Schellekens Arnt
UMC St Radboud, afd. Psychiatrie, Nijmegen, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(23):A5725.
This article describes the current scientific knowledge regarding pharmacogenetic predictors of treatment outcome for substance-dependent patients. PubMed was searched for articles on pharmacogenetics and addiction. This search yielded 53 articles, of which 27 were selected. The most promising pharmacogenetic findings are related to the treatment of alcohol dependence. Genetic variation in the µ-opioid receptor (OPRM1) and the serotonin transporter (5-HTTLPR) appear to be associated with treatment outcomes for naltrexone and ondansetron, respectively. Genetic variation in CYP2D6 is related to efficacy of methadone treatment for opiate dependence. Pharmacogenetics may help explain the great inter-individual variation in treatment response. In the future, treatment matching, based on genetic characteristics of individual patients, could lead to a 'personalized medicine' approach. Pharmacogenetic matching of naltrexone in alcohol-dependent carriers of the OPRM1 G-allele currently seems most promising.
本文描述了目前有关物质依赖患者治疗结果的药物遗传学预测指标的科学知识。通过在PubMed上搜索有关药物遗传学和成瘾的文章。此次搜索得到53篇文章，从中选取了27篇。最有前景的药物遗传学研究结果与酒精依赖的治疗有关。μ-阿片受体（OPRM1）和5-羟色胺转运体（5-HTTLPR）的基因变异似乎分别与纳曲酮和昂丹司琼的治疗结果相关。CYP2D6的基因变异与美沙酮治疗阿片类药物依赖的疗效有关。药物遗传学可能有助于解释个体治疗反应的巨大差异。未来，基于个体患者的遗传特征进行治疗匹配，可能会导致一种“个性化医疗”方法。目前，对于携带OPRM1 G等位基因的酒精依赖者，纳曲酮的药物遗传学匹配似乎最有前景。
