全基因组关联研究确定了六个与精神分裂症患者对阿立哌唑药物不良反应相关的基因座。

Genome-wide association study identified six loci associated with adverse drug reactions to aripiprazole in schizophrenia patients.

作者信息

Wang Xueping, Mei Dongli, Lu Zhe, Zhang Yuyanan, Sun Yaoyao, Lu Tianlan, Yan Hao, Yue Weihua

机构信息

Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.

National Clinical Research Center for Mental Disorders & NHC Key Laboratory of Mental Health (Peking University), 100191, Beijing, China.

出版信息

Schizophrenia (Heidelb). 2023 Jul 25;9(1):44. doi: 10.1038/s41537-023-00369-6.

Abstract

Aripiprazole is recommended for routine use in schizophrenia patients. However, the biological mechanism for the adverse drug reactions (ADRs) among schizophrenia patients with the antipsychotic drug aripiprazole is far from clear. To explore the potential genetic factors that may cause movement-related adverse antipsychotic effects in patients, we conducted an association analysis between movement-related ADRs and SNPs in schizophrenia patients receiving aripiprazole monotherapy. In this study, multiple ADRs of 384 patients were quantified within 6-week treatment, and the scores of movement-related ADRs at baseline and follow-up time points during treatment were obtained. The highest score record was used as the quantitative index in analysis, and genetic analysis at the genome-wide level was conducted. The SNP rs4149181 in SLC22A8 [P = 2.28 × 10] showed genome-wide significance, and rs2284223 in ADCYAP1R1 [P = 9.76 × 10], rs73258503 in KCNIP4 [P = 1.39 × 10], rs678428 in SMAD9 [P = 4.70 × 10], rs6421034 in NAP1L4 [P = 6.80 × 10], and rs1394796 in ERBB4 [P = 8.60 × 10] were found to be significantly associated with movement-related ADRs. The combined prediction model of these six loci showed acceptable performance in predicting adverse events [area under the curve (AUC): 0.84]. Combined with the function and network of the above genes and other candidate loci (KCNA1, CACNG1, etc.), we hypothesize that SLC22A8 and KCNIP4-Kv channel perform their respective functions as transporter or channel and participate in the in vivo metabolism or effects of aripiprazole. The above results imply the important function of ion transporters and channels in movement-related adverse antipsychotic effects in aripiprazole monotherapy schizophrenia patients.

摘要

阿立哌唑被推荐用于精神分裂症患者的常规治疗。然而,抗精神病药物阿立哌唑在精神分裂症患者中引起药物不良反应(ADR)的生物学机制尚不清楚。为了探究可能导致患者出现与运动相关的抗精神病药物不良反应的潜在遗传因素,我们对接受阿立哌唑单药治疗的精神分裂症患者的与运动相关的ADR和单核苷酸多态性(SNP)进行了关联分析。在本研究中,对384例患者在6周治疗期内的多种ADR进行了量化,并获得了治疗期间基线和随访时间点与运动相关ADR的评分。分析中采用最高评分记录作为定量指标,并进行了全基因组水平的遗传分析。溶质载体家族22成员8(SLC22A8)中的SNP rs4149181[P = 2.28×10]显示出全基因组显著性,促肾上腺皮质激素释放因子受体1(ADCYAP1R1)中的rs2284223[P = 9.76×10]、钾离子通道相互作用蛋白4(KCNIP4)中的rs73258503[P = 1.39×10]、SMAD家族成员9(SMAD9)中的rs678428[P = 4.70×10]、核小体组装蛋白1样4(NAP1L4)中的rs6421034[P = 6.80×10]以及表皮生长因子受体4(ERBB4)中的rs1394796[P = 8.60×10]被发现与与运动相关的ADR显著相关。这六个位点的联合预测模型在预测不良事件方面表现出可接受的性能[曲线下面积(AUC):0.84]。结合上述基因以及其他候选位点(钾通道亚家族A成员1(KCNA1)、电压门控钙通道γ1亚基(CACNG1)等)的功能和网络,我们推测SLC22A8和KCNIP4-Kv通道作为转运体或通道发挥各自功能,参与阿立哌唑的体内代谢或作用。上述结果表明离子转运体和通道在阿立哌唑单药治疗的精神分裂症患者与运动相关的抗精神病药物不良反应中具有重要作用。

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