Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA.
Int J Mol Sci. 2020 Jan 28;21(3):826. doi: 10.3390/ijms21030826.
Major depressive disorder (MDD) is the leading cause of disability worldwide and is associated with high rates of suicide and medical comorbidities. Current antidepressant medications are suboptimal, as most MDD patients fail to achieve complete remission from symptoms. At present, clinicians are unable to predict which antidepressant is most effective for a particular patient, exposing patients to multiple medication trials and side effects. Since MDD's etiology includes interactions between genes and environment, the epigenome is of interest for predictive utility and treatment monitoring. Epigenetic mechanisms of antidepressant medications are incompletely understood. Differences in epigenetic profiles may impact treatment response. A systematic literature search yielded 24 studies reporting the interaction between antidepressants and eight genes (, , , , , ) and whole genome methylation. Methylation of certain sites within , , , , , and the whole genome was predictive of antidepressant response. Comparing DNA methylation in patients during depressive episodes, during treatment, in remission, and after antidepressant cessation would help clarify the influence of antidepressant medications on DNA methylation. Individuals' unique methylation profiles may be used clinically for personalization of antidepressant choice in the future.
重度抑郁症（MDD）是全球致残的主要原因，与高自杀率和医疗合并症有关。目前的抗抑郁药物并不理想，因为大多数 MDD 患者未能完全缓解症状。目前，临床医生无法预测哪种抗抑郁药对特定患者最有效，使患者面临多次药物试验和副作用。由于 MDD 的病因包括基因与环境的相互作用，因此表观基因组对于预测效用和治疗监测很有意义。抗抑郁药物的表观遗传机制尚不完全清楚。表观遗传特征的差异可能会影响治疗反应。系统文献检索产生了 24 项研究报告了抗抑郁药与八个基因（,,,,,,, ）和全基因组甲基化之间的相互作用。,,,,,, 和全基因组中某些位点的甲基化可预测抗抑郁反应。比较抑郁发作期间、治疗期间、缓解期间和抗抑郁药停药后的患者 DNA 甲基化情况，将有助于阐明抗抑郁药物对 DNA 甲基化的影响。个体独特的甲基化谱将来可能会在临床上用于个性化选择抗抑郁药物。
