Center for Neurobiology and Behavior, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Cold Spring Harb Perspect Med. 2013 Jul 1;3(7):a012203. doi: 10.1101/cshperspect.a012203.
Alcohol addiction is one of the most common and devastating diseases in the world. Given the tremendous heterogeneity of alcohol-addicted individuals, it is unlikely that one medication will help nearly all patients. Thus, there is a clear need to develop predictors of response to existing medications. Naltrexone is a μ-opioid receptor antagonist, which has been approved in the United States for treatment of alcohol addiction since 1994. It has limited efficacy, in part because of noncompliance, but many patients do not respond despite high levels of compliance. There are reports that a missense single nucleotide polymorphism (rs179919 or A118G) in the μ-opioid receptor gene predicts a favorable response to naltrexone if an individual carries a "G" allele. This work will review the evidence for this hypothesis. The data are promising that the "G" allele predisposes to a beneficial naltrexone response among alcohol-addicted persons, but additional research is needed to prove this hypothesis in prospective clinical trials.
酒精成瘾是世界上最常见和最具破坏性的疾病之一。鉴于酒精成瘾个体存在巨大的异质性，不太可能有一种药物能帮助几乎所有患者。因此，显然需要开发对现有药物反应的预测指标。纳曲酮是一种μ-阿片受体拮抗剂，自 1994 年以来已获美国批准用于治疗酒精成瘾。它的疗效有限，部分原因是不遵守规定，但许多患者尽管遵守规定的程度很高，但仍没有反应。有报道称，μ-阿片受体基因中的错义单核苷酸多态性（rs179919 或 A118G）预测，如果个体携带“G”等位基因，纳曲酮的反应良好。这项工作将回顾这一假设的证据。有数据表明，“G”等位基因使酒精成瘾者对纳曲酮的反应更有利，但需要进一步的研究来在前瞻性临床试验中证明这一假设。
