韩国老年抑郁症患者单胺转运蛋白基因多态性与抗抑郁反应。

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Kim H, Lim SW, Kim S, Kim JW, Chang YH, Carroll BJ, Kim DK

韩国老年抑郁症患者单胺转运蛋白基因多态性与抗抑郁反应。

《美国医学协会杂志》上。2006 10月4日;296(13):1609-18。

PubMed ID

17018806 (PubMed视图

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摘要

背景:血清素转运体基因(5-HTT)的多态性可能会影响抗抑郁药对选择性血清素再摄取抑制剂(SSRIs)的反应。去甲肾上腺素转运体(NET)是去甲肾上腺素再摄取抑制剂(NRIs)的类似靶点。目的:确定对SSRIs或NRIs的抗抑郁反应是否与相应单胺转运蛋白的遗传多态性相关。设计、环境和患者:一项为期6周的自然治疗研究，对241名韩国重度抑郁症住院和门诊患者进行了盲法结果评估。从1998年3月到2003年2月，该研究招募了患者。干预措施:SSRI治疗(氟西汀或舍曲林;n = 136)或NRI(去甲替林;N = 105)抗抑郁药。4周时通过测量血浆浓度来评估依从性。对患者5-HTT启动子区(5-HTTLPR) s/l多态性、5-HTT内含子2 s/l变异和外显子9 NET G1287A变异进行基因分型。 MAIN OUTCOME MEASURES: An SSRI and NRI response (defined as > or =50% decrease in Hamilton Rating Scale for Depression score at 6 weeks). RESULTS: NRI response was associated with the NET G1287A polymorphism (odds ratio [OR], 7.54; 95% confidence interval [CI], 2.53-22.49; P<.001). An SSRI response was associated with the 5-HTT intron 2 s/l variation (OR, 20.11; 95% CI, 4.27-94.74; P<.001). The 5-HTTLPR was also associated with an SSRI response (OR, 3.34; 95% CI, 1.41-7.91; P = .006). In contrast to studies in white patients, the favorable allele for SSRI response was S 5-HTTLPR. The S 5-HTTLPR was associated also with NRI response (OR, 3.73; 95% CI, 1.32-10.53; P = .01). The NET polymorphism was not associated with an SSRI response. The NET G1287A GG genotype (56% of the population) was associated with better response to the NRI (83.3% [35/42]) than to SSRI (58.7% [44/75]) (OR, 3.52; 95% CI, 1.39-8.95; P = .006). Some genotype combinations were associated with high rates of antidepressant response and others with low rates of response. CONCLUSIONS: Monoamine transporter gene polymorphisms were associated with response to antidepressants with homologous monoamine transporter targets. Combinations of polymorphisms were informative for response and nonresponse. Confirmation of these preliminary findings would permit refined pharmacogenetic selection of antidepressant treatment.

引用本文的药物库数据

药物靶点

药物	目标	种类	生物	药理作用	行动
去甲替林	钠依赖性去甲肾上腺素转运体	蛋白质	人类	是的	抑制剂	细节