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双相障碍的遗传学与抗癫痫心境稳定剂治疗反应:我们了解多少?

Genetics and antiepileptic mood stabilizer treatment response in bipolar disorder: what do we know?

机构信息

Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN 55905, USA.

Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

Pharmacogenomics. 2021 Sep;22(14):913-925. doi: 10.2217/pgs-2021-0041. Epub 2021 Sep 6.

Abstract

Antiepileptic mood stabilizers (AED-MS) are often used to treat bipolar disorder (BD). Similar to other mood disorder medications, AED-MS treatment response varies between patients. Identification of biomarkers associated with treatment response may ultimately help with the delivery of individualized treatment and lead to improved treatment efficacy. Here, we conducted a narrative review of the current knowledge of the pharmacogenomics of AED-MS (valproic acid, lamotrigine and carbamazepine) treatment response in BD, including genetic contributions to AED-MS pharmacokinetics. Genes involved in neurotransmitter systems and drug transport have been shown to be associated with AED-MS treatment response. As more studies are conducted, and experimental and analytical methods advance, knowledge of AED-MS pharmacogenomics is expected to grow and contribute to precision medicine in BD.

摘要

抗癫痫心境稳定剂 (AED-MS) 常用于治疗双相情感障碍 (BD)。与其他心境障碍药物一样,AED-MS 的治疗反应在患者之间存在差异。与治疗反应相关的生物标志物的鉴定最终可能有助于提供个体化治疗,并提高治疗效果。在这里,我们对 AED-MS(丙戊酸、拉莫三嗪和卡马西平)治疗 BD 反应的药物基因组学的现有知识进行了叙述性综述,包括遗传因素对 AED-MS 药代动力学的影响。已发现参与神经递质系统和药物转运的基因与 AED-MS 治疗反应相关。随着更多研究的进行,以及实验和分析方法的进步,预计 AED-MS 药物基因组学的知识将不断增长,并为 BD 的精准医疗做出贡献。

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