Kato Masaki, Fukuda Takeshi, Wakeno Masaki, Okugawa Gaku, Takekita Yoshiteru, Serretti Alessandro, Azuma Junichi, Kinoshita Toshihiko
Department of Neuropsychiatry, Kansai Medical University, 10-15 Fumizonocho, Moriguchi 570-8506, Japan.
Nihon Shinkei Seishin Yakurigaku Zasshi. 2009 Feb;29(1):23-31.
Variability in antidepressant response is due to genetic and environmental factors. Among genetic factors, the ones controlling for availability of the drug at the target site are interesting candidates. Rs6295C/G SNP in the 5-HT1A gene (HTR1A) has been found to affect the expression and function of HTR1A. In fact rs6295C/G is in strong linkage disequilibrium with other polymorphisms of HTR1A suggesting that those functional effects could be associated with polymorphisms other than or together with the synonymous rs6295C/G. In the present study we examined the possible association of a panel of markers in strong linkage disequilibrium of HTR1A with SSRI/SNRI response in 137 Japanese major depression subjects followed for 6 weeks. We observed a significant association of better response to antidepressant in rs10042486C/C (P < 0.0001), rs6295G/G (P < 0.0001) and rs1364043T/T (P = 0.018) genotype carriers, independently from clinical variables. Furthermore minor allele homozygous carriers in all these 3 SNPs were associated with treatment response by various assessments such as HAM-D score change over time (P = 0.001), week 2 (P < 0.0001), 4 (P = 0.007), and 6 (P = 0.048) as well as response rate (P = 0.0005) and remission rate (P = 0.004). We also pointed out the genotyping mis-definition of rs6295C/G in the previous four papers.
抗抑郁反应的变异性归因于遗传和环境因素。在遗传因素中,控制药物在靶位点可用性的因素是有趣的候选因素。已发现5-HT1A基因(HTR1A)中的Rs6295C/G单核苷酸多态性(SNP)会影响HTR1A的表达和功能。实际上,Rs6295C/G与HTR1A的其他多态性处于强连锁不平衡状态,这表明这些功能效应可能与同义的Rs6295C/G之外的多态性或与其一起相关。在本研究中,我们在137名日本重度抑郁症患者中随访6周,研究了HTR1A强连锁不平衡中的一组标记物与SSRI/SNRI反应之间的可能关联。我们观察到,rs10042486C/C(P < 0.0001)、rs6295G/G(P < 0.0001)和rs1364043T/T(P = 0.018)基因型携带者对抗抑郁药的反应明显更好,且与临床变量无关。此外,所有这3个SNP中的次要等位基因纯合携带者通过各种评估与治疗反应相关,如随时间变化的汉密尔顿抑郁量表(HAM-D)评分(P = 0.001)、第2周(P < 0.0001)、第4周(P = 0.007)和第6周(P = 0.048)以及反应率(P = 0.0005)和缓解率(P = 0.004)。我们还指出了前四篇论文中Rs6295C/G基因分型的错误定义。