Department of Child and Adolescent Psychiatry, Erzincan Binali Yıldırım University, Erzincan, Turkey.
Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey.
J Psychopharmacol. 2022 Jun;36(6):715-722. doi: 10.1177/02698811211015245. Epub 2021 May 4.
Atomoxetine (ATX), one of the most commonly used drugs after stimulants in attention deficit hyperactivity disorder (ADHD) treatment, is an inhibitor of the norepinephrine transporter (), which is also associated with the etiology of ADHD. In this study, we aimed to investigate the effect of gene polymorphisms on response to ATX treatment and to find the answers to the questions about whether there is a relationship between the severity of the disorder and the observed side effects in children with ADHD.
About 100 children with ADHD and 80 healthy controls (HCs) were included in this study. The dose of ATX was started at 0.5 mg/kg/day and titrated at 1.2 mg/kg/day. Response to treatment of 78 patients was evaluated 2 months after the beginning of the treatment. After whole blood samples were obtained, DNAs were isolated, and samples were stored at -80°C. Two single-nucleotide polymorphisms (SNPs) (rs12708954 and rs3785143) were analyzed by real-time quantitative PCR (qRT-PCR).
The patients with both rs12708954 and rs3785143 heterozygous genotype had better treatment response and more side effects than patients with wild type. There was not found any association between any of the investigated polymorphisms and ADHD severity.
It was, however, found that the rs12708954 and rs3785143 genotypes affect the treatment response to ATX in our study; thus, further studies with a large population are needed to understand the effects of polymorphisms on treatment, side effects, and also the severity of ADHD.
阿托西汀(ATX)是治疗注意缺陷多动障碍(ADHD)中除兴奋剂外最常用的药物之一,是去甲肾上腺素转运体(NET)的抑制剂,与 ADHD 的病因也有关。本研究旨在探讨 基因多态性对 ATX 治疗反应的影响,并解答有关 ADHD 儿童中,疾病严重程度与观察到的不良反应之间是否存在关系的问题。
本研究纳入了约 100 名 ADHD 儿童和 80 名健康对照者(HCs)。ATX 的起始剂量为 0.5mg/kg/天,滴定至 1.2mg/kg/天。在治疗开始后 2 个月对 78 例患者的治疗反应进行评估。采集全血样本后,分离 DNA,将样本储存在-80°C。通过实时定量 PCR(qRT-PCR)分析两个单核苷酸多态性(SNP)(rs12708954 和 rs3785143)。
同时携带 rs12708954 和 rs3785143 杂合基因型的患者治疗反应更好,不良反应更多,而野生型患者则无差异。未发现任何所研究的多态性与 ADHD 严重程度之间存在关联。
然而,我们发现 rs12708954 和 rs3785143 基因型影响 ATX 在我们研究中的治疗反应;因此,需要进行更大规模的研究,以了解 多态性对治疗、不良反应以及 ADHD 严重程度的影响。