创伤后应激障碍（PTSD）的分子机制作为个体化和个性化治疗的基础：东南欧（SEE）-PTSD研究的基本原理、设计与方法

Molecular Mechanisms of Posttraumatic Stress Disorder (PTSD) as a Basis for Individualized and Personalized Therapy: Rationale, Design and Methods of the South Eastern Europe (SEE)-PTSD study.

作者信息

Kulenovic Alma Dzubur, Agani Ferid, Avdibegovic Esmina, Jakovljevic Miro, Babic Dragan, Kucukalic Abdulah, Kucukalic Sabina, Dzananovic Emina Sabic, Mehmedbasic Alma Bravo, Uka Aferdita Goci, Haxhibeqiri Shpend, Haxhibeqiri Valdete, Hoxha Blerina, Sinanovic Osman, Kravic Nermina, Muminovic Mirnesa, Aukst-Margetic Branka, Jaksic Nenad, Franc Ana Cima, Rudan Dusko, Pavlovic Marko, Babic Romana, Bojic Elma Feric, Marjanovic Damir, Bozina Nada, Ziegler Christiane, Wolf Christiane, Warrings Bodo, Domschke Katharina, Deckert Jürgen

机构信息

Department of Psychiatry, University Clinical Center Sarajevo, Bolnicka 25, 71000 Sarajevo, Bosnia and Herzegovina,

出版信息

Psychiatr Danub. 2016 Jun;28(2):154-63.

PMID:27287790

Abstract

Posttraumatic Stress Disorder (PTSD) is a major health problem in South Eastern Europe (SEE). Available treatment options are not efficient enough and the course is often chronic. Little is known about molecular mediators and moderators of pathogenesis and therapy. Genetic and epigenetic variation may be one central molecular mechanism. We therefore established a consortium combining clinical expertise on PTSD from SEE countries Bosnia-Herzegovina (Sarajevo, Tuzla and Mostar), Kosovo (Prishtina) and Croatia (Zagreb) with genetic and epigenetic competence from Germany (Würzburg) in 2011 within the framework of the DAAD (Deutscher Akademischer Austauschdienst)-funded Stability Pact for South Eastern Europe. After obtaining ethical votes and performing rater trainings as well as training in DNA extraction from EDTA blood between 2011 and 2013, we recruited 747 individuals who had experienced war-related trauma in the SEE conflicts between 1991 and 1999. 236 participants had current PTSD, 161 lifetime PTSD and 350 did not have and never had PTSD. Demographic and clinical data are currently merged together with genetic and epigenetic data in a single database to allow for a comprehensive analysis of the role of genetic and epigenetic variation in the pathogenesis and therapy of PTSD. Analyses will be done to a great degree by PhD students from participating SEE centers who in addition to participation in the project had an opportunity to take part in spring and summer schools of the DFG (Deutsche Forschungsgemeinschaft) funded Research Training Group (RTG) 1253 and thus meet PhD students from Germany and other countries We are confident that our project will not only contribute to a better understanding of genetic and epigenetic mechanisms of PTSD as a basis for future individualized and personalized therapies, but also to the academic development of South Eastern Europe.

摘要

创伤后应激障碍（PTSD）是东南欧（SEE）的一个主要健康问题。现有的治疗方案效率不够高，病程往往呈慢性。关于发病机制和治疗的分子介质和调节因素知之甚少。基因和表观遗传变异可能是一个核心分子机制。因此，我们于2011年在德国学术交流中心（DAAD）资助的东南欧稳定公约框架内，建立了一个联盟，将来自东南欧国家波斯尼亚和黑塞哥维那（萨拉热窝、图兹拉和莫斯塔尔）、科索沃（普里什蒂纳）和克罗地亚（萨格勒布）的PTSD临床专业知识与来自德国（维尔茨堡）的基因和表观遗传能力结合起来。在2011年至2013年获得伦理投票、进行评分员培训以及EDTA血样DNA提取培训后，我们招募了747名在1991年至1999年东南欧冲突中经历过与战争相关创伤的个体。236名参与者患有当前PTSD，161名有终生PTSD病史，350名没有且从未患过PTSD。目前，人口统计学和临床数据与基因和表观遗传数据合并在一个单一数据库中，以便全面分析基因和表观遗传变异在PTSD发病机制和治疗中的作用。很大程度上，分析工作将由来自东南欧参与中心的博士生进行，他们除了参与该项目外，还有机会参加德国研究基金会（DFG）资助的研究培训小组（RTG）1253的春季和夏季学校，从而结识来自德国和其他国家的博士生。我们相信，我们的项目不仅将有助于更好地理解PTSD的基因和表观遗传机制，为未来的个体化和个性化治疗奠定基础，还将促进东南欧的学术发展。