* 1; Manal Safan1; Mahmoud Hadhoud2 | ||||
| 1Medical Biochemistry Department, Faculty of Medicine – Minoufiya University | ||||
| 2Orthopedic Surgery Department, Faculty of Medicine – Minoufiya University | ||||
| Abstract | ||||
| Object: Cervical spondylotic myelopathy is a common disease of multifactorial origin in which neural and vascular processes contribute to the final neurological damage. Apolipoprotein (Apo) E is a multifunctional protein with central roles in lipid metabolism and neurobiology. The aim of present study is to determine the possible relationship of polymorphisms of apolipoprotein E (Apo E) gene with occurrence of cervical spondylotic myelopathy (CSM) in spinal cord compression patients. Methods: The present study was carried out on 60 consecutive patients (34 men, 26 women), with spinal cord compression who underwent anterior microsurgical decompression. The studied subjects were classified into two groups: Group (I): It included 32 patients with chronic spinal cord compression without cervical spondylotic myelopathy (18 males and 14 females), Group (II): It included 28 patients with chronic spinal cord compression with cervical spondylotic myelopathy (16 males and 12 females). Neurological deficits were classified according to the modified Japanese Orthopedic Association Scale. All studied persons were subjected to full history taking, general clinical examination, MRI and laboratory investigations including ApoE genotyping which was carried out by isolation of DNA from venous blood samples. The APOE genotypes were determined by polymerase chain reaction followed by restriction enzyme digestion (PCR-RFLP) analysis followed by agarose gel electrophoresis of digested fragments. Results: The results of the present study showed a significant increase in group II when compared to group I as regarding the age (P<0.05), duration of symptoms (P<0.001), number of affected segment s(P<0.001) and a significant decrease in the diameter of spinal canal (P< 0.001), whereas no significant difference regarding gender. On comparing the two studied groups a significant difference was found as regards apolipoprotein E genotype distribution with increased frequency of the E4 genotype in group II, the E4 allele was significantly increased in patients with CSM when compared with the other group without CSM, whereas no significant differences in the distribution of E2 and E3 alleles. The odds ratio for E4 allele was 3.2 (95% CI: 1.3-9.8). Multiple regression analysis revealed that duration of symptoms, number of affected segments and diameter of spinal canal are independent risk factors for CSM. Conclusions: It could be concluded that E4 polymorphism of the ApoE gene is associated with the susceptibility to CSM in spinal cord compression and that, longer duration of symptoms, smaller diameter of spinal canal and more number of affected segments are risk factors for such complication. The presence of the ApoE E4 allele is an independent predictor for presence of CSM. Further studies are needed to evaluate the type of ApoE polymorphism in patient with improvement or no improvement after surgery. | ||||
| Keywords | ||||
| cervical spondylotic myelopathy; apolipoprotein E; apolipoprotein E polymorphism; spinal cord compression | ||||
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