Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.
Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Sci Rep. 2018 Jan 30;8(1):1881. doi: 10.1038/s41598-018-20194-7.
Methylphenidate (MPH) is the most frequently used pharmacological treatment in children with attention-deficit/hyperactivity disorder (ADHD). However, a considerable interindividual variability exists in clinical outcome. Thus, we performed a genome-wide association study of MPH efficacy in 173 ADHD paediatric patients. Although no variant reached genome-wide significance, the set of genes containing single-nucleotide polymorphisms (SNPs) nominally associated with MPH response (P < 0.05) was significantly enriched for candidates previously studied in ADHD or treatment outcome. We prioritised the nominally significant SNPs by functional annotation and expression quantitative trait loci (eQTL) analysis in human brain, and we identified 33 SNPs tagging cis-eQTL in 32 different loci (referred to as eSNPs and eGenes, respectively). Pathway enrichment analyses revealed an over-representation of genes involved in nervous system development and function among the eGenes. Categories related to neurological diseases, psychological disorders and behaviour were also significantly enriched. We subsequently meta-analysed the association with clinical outcome for the 33 eSNPs across the discovery sample and an independent cohort of 189 ADHD adult patients (target sample) and we detected 15 suggestive signals. Following this comprehensive strategy, our results provide a better understanding of the molecular mechanisms implicated in MPH treatment effects and suggest promising candidates that may encourage future studies.
哌醋甲酯(MPH)是治疗注意缺陷多动障碍(ADHD)儿童最常用的药物。然而,临床疗效存在相当大的个体间差异。因此,我们对 173 名 ADHD 儿科患者的 MPH 疗效进行了全基因组关联研究。虽然没有变异达到全基因组显著水平,但与 MPH 反应(P < 0.05)名义上相关的单核苷酸多态性(SNP)所包含的一组基因,在 ADHD 或治疗结果方面有显著的候选基因富集。我们通过功能注释和人类大脑中的表达数量性状基因座(eQTL)分析对名义上显著的 SNP 进行优先级排序,并确定了 32 个不同位点的 33 个 SNP 标记顺式 eQTL(分别称为 eSNP 和 eGene)。通路富集分析显示,eGene 中与神经系统发育和功能相关的基因过度表达。与神经疾病、心理障碍和行为相关的类别也显著富集。随后,我们对 33 个 eSNP 在发现样本和 189 名 ADHD 成年患者(目标样本)的独立队列中的与临床结果的关联进行了荟萃分析,检测到 15 个提示信号。通过这种综合策略,我们的研究结果更好地理解了与 MPH 治疗效果相关的分子机制,并为未来的研究提供了有前途的候选基因。