多巴胺能基因变异影响阿立哌唑对酒精自我给药的影响以及随机试验中对酒精线索的神经反应。

Dopaminergic Genetic Variation Influences Aripiprazole Effects on Alcohol Self-Administration and the Neural Response to Alcohol Cues in a Randomized Trial.

机构信息

Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.

出版信息

Neuropsychopharmacology. 2018 May;43(6):1247-1256. doi: 10.1038/npp.2017.298. Epub 2017 Dec 6.

Abstract

Dopamine (DA) signaling regulates many aspects of Alcohol Use Disorder (AUD). However, clinical studies of dopaminergic medications, including the DA partial agonist aripiprazole (APZ), have been inconsistent, suggesting the possibility of a pharmacogenetic interaction. This study examined whether variation in DA-related genes moderated APZ effects on reward-related AUD phenotypes. The interacting effects of APZ and a variable number tandem repeat (VNTR) polymorphism in DAT1/SLC6A3 (the gene encoding the DA transporter (DAT)) were tested. In addition, interactions between APZ and a genetic composite comprising the DAT1 VNTR and functional polymorphisms in catechol-O-methyltransferase (COMT), DRD2, and DRD4 were evaluated. Ninety-four non-treatment-seeking individuals with AUD were genotyped for these polymorphisms, randomized to APZ (titrated to 15 mg) or placebo for 8 days, and underwent an fMRI alcohol cue-reactivity task (day 7; n=81) and a bar lab paradigm (day 8). Primary outcomes were alcohol cue-elicited ventral striatal (VS) activation and the number of drinks consumed in the bar lab. DAT1 genotype significantly moderated medication effects, such that APZ, relative to placebo, reduced VS activation and bar-lab drinking only among carriers of the DAT1 9-repeat allele, previously associated with lower DAT expression and greater reward-related brain activation. The genetic composite further moderated medication effects, such that APZ reduced the primary outcomes more among individuals who carried a larger number of DAT1, COMT, DRD2, and DRD4 alleles associated with higher DA tone. Taken together, these data suggest that APZ may be a promising AUD treatment for individuals with a genetic predisposition to higher synaptic DA tone.

摘要

多巴胺(DA)信号调节酒精使用障碍(AUD)的许多方面。然而,包括 DA 部分激动剂阿立哌唑(APZ)在内的多巴胺能药物的临床研究结果不一致,这表明可能存在药物遗传学相互作用。本研究旨在探讨 DA 相关基因的变异是否调节了 APZ 对与奖赏相关的 AUD 表型的影响。检测了 APZ 与 DAT1/SLC6A3(编码多巴胺转运体(DAT)的基因)中的多巴胺相关基因的可变数目串联重复(VNTR)多态性之间的相互作用。此外,还评估了 APZ 与包含 DAT1 VNTR 和儿茶酚-O-甲基转移酶(COMT)、DRD2 和 DRD4 功能多态性的基因组合之间的相互作用。94 名未经治疗的 AUD 患者接受了这些多态性的基因分型,随机分为 APZ(滴定至 15mg)或安慰剂组,共 8 天,并进行了 fMRI 酒精线索反应性任务(第 7 天;n=81)和酒吧实验室范式(第 8 天)。主要结局指标是酒精线索诱发的腹侧纹状体(VS)激活和酒吧实验室中饮酒量。DAT1 基因型显著调节了药物的作用,与安慰剂相比,仅在携带 DAT1 9 重复等位基因的个体中,APZ 降低了 VS 激活和酒吧实验室饮酒量,而携带该等位基因与 DAT 表达降低和与奖赏相关的大脑激活增加有关。遗传综合进一步调节了药物的作用,与安慰剂相比,携带更多与更高 DA 音调相关的 DAT1、COMT、DRD2 和 DRD4 等位基因的个体,APZ 降低了主要结局。总的来说,这些数据表明,APZ 可能是一种有前途的 AUD 治疗方法,适用于具有较高突触 DA 音调遗传易感性的个体。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索