title: Relationship between endothelial nitric oxide synthase (eNOS) and natural history of intracranial aneurysms: meta-analysis.
abstract: The aneurysmal subarachnoid hemorrhage is a major public health problem described as a sudden drastic event with no warning symptoms and high morbidity and mortality rates. The role of the endothelial isoform of nitric oxide synthase gene polymorphism in intracranial aneurysms (IAs) is still a matter of controversy with divergent findings among European, American, and Asian populations. Our study purposed to test the association between intracranial aneurysms formation and nitric oxide gene polymorphisms through a systematic review and meta-analysis. Systematic search on Medline, Lilacs, and EMBASE was performed. The primary search resulted in 139 papers, out of which 9 met our inclusion criteria after a full text analysis. The dominant T786C model found a significant association with IA (OR 1.22, 95 % CI 1.04-1.44, p = 0.01), so did studies of the recessive T786C model (OR 0.37, 95 % CI 0.30-0.45, p < 0.0001) but with opposite effect. Our findings support the presence of the T786C polymorphism as a predictor for the development of intracranial aneurysm in the cerebral vascular system. More studies are necessary in order to elucidate the pathways of the endothelial nitric oxide synthase (eNOS) in cerebrovascular diseases and in defining how different allelic combinations of the eNOS gene single-nucleotide polymorphism (SNP) could favor this pathological process.
authors.affiliation: Department of Neurosurgery, Universidade Federal do Pará, Rua Bernal do Couto, 106; Apt 1202, 66055-080, Belem, PA, Brazil. ericpaschoal@yahoo.com.br.|Department of Neurosurgery, Universidade de São Paulo, São Paulo, SP, Brazil. ericpaschoal@yahoo.com.br.
authors.forename: Eric Homero Albuquerque
authors.initials: EHA
authors.lastname: Paschoal
authors.affiliation: Department of Neurosurgery, Universidade do Estado do Pará, Belém, PA, Brazil.
authors.forename: Vitor Nagai
authors.initials: VN
authors.lastname: Yamaki
authors.affiliation: Department of Surgery, Universidade do Estado do Pará, Belém, PA, Brazil.
authors.forename: Renan Kleber Costa
authors.initials: RKC
authors.lastname: Teixeira
authors.affiliation: Department of Neurosurgery, Universidade de São Paulo, São Paulo, SP, Brazil.|Department of Neurology, Universidade Federal do Pará, Belem, PA, Brazil.
authors.forename: Fernando Mendes
authors.initials: FM
authors.lastname: Paschoal Junior
authors.affiliation: Department of Neurosurgery, Universidade do Estado do Pará, Belém, PA, Brazil.
authors.forename: Glaucia Suzanna
authors.initials: GS
authors.lastname: Jong-A-Liem
authors.affiliation: Department of Neurosurgery, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Department of Genetics, Universidade Federal do Pará, Belem, PA, Brazil.
authors.forename: Elizabeth Sumi
authors.initials: ES
authors.lastname: Yamada
authors.affiliation: Department of Genetics, Universidade Federal do Pará, Belem, PA, Brazil.
authors.forename: Ândrea
authors.initials: Â
authors.lastname: Ribeiro-Dos-Santos
authors.affiliation: Department of Neurosurgery, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Edson
authors.initials: E
authors.lastname: Bor-Seng-Shu
mesh_terms: D020022:Genetic Predisposition to Disease; D006801:Humans; D002532:Intracranial Aneurysm / Q000235:genetics; D052250:Nitric Oxide Synthase Type III / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D013345:Subarachnoid Hemorrhage / Q000235:genetics*
chemical_list: C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III
keywords: Endothelial nitric oxide synthase; Genetic polymorphisms; Intracranial aneurysms; Meta-analysis; Subarachnoid hemorrhage