Vizeli Patrick, Meyer Zu Schwabedissen Henriette E, Liechti Matthias E
Division of Clinical Pharmacology and Toxicology, Department of Biomedicine, Department of Clinical Research, University Hospital Basel, University of Basel, Schanzenstrasse 55, 4056, Basel, Switzerland.
Biopharmacy, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Eur J Clin Pharmacol. 2018 Mar;74(3):275-283. doi: 10.1007/s00228-017-2392-2. Epub 2017 Dec 2.
Methylenedioxymethamphetamine (MDMA, ecstasy) is used recreationally and frequently leads to sympathomimetic toxicity. MDMA produces cardiovascular and subjective stimulant effects that were shown to partially depend on the norepinephrine transporter (NET)-mediated release of norepinephrine and stimulation of α-adrenergic receptors. Genetic variants, such as single-nucleotide polymorphisms (SNPs), of the NET gene (SLC6A2) may explain interindividual differences in the acute stimulant-type responses to MDMA in humans.
We characterized the effects of common genetic variants of the SLC6A2 gene (rs168924, rs47958, rs1861647, rs2242446, and rs36029) on cardiovascular and subjective stimulation after MDMA administration in 124 healthy subjects in a pooled analysis of eight double-blind, placebo-controlled studies.
Carriers of the GG genotype of the SLC6A2 rs1861647 SNP presented higher elevations of heart rate and rate-pressure product after MDMA than subjects with one or no G alleles. Subjects with a C allele in the SLC6A2 rs2242446 SNP presented higher elevations of the heart rate after MDMA administration compared with the TT genotype. Subjects with the AA genotype of the SLC6A2 rs36029 SNP presented higher elevations of mean arterial pressure and rate pressure product after MDMA administration than carriers of the G allele. The SLC6A2 rs168924 and rs47958 SNPs did not alter the response to MDMA.
Genetic polymorphisms of the SLC6A2 gene weakly moderated the acute cardiovascular response to MDMA in controlled studies and may play a minor role in adverse cardiovascular events when MDMA is used recreationally.
亚甲基二氧甲基苯丙胺(摇头丸,MDMA)被用于娱乐用途,且经常导致拟交感神经毒性。MDMA会产生心血管和主观刺激作用,已表明这些作用部分依赖于去甲肾上腺素转运体(NET)介导的去甲肾上腺素释放及α-肾上腺素能受体的刺激。NET基因(SLC6A2)的遗传变异,如单核苷酸多态性(SNP),可能解释人类对MDMA急性刺激型反应的个体差异。
在对八项双盲、安慰剂对照研究的汇总分析中,我们对124名健康受试者给予MDMA后,研究了SLC6A2基因常见遗传变异(rs168924、rs47958、rs1861647、rs2242446和rs36029)对心血管和主观刺激的影响。
SLC6A2 rs1861647 SNP的GG基因型携带者在服用MDMA后心率和率压乘积升高幅度高于有一个或没有G等位基因的受试者。SLC6A2 rs2242446 SNP中有C等位基因的受试者在服用MDMA后心率升高幅度高于TT基因型受试者。SLC6A2 rs36029 SNP的AA基因型受试者在服用MDMA后平均动脉压和率压乘积升高幅度高于G等位基因携带者。SLC6A2 rs168924和rs47958 SNPs未改变对MDMA的反应。
在对照研究中,SLC6A2基因的遗传多态性对MDMA的急性心血管反应影响较弱,在娱乐性使用MDMA时可能在不良心血管事件中起较小作用。