Levin Gary M, Bowles Toya M, Ehret Megan J, Langaee Taimour, Tan Jennifer Y, Johnson Julie A, Millard William J
College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Mol Diagn Ther. 2007;11(3):155-60. doi: 10.1007/BF03256237.
Depression is thought to involve, in part, dysregulation of serotonergic neurotransmission. In depressed individuals, the number of serotonin receptors, including the 5-hydroxytryptamine (serotonin)-1A (5-HT(1A)) autoreceptors, are increased. Clinical improvement with selective serotonin reuptake inhibitors (SSRIs) is not usually observed until several weeks after treatment initiation. This delay may be due to the time it takes for the autoreceptors to downregulate. Roughly one-third of patients with depression do not respond to an initial trial of antidepressant medication treatment, possibly as a result of structural variations in the 5-HT(1A) receptor.
This study was designed to determine the allelic frequency of seven 5-HT(1A) receptor polymorphisms in a depressed versus a nondepressed population, and in SSRI responders versus nonresponders. All the polymorphisms studied are single nucleotide polymorphisms (SNPs) in the HTR1A gene, which encodes 5-HT(1A). Seven prevalent SNPs were included in the analysis.
The study showed no relationship between any of the HTR1A polymorphisms and SSRI responders versus nonresponders.
While the study has several limitations, the results are consistent with a growing body of literature that suggests that the pharmacogenetics of depression (an inherently complex disorder) may turn out to be multifactorial, and may include the HTR1A gene in concert with other serotonin-related genes.
抑郁症被认为部分涉及血清素能神经传递的失调。在抑郁症患者中,包括5-羟色胺(血清素)-1A(5-HT(1A))自身受体在内的血清素受体数量会增加。选择性血清素再摄取抑制剂(SSRI)治疗通常在开始治疗数周后才会观察到临床改善。这种延迟可能是由于自身受体下调所需的时间。大约三分之一的抑郁症患者对初始抗抑郁药物治疗无反应,这可能是5-HT(1A)受体结构变异的结果。
本研究旨在确定抑郁症患者与非抑郁症患者以及SSRI反应者与无反应者中7种5-HT(1A)受体多态性的等位基因频率。所有研究的多态性均为编码5-HT(1A)的HTR1A基因中的单核苷酸多态性(SNP)。分析中纳入了7种常见的SNP。
研究表明,任何HTR1A基因多态性与SSRI反应者和无反应者之间均无关联。
虽然该研究有几个局限性,但结果与越来越多的文献一致,这些文献表明抑郁症(一种本质上复杂的疾病)的药物遗传学可能是多因素的,可能包括HTR1A基因以及其他与血清素相关的基因。