De Luca Vincenzo, Müller Daniel J, Hwang Rudi, Lieberman Jeffrey A, Volavka Jan, Meltzer Herbert Y, Kennedy James L
Department of Psychiatry, Centre for Addiction and Mental Health, Neurogenetics Section, University of Toronto, Toronto, ON, Canada.
Hum Psychopharmacol. 2007 Oct;22(7):463-7. doi: 10.1002/hup.868.
The 5HT2C receptor (HTR2C) has been hypothesized to represent an important modulator in feeding behavior. Evidence was based on the observation that knock-out mice for the HTR2C receptor gene develop obesity and that many antipsychotics (AP) with potent HTR2C antagonism may induce weight gain in susceptible individuals. Pharmacogenetic studies focusing either on the Cys23Ser polymorphism or on the -759C/T promoter polymorphism of the X-linked HTR2C receptor gene revealed significant findings for the -759C/T polymorphism, however, no study has performed haplotype analyses for both polymorphisms.
We analyzed three functional polymorphisms (Cys23Ser, -759C/T, and (GT)12-18/(CT) 4-5) of the HTR2C in 139 schizophrenic patients mainly treated with clozapine. Weight gain was assessed over a time course of 6-14 weeks (mean 8.2 weeks).
Single marker and haplotype analysis revealed no significant associations with AP-induced weight gain. The haplotype Long-C-Ser was protective against weight gain, but the number of subjects available for that analysis was small.
Our pilot study did not detect any significant haplotype conferring risk for antipsychotic-induced weight gain although the statistical model took into account the X-linked heterogeneity and did correct for confounding factors (i.e., ethnicity, medications, clinical response, time of assessment).
5-羟色胺2C受体(HTR2C)被假设为进食行为的重要调节因子。证据基于以下观察结果:HTR2C受体基因敲除小鼠会出现肥胖,并且许多具有强效HTR2C拮抗作用的抗精神病药物(AP)可能会使易感个体体重增加。针对X连锁HTR2C受体基因的Cys23Ser多态性或-759C/T启动子多态性的药物遗传学研究揭示了-759C/T多态性的显著结果,然而,尚无研究对这两种多态性进行单倍型分析。
我们分析了139例主要接受氯氮平治疗的精神分裂症患者中HTR2C的三种功能性多态性(Cys23Ser、-759C/T和(GT)12-18/(CT)4-5)。在6至14周(平均8.2周)的时间内评估体重增加情况。
单标记和单倍型分析显示与AP引起的体重增加无显著关联。单倍型Long-C-Ser对体重增加有保护作用,但可用于该分析的受试者数量较少。
我们的初步研究未发现任何显著的单倍型会增加抗精神病药物引起体重增加的风险,尽管统计模型考虑了X连锁异质性并对混杂因素(即种族、药物、临床反应、评估时间)进行了校正。