Mihara K, Suzuki A, Kondo T, Yasui-Furukori N, Ono S, Otani K, Kaneko S, Inoue Y
Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan.
Am J Med Genet. 2001 Apr 8;105(3):271-4. doi: 10.1002/ajmg.1303.
The dopamine D2 receptor (DRD2) gene has a Taq1 A restriction fragment length polymorphism yielding two alleles, A1 and A2. We have previously shown that female patients with the A1 allele show greater prolactin response to nemonapride, a selective antagonist for D2-like dopamine receptors, in schizophrenic patients. In the present study, the relationship between this polymorphism and prolactin response to bromperidol was investigated in 32 untreated schizophrenic inpatients (16 males, 16 females). The daily dose of bromperidol was fixed at 6 (n = 10), 12 (n = 13), or 18 mg (n = 9) during a 2-week treatment period. Taq1 A genotypes were determined by PCR method. Plasma prolactin concentration was measured by radioimmunoassay. Plasma concentration of bromperidol was measured by HPLC method. The subjects were divided into four subgroups by gender and the genotypes, i.e., 10 males and 11 females with the A1 allele, 6 males and 5 females with no A1 allele. The females with the A1 allele had the highest Delta prolactin (the change from the pretreatment concentration)/bromperidol concentration ratio among the other groups (P < 0.05). The present study thus suggests that female patients with the A1 allele show greater prolactin response to bromperidol, who may have a high risk for adverse effects associated with neuroleptic-induced hyperprolactinemia.
多巴胺D2受体(DRD2)基因存在Taq1 A限制性片段长度多态性,产生两个等位基因,A1和A2。我们之前已经表明,在精神分裂症患者中,携带A1等位基因的女性患者对奈莫必利(一种D2样多巴胺受体的选择性拮抗剂)的催乳素反应更大。在本研究中,我们调查了32名未经治疗的精神分裂症住院患者(16名男性,16名女性)中这种多态性与对溴哌利多的催乳素反应之间的关系。在为期2周的治疗期间,溴哌利多的每日剂量固定为6mg(n = 10)、12mg(n = 13)或18mg(n = 9)。通过PCR方法确定Taq1 A基因型。通过放射免疫测定法测量血浆催乳素浓度。通过HPLC方法测量血浆溴哌利多浓度。根据性别和基因型将受试者分为四个亚组,即10名携带A1等位基因的男性和11名携带A1等位基因的女性,6名不携带A1等位基因的男性和5名不携带A1等位基因的女性。携带A1等位基因的女性在其他组中具有最高的Δ催乳素(从治疗前浓度的变化)/溴哌利多浓度比值(P < 0.05)。因此,本研究表明,携带A1等位基因的女性患者对溴哌利多的催乳素反应更大,她们可能有更高的风险发生与抗精神病药物引起的高催乳素血症相关的不良反应。