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综述:酒精中毒治疗的药物遗传学:种族多样性的影响

Review: Pharmacogenetics of alcoholism treatment: Implications of ethnic diversity.

作者信息

Cservenka Anita, Yardley Megan M, Ray Lara A

机构信息

School of Psychological Science, Oregon State University, Corvallis, Oregon.

Department of Psychology, University of California, Los Angeles, California.

出版信息

Am J Addict. 2017 Aug;26(5):516-525. doi: 10.1111/ajad.12463. Epub 2016 Nov 4.

Abstract

BACKGROUND AND OBJECTIVES

Pharmacogenetic studies of alcohol use disorder (AUD) have suggested that the efficacy of treatments for AUD is, in part, influenced by the genetic background of an individual. Since the frequency of alleles associated with pharmacotherapy for AUD varies by ancestral background, the effectiveness of medications used to treat AUD may vary among different populations. The purpose of this review is to summarize the existing pharmacogenetic studies of treatments for AUD in individuals of European, East Asian, African, and American Indian/Alaska Native ancestry.

METHODS

Electronic databases were searched for pharmacogenetic studies of AUD treatment that included individuals of diverse ancestral backgrounds.

RESULTS

Pharmacogenetic studies of AUD reviewed here have primarily investigated genetic variation thought to play a role in the response to naltrexone, ondansetron, and topiramate. There is support that the A118G polymorphism should be further investigated in individuals of East Asian ancestry.

DISCUSSION AND CONCLUSIONS

Given the lack of pharmacogenetic research on response to AUD medication in ethnic minority populations and the mixed results, there is a critical need for future studies among individuals of different ancestries. More efforts should be devoted to standardizing procedures such that results can be more readily integrated into a body of literature that can directly inform clinical practice.

SCIENTIFIC SIGNIFICANCE

This review highlights the importance for future research to aim for inclusiveness in pharmacogenetic studies of AUD and increase diversity of clinical trials in order to provide the best treatment outcomes for individuals across different racial and ethnic groups. (Am J Addict 2017;26:516-525).

摘要

背景与目的

酒精使用障碍(AUD)的药物遗传学研究表明,AUD治疗的疗效部分受个体遗传背景影响。由于与AUD药物治疗相关的等位基因频率因祖先背景而异,用于治疗AUD的药物有效性在不同人群中可能有所不同。本综述的目的是总结欧洲、东亚、非洲以及美洲印第安/阿拉斯加原住民血统个体中AUD治疗的现有药物遗传学研究。

方法

检索电子数据库中包含不同祖先背景个体的AUD治疗药物遗传学研究。

结果

本文综述的AUD药物遗传学研究主要调查了被认为在对纳曲酮、昂丹司琼和托吡酯反应中起作用的基因变异。有证据支持应在东亚血统个体中进一步研究A118G多态性。

讨论与结论

鉴于少数族裔人群中AUD药物反应的药物遗传学研究缺乏且结果不一,未来对不同祖先个体的研究至关重要。应更加努力规范程序,以便结果能更易于整合到可直接指导临床实践的文献体系中。

科学意义

本综述强调了未来研究在AUD药物遗传学研究中追求包容性并增加临床试验多样性的重要性,以便为不同种族和族裔群体的个体提供最佳治疗效果。(《美国成瘾杂志》2017年;26:516 - 525)

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