Carlino Davide, De Vanna Maurizio
Riv Psichiatr. 2011 May-Jun;46(3):155-71. doi: 10.1708/889.9806.
While for other complex disorders like cancer a limited number of markers are at hand, there are currently no biomarkers available for major depression. A major goal is therefore the identification of biomarkers that can categorize subsets of patients in a consistent manner. Biomarkers for mood disorders provides discovery strategies from scientists in academia and pharma and biotech industries. This will allow a more precise definition of psychiatric disorders and in turn facilitate investigations of the pathophysiology and enhance the ability for patient treatment. Moreover, pharmacogenomics is a new area of medicine that uses the data emerging from the sequencing of the human genome to predict drug responses and to identify new targets for treatment. Pharmacogenomics is of particular relevance to depression, which is a common and complex disorder of unknown cause for which prediction of treatment response and identification of new targets for therapeutics is of crucial importance. Depression represents major health problems in the 21 st century, and is major causes of disability. The fundamental biological mechanisms underlying the effects of psychopharmacological treatments are unknown. Pharmacogenomic approaches to psychiatric disorders offer the possibility to identify a network of genes that may underlie the mechanisms of psychotropic drugs, and the possibility of identifying groups of individuals who are more likely to respond to specific drugs or to suffer from side effects. Such efforts will lead to novel therapeutic targets for drug development and to the individualization of treatment, maximizing the likelihood of positive therapeutic outcomes. In this paper we review studies that has been focused on the prediction of antidepressants response based on genotype. We will also address the methodological issues that are emerging in the context of clinical pharmacogenomic and biomarker's investigation.
虽然对于癌症等其他复杂疾病来说,手头已有数量有限的标志物,但目前尚无用于重度抑郁症的生物标志物。因此,一个主要目标是识别能够以一致方式对患者亚组进行分类的生物标志物。《情绪障碍的生物标志物》介绍了学术界以及制药和生物技术行业科学家的发现策略。这将使精神疾病的定义更加精确,进而有助于对病理生理学进行研究,并提高患者治疗能力。此外,药物基因组学是医学的一个新领域,它利用人类基因组测序产生的数据来预测药物反应并识别新的治疗靶点。药物基因组学与抑郁症尤其相关,抑郁症是一种常见且复杂的疾病,病因不明,因此预测治疗反应和识别新的治疗靶点至关重要。抑郁症是21世纪的主要健康问题,也是致残的主要原因。精神药物治疗效果背后的基本生物学机制尚不清楚。针对精神疾病的药物基因组学方法有可能识别出可能构成精神药物作用机制基础的基因网络,以及识别出更可能对特定药物有反应或出现副作用的个体群体。这些努力将为药物开发带来新的治疗靶点,并实现治疗个体化,从而最大程度地提高积极治疗结果的可能性。在本文中,我们综述了基于基因型预测抗抑郁药反应的研究。我们还将探讨临床药物基因组学和生物标志物研究背景下出现的方法学问题。