Stewart Juhani Akseli, Kampman Olli, Huuhka Martti, Anttila Sami, Huuhka Kaija, Lehtimäki Terho, Leinonen Esa
University of Tampere, Medical School, 33014 Tampere, Finland.
Neurosci Lett. 2009 Jul 24;458(3):122-5. doi: 10.1016/j.neulet.2009.04.057. Epub 2009 May 4.
The angiotensin I-converting enzyme gene (ACE) has been repeatedly suggested as a major gene affecting affective disorders and their treatment, but the study results have been ambiguous so far. The primary purpose of this study was to compare the effects of the ACE genotype distributions and treatment response to electroconvulsive therapy (ECT) in patients with major depressive disorder (MDD). The association in ACE genotypes and the age at onset of depression was also analyzed and these gene distributions were also compared between patients and healthy controls. The study included 119 treatment-resistant MDD patients who were referred to ECT treatment, and 392 voluntary blood donors as controls. All participants were tested for their ACE genotype, and all study patients were evaluated both before and after treatment. The Montgomery-Asberg Depression Scale (MADRS) was used as a primary efficacy evaluating method. The ACE genotype was not associated in treatment results for MDD. However, younger onset age of primary depression was associated with the I/D genotype in the whole patient group. The finding was partly gender dependent; in male patients the I allele carried a higher risk of earlier depression onset age, while in female patients the higher risk was seen only in the heterozygous I/D allele carriers. Distributions of these genotypes or alleles did not differ between patients and controls. The studied ACE genotype was not associated with ECT results but may be associated with age of onset of the illness in patients with MDD.
血管紧张素I转换酶基因（ACE）一再被认为是影响情感障碍及其治疗的主要基因，但迄今为止研究结果仍不明确。本研究的主要目的是比较重度抑郁症（MDD）患者中ACE基因型分布及对电休克治疗（ECT）的治疗反应。还分析了ACE基因型与抑郁症发病年龄之间的关联，并比较了患者与健康对照之间的这些基因分布。该研究纳入了119例转诊接受ECT治疗的难治性MDD患者以及392名自愿献血者作为对照。对所有参与者进行ACE基因型检测，所有研究患者在治疗前后均进行评估。蒙哥马利-艾斯伯格抑郁量表（MADRS）用作主要疗效评估方法。ACE基因型与MDD的治疗结果无关。然而，在整个患者组中，原发性抑郁症发病年龄较轻与I/D基因型有关。这一发现部分取决于性别；在男性患者中，I等位基因携带较早抑郁症发病年龄的较高风险，而在女性患者中，较高风险仅见于杂合I/D等位基因携带者。患者与对照之间这些基因型或等位基因的分布没有差异。所研究的ACE基因型与ECT结果无关，但可能与MDD患者的发病年龄有关。
