Chen Andrew Ch, Morgenstern Jon, Davis Christine M, Kuerbis Alexis N, Covault Jonathan, Kranzler Henry R
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA.
Research Foundation for Mental Hygiene, Inc., New York State Psychiatric Institute, New York, USA.
J Alcohol Drug Depend. 2013 Jan 1;1(1):101. doi: 10.4172/2329-6488.1000101.
It is well known that naltrexone, an FDA-approved medication for treatment of alcohol dependence, is effective for only a subset of individuals. Recent studies have examined the utility of a functional A118G single nucleotide polymorphism (SNP) of the mu-opioid receptor gene as a predictor of naltrexone treatment response. Although the findings to date have generally been consistent with a moderating effect of the SNP, further evaluation of this hypothesis is warranted.
To evaluate whether problem drinkers with one or two copies of the 118G allele respond better to naltrexone treatment. The treatment goal in this cohort of high functioning men who have sex with men (MSM) was to reduce heavy drinking, rather than to promote abstinence.
112 subjects of European ancestry from a randomized clinical trial of naltrexone and behavioral therapy for problem drinking MSM were included in the analysis. Subjects were treated for 12 weeks with 100 mg/day of oral naltrexone hydrochloride. All participants received medical management with a modified version of the Brief Behavioral Compliance Enhancement Treatment (BBCET), alone or in combination with Modified Behavioral Self-control Therapy (MBSCT).
Naltrexone-treated subjects with one or two 118G alleles had a significantly greater percentage of non-hazardous drinking (NoH) (p < 0.01) than those treated with placebo or A118 homozygotes in either medication group.
These results are consistent with a modest moderating effect of the 118G allele on the reduction of heavy drinking by naltrexone treatment.
众所周知，纳曲酮是一种经美国食品药品监督管理局（FDA）批准用于治疗酒精依赖的药物，但仅对一部分个体有效。最近的研究探讨了μ-阿片受体基因功能性A118G单核苷酸多态性（SNP）作为纳曲酮治疗反应预测指标的效用。尽管迄今为止的研究结果总体上与该SNP的调节作用一致，但仍有必要对这一假设进行进一步评估。
评估携带一个或两个118G等位基因拷贝的问题饮酒者对纳曲酮治疗的反应是否更好。在这个与男性发生性关系的高功能男性（MSM）队列中，治疗目标是减少重度饮酒，而非促进戒酒。
分析纳入了112名来自欧洲血统的受试者，这些受试者来自一项针对问题饮酒MSM的纳曲酮与行为疗法的随机临床试验。受试者接受为期12周的治疗，每天口服100毫克盐酸纳曲酮。所有参与者均接受改良版简短行为依从性增强治疗（BBCET）的医疗管理，单独使用或与改良行为自我控制疗法（MBSCT）联合使用。
与接受安慰剂治疗的受试者或任一药物组中的A118纯合子相比，携带一个或两个118G等位基因的纳曲酮治疗受试者的无危险饮酒（NoH）百分比显著更高（p < 0.01）。
这些结果与118G等位基因对纳曲酮治疗减少重度饮酒有适度调节作用的观点一致。
