Stroke neurobiobanking and genomic research in Africa: a narrative review
摘要
Stroke represents a significant public health challenge globally, with the African populations bearing a disproportionate burden of its impact. The 2019 update on global stroke statistics revealed a steady rise in stroke incidence across low-income and middle-income countries (LMICs), with LMICs accounting for the majority of stroke deaths and disability. Neurobiobanking and genomics have emerged as promising tools in stroke research, yet their integration remains to be developed in Africa. This narrative review provides an overview of stroke epidemiology, neurobiobanking and genomics integration in stroke research, aiming to synthesize existing knowledge and explore their potential contributions to personalized medicine in Africa.
DiscussionNeurobiobanking is pivotal for stroke research in Africa. This infrastructure facilitates research on stroke genetics and biomarkers, important for personalized medicine in stroke treatment. Understanding genetic factors independent of common risk factors like hypertension is essential for identifying stroke risk and recovery genes. Biomarker research is vital for comprehending stroke pathophysiology and developing targeted interventions. Establishing standardized protocols and ethical guidelines for sample collection is important to maintain the quality and integrity of neurobiobank samples. Initiatives like the Human Hereditary and Health in Africa (H3Africa) project have led to the establishment of biorepositories in Africa, such as the Integrated Biorepository of H3Africa Uganda (IBRH3AU) and the Institute of Human Virology Nigeria H3Africa Biorepository (I-HAB). Additionally, stroke-focused biobanks such as the IBADAN Brain Bank and the Stroke Investigative Research and Education Network (SIREN) are collecting brain tissues for research purposes. African populations exhibit a higher prevalence of hemorrhagic and small vessel ischemic stroke types. Candidate gene studies (CGS) and genome-wide association study (GWAS) have identified genes predisposing Africans to stroke, some of which are low-density lipoprotein receptor-related protein 1 (LRP1), apolipoprotein L1 (APOL1), cyclin-dependent kinase inhibitor 2A/2B (CDKN2A/CDKN2B), histone deacetylase 9 (HDAC9), and AADACL2 gene, among others.
ConclusionStroke neurobiobanking and genomic research offer promising avenues for understanding stroke pathophysiology and developing personalized treatments. Collaboration, data sharing, and ethical considerations are important for progress. Advancing technology and translating research into clinical practice can improve the outcomes for stroke patients.