García-González Xandra, Cubo Esther, Simón-Vicente Lucía, Mariscal Natividad, Alcaraz Raquel, Aguado Laura, Rivadeneyra-Posadas Jéssica, Sanz-Solas Antonio, Saiz-Rodríguez Miriam
Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
Neurology Department, Hospital Universitario de Burgos, 09006 Burgos, Spain.
J Pers Med. 2023 Feb 22;13(3):385. doi: 10.3390/jpm13030385.
Huntington's disease (HD) is an autosomal dominant progressive brain disorder, caused by a pathological expansion of a CAG repeat that encodes the huntingtin gene. This genetic neurodegenerative rare disease is characterized by cognitive, motor, and neuropsychiatric manifestations. The aim of the treatment is symptomatic and addresses the hyperkinetic disorders (chorea, dystonia, myoclonus, tics, etc.) and the behavioural and cognitive disturbances (depression, anxiety, psychosis, etc.) associated with the disease. HD is still a complex condition in need of innovative and efficient treatment. The long-term goal of pharmacogenetic studies is to use genotype data to predict the effective treatment response to a specific drug and, in turn, prevent potential undesirable effects of its administration. Chorea, depression, and psychotic symptoms have a substantial impact on HD patients' quality of life and could be better controlled with the help of pharmacogenetic knowledge. We aimed to carry out a review of the available publications and evidence related to the pharmacogenetics of HD, with the objective of compiling all information that may be useful in optimizing drug administration. The impact of pharmacogenetic information on the response to antidepressants and antipsychotics is well documented in psychiatric patients, but this approach has not been investigated in HD patients. Future research should address several issues to ensure that pharmacogenetic clinical use is appropriately supported, feasible, and applicable.
亨廷顿舞蹈症(HD)是一种常染色体显性遗传性进行性脑部疾病,由编码亨廷顿蛋白基因的CAG重复序列病理性扩增所致。这种遗传性神经退行性罕见病的特征为认知、运动及神经精神方面的表现。治疗目的在于缓解症状,针对多动性疾病(舞蹈症、肌张力障碍、肌阵挛、抽搐等)以及与该疾病相关的行为和认知障碍(抑郁、焦虑、精神病等)。HD仍是一种需要创新且有效治疗方法的复杂病症。药物遗传学研究的长期目标是利用基因型数据预测对特定药物的有效治疗反应,进而预防用药可能产生的潜在不良影响。舞蹈症、抑郁及精神病性症状对HD患者的生活质量有重大影响,借助药物遗传学知识或许能更好地加以控制。我们旨在对与HD药物遗传学相关的现有出版物及证据进行综述,目的是汇总所有可能有助于优化药物治疗的信息。药物遗传学信息对精神科患者对抗抑郁药和抗精神病药反应的影响已有充分记录,但该方法尚未在HD患者中进行研究。未来研究应解决若干问题,以确保药物遗传学在临床中的应用得到适当支持、可行且适用。