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酒精成瘾的药物遗传学:当前观点

Pharmacogenetics of alcohol addiction: current perspectives.

作者信息

Zastrozhin M S, Skryabin V Yu, Miroshkin S S, Bryun E A, Sychev D A

机构信息

Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare , Moscow 109390, Russian Federation.

Department of Addictology, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow 123995, Russian Federation.

出版信息

Appl Clin Genet. 2019 Jul 11;12:131-140. doi: 10.2147/TACG.S206745. eCollection 2019.

Abstract

Genetics of alcohol addiction is currently a contradictive and complex field, where data in the most studies reflect methods' limitations rather than meaningful and complementary results. In our review, we focus on the genetics of alcohol addiction, leaving genetics of acute alcohol intoxication out of the scope. A review of the literature on pharmacogenetic biomarkers development for the pharmacotherapy personalization reveals that today the evidence base concerning these biomarkers is still insufficient. In particular, now the researches with the design of randomized controlled trials and meta-analysis investigating the effect of the SNPs as biomarkers on the therapy efficacy are available for naltrexone only. For other medications, there are only a few studies in small samples. It decreases the possibilities to implement the pharmacogenetic algorithms for the pharmacotherapy personalization in patients with alcohol use disorders (AUD). In view of the importance of the precision approaches development not in addiction medicine only, but in other fields of medicine also to increase the efficacy and safety of the therapy, studies on pharmacogenetic biomarkers development for the medications used in patients with AUD (eg, naltrexone, disulfiram, nalmefene, acamprosate, etc.) remain relevant to this day.

摘要

酒精成瘾的遗传学目前是一个充满矛盾且复杂的领域,大多数研究中的数据反映的是方法的局限性,而非有意义且互补的结果。在我们的综述中,我们聚焦于酒精成瘾的遗传学,将急性酒精中毒的遗传学排除在外。对用于药物治疗个体化的药物遗传学生物标志物开发的文献综述表明,如今关于这些生物标志物的证据基础仍然不足。特别是,目前只有针对纳曲酮开展了设计为随机对照试验和荟萃分析的研究,以探究单核苷酸多态性(SNP)作为生物标志物对治疗效果的影响。对于其他药物,仅有少量小样本研究。这降低了在酒精使用障碍(AUD)患者中实施药物治疗个体化的药物遗传学算法的可能性。鉴于精准方法的开发不仅在成瘾医学领域,而且在其他医学领域对于提高治疗的有效性和安全性都很重要,针对AUD患者使用的药物(如纳曲酮、双硫仑、纳美芬、阿坎酸等)开展药物遗传学生物标志物开发的研究至今仍具有相关性。

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