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代谢型谷氨酸受体 1 基因内的多态性与抑郁表型有关。

Polymorphisms within the metabotropic glutamate receptor 1 gene are associated with depression phenotypes.

机构信息

Max Planck Institute of Psychiatry, Kraepelinstr. 10, D-80804 Munich, Germany.

出版信息

Psychoneuroendocrinology. 2012 Apr;37(4):565-75. doi: 10.1016/j.psyneuen.2011.09.003. Epub 2011 Sep 29.

Abstract

OBJECTIVES

Glutamate has been implicated in the pathophysiology and treatment of mood disorders possibly by affecting the regulation of the hypothalamus-pituitary-adrenocortical (HPA) axis. Growing evidence suggests an important role of the metabotropic glutamate receptor 1 (mGlu1) in depression-related phenotypes. To test whether these findings can also be supported by human genetics data, we explored polymorphisms within the metabotropic glutamate receptor 1 gene (GRM1) for their association with unipolar depression (UPD) as well as with biological phenotypes of this disorder.

METHODS

We first tested the association of 43 tag-SNPs covering the GRM1 locus with UPD in 350 patients and 370 matched controls. We then investigated the effects of the associated SNPs on hippocampal glutamate levels estimated using ¹H-MR-spectroscopy (¹H-MRS) and on endocrine measures from the combined dexamethasone-suppression/CRH stimulation (dex/CRH) test.

RESULTS

Within the GRM1 locus, 22 SNPs showed nominally significant association with UPD, of which 6 withstood corrections for multiple testing (rs2268666 with best allelic p=7.0×10⁻⁵). Supportive evidence for an association with UPD was gained from a second independent sample with 904 patients and 1012 controls. Furthermore, patients homozygous for the non-risk genotypes showed reduced hippocampal glutamate levels as measured by ¹H-MRS, a more pronounced normalization of HPA-axis hyperactivity as well as a better antidepressant treatment outcome.

CONCLUSIONS

These results suggest that the combination of genetic and biological markers may allow to subgroup patients into etiopathogenetically more relevant subcategories which could guide clinicians in their antidepressant treatment choices.

摘要

目的

谷氨酸可能通过影响下丘脑-垂体-肾上腺皮质(HPA)轴的调节而参与心境障碍的病理生理学和治疗。越来越多的证据表明代谢型谷氨酸受体 1(mGlu1)在与抑郁相关的表型中起着重要作用。为了测试这些发现是否也可以得到人类遗传学数据的支持,我们探索了代谢型谷氨酸受体 1 基因(GRM1)内的多态性与单相抑郁(UPD)以及该疾病的生物学表型的关联。

方法

我们首先测试了 43 个覆盖 GRM1 基因座的标签单核苷酸多态性与 350 名患者和 370 名匹配对照者的 UPD 之间的关联。然后,我们研究了相关 SNP 对使用 1H-MR 光谱(1H-MRS)估计的海马回谷氨酸水平的影响,以及对联合地塞米松抑制/CRH 刺激(dex/CRH)试验的内分泌测量的影响。

结果

在 GRM1 基因座内,22 个 SNP 与 UPD 呈显著关联,其中 6 个 SNP 在多重检验校正后仍具有统计学意义(最佳等位基因 p=7.0×10⁻⁵)。来自第二个包含 904 名患者和 1012 名对照者的独立样本的证据进一步支持了与 UPD 的关联。此外,1H-MRS 测量的患者纯合非风险基因型的海马回谷氨酸水平降低,HPA 轴活性亢进的正常化更明显,抗抑郁治疗效果更好。

结论

这些结果表明,遗传和生物学标志物的组合可能允许将患者分为更具病因学相关性的亚组,这可以指导临床医生在抗抑郁治疗选择中。

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