Zanardi R, Serretti A, Rossini D, Franchini L, Cusin C, Lattuada E, Dotoli D, Smeraldi E
Department of Psychiatry, Vita-Salute University, San Raffaele Institute, Via Prinetti, Milan 29-20127, Italy.
Biol Psychiatry. 2001 Sep 1;50(5):323-30. doi: 10.1016/s0006-3223(01)01118-0.
It has been recently reported that the short variant of the serotonin transporter (5-HTT) gene-linked functional polymorphic region (5-HTTLPR) influences the antidepressant response to certain selective serotonin reuptake inhibitors. The aim of the present study was to test this finding in a sample of major and bipolar depressives, with or without psychotic features.
One hundred fifty-five inpatients were treated with fluvoxamine 300 mg and either placebo or pindolol in a double-blind design for 6 weeks. The severity of depressive symptoms was weekly assessed with the Hamilton Rating Scale for Depression. Allelic variation of 5-HTTLPR in each subject was determined using a polymerase chain reaction-based technique.
5-HTTLPR short variant was associated with a poor response to fluvoxamine treatment, independently from the recorded clinical variables. More specifically, the diagnosis, the presence of psychotic features, and the severity of depressive symptomatology did not influence this association. Conversely, pindolol augmentation may ameliorate the rate of response in 5-HTTLPR short variant subjects, thus reducing the difference in the response rate among the genotype variants.
If confirmed, these results may improve patient care by helping the clinician to individualize treatment according to the patient's genetic 5-HTTLPR pattern.
最近有报道称，血清素转运体（5-HTT）基因连锁功能多态区（5-HTTLPR）的短变体影响对某些选择性血清素再摄取抑制剂的抗抑郁反应。本研究的目的是在伴有或不伴有精神病性特征的重度抑郁症和双相抑郁症患者样本中验证这一发现。
155名住院患者采用双盲设计，接受300毫克氟伏沙明治疗，并联合使用安慰剂或吲哚洛尔，为期6周。每周使用汉密尔顿抑郁评定量表评估抑郁症状的严重程度。采用基于聚合酶链反应的技术测定每个受试者5-HTTLPR的等位基因变异。
5-HTTLPR短变体与氟伏沙明治疗反应不佳相关，与所记录的临床变量无关。更具体地说，诊断、精神病性特征的存在以及抑郁症状的严重程度均不影响这种关联。相反，吲哚洛尔增效可能改善5-HTTLPR短变体受试者的反应率，从而缩小基因型变体之间的反应率差异。
如果得到证实，这些结果可能通过帮助临床医生根据患者的5-HTTLPR基因模式进行个体化治疗来改善患者护理。
