Bauer Lance O, Covault Jonathan, Harel Ofer, Das Sourish, Gelernter Joel, Anton Raymond, Kranzler Henry R
Department of Psychiatry, Alcohol Research Center, University of Connecticut School of Medicine, Farmington, Connecticut 06030-2103, USA.
Alcohol Clin Exp Res. 2007 Nov;31(11):1780-7. doi: 10.1111/j.1530-0277.2007.00517.x.
Previous studies demonstrated, and replicated, an association between single nucleotide polymorphisms (SNPs) within the GABRA2 gene and risk for alcohol dependence. The present study examines the association of a GABRA2 SNP with another definition of alcohol involvement and with the effects of psychosocial treatment.
European-American subjects (n = 812, 73.4% male) provided DNA samples for the analysis. All were participants in Project Matching Alcoholism Treatment to Client Heterogeneity (MATCH), a multi-center randomized clinical trial evaluating the efficacy of 3 types of psychosocial treatment for alcoholism: Cognitive Behavioral Therapy (CBT), Motivational Enhancement Therapy (MET), or twelve-step facilitation (TSF). The daily probabilities of drinking and heavy drinking were estimated during the 12-week treatment and 12-month post-treatment periods.
Subjects homozygous for the allele associated with low risk for alcohol dependence in previous studies had lower daily probabilities of drinking and heavy drinking in the present study. This low-risk allele was also associated with a greater difference in drinking outcomes between the treatments. In addition, it enhanced the relative superiority of TSF over CBT and MET. Population stratification was excluded as a confound using ancestry informative marker analysis.
The assessment of genetic vulnerability may be relevant to studies of the efficacy of psychosocial treatment: GABRA2 genotype modifies the variance in drinking and can therefore moderate power for resolving differences between treatments.
先前的研究证实并重复了γ-氨基丁酸A2受体基因(GABRA2)内单核苷酸多态性(SNP)与酒精依赖风险之间的关联。本研究考察了一种GABRA2 SNP与酒精使用的另一种定义以及心理社会治疗效果之间的关联。
欧美受试者(n = 812,73.4%为男性)提供DNA样本用于分析。所有受试者均参与了酒精成瘾治疗与患者异质性匹配项目(MATCH),这是一项多中心随机临床试验,评估三种心理社会治疗方法对酒精成瘾的疗效:认知行为疗法(CBT)、动机强化疗法(MET)或十二步促进法(TSF)。在12周治疗期和治疗后12个月期间估算每日饮酒和重度饮酒的概率。
在本研究中,先前研究中与低酒精依赖风险相关等位基因的纯合子受试者每日饮酒和重度饮酒的概率较低。这种低风险等位基因还与各治疗方法之间饮酒结果的更大差异相关。此外,它增强了TSF相对于CBT和MET的相对优势。使用祖先信息标记分析排除了群体分层作为混杂因素。
遗传易感性评估可能与心理社会治疗疗效的研究相关:GABRA2基因型改变饮酒差异,因此可以调节分辨各治疗方法之间差异的效能。