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评估 SLC6A2 和 CYP2D6 多态性对注意缺陷多动障碍中托莫西汀治疗的影响。

Evaluation of SLC6A2 and CYP2D6 polymorphisms' effects on atomoxetine treatment in attention deficit and hyperactivity disorder.

机构信息

Department of Child and Adolescent Psychiatry, Faculty of Medicine, Bursa Uludag University, Bursa, Türkiye.

Department of Psychology, Faculty of Humanities and Social Sciences, Fatih Sultan Mehmet Vakif University, Istanbul, Türkiye.

出版信息

Eur J Clin Pharmacol. 2024 Nov;80(11):1773-1785. doi: 10.1007/s00228-024-03744-z. Epub 2024 Aug 19.

Abstract

BACKGROUND

There is insufficient replicated data to establish a relationship between the polymorphisms of SLC6A2 and CYP2D6 and the treatment responses of atomoxetine (ATX) in ADHD. We focused on evaluating the effect of top-line single nucleotide polymorphisms (SNPs) in SLC6A2 and CYP2D6 on the ATX treatment response in attention deficit and hyperactivity disorder (ADHD).

METHODS

Of 160 patient records, 34 patients who met the inclusion criteria were evaluated to determine the relationship between genotypes of ten SNPs (six of SLC6A2 and four of CYP2D6) and ATX treatment response. Additionally, the connection between SNPs of CYP2D6 and the severity of side effects associated with ATX was analyzed in 37 patients, including the 34 study patients, and three patients discontinued because of ATX-dependent side effects.

RESULTS

All six polymorphisms we studied in SLC6A2 were associated with the treatment response of ATX. Clinical improvement in oppositional defiant disorder symptoms of patients with ADHD was only observed in carriers of the homozygous "C" allele of rs3785143 (p = 0.026). We detected an association between higher CGI-side-effect severity scores and the "TT" genotype of rs1065852 polymorphism in CYP2D6 (p = 0.043).

CONCLUSIONS

The findings of this study suggest that genotypes of polymorphisms within the SLC6A2 and CYP2D6 may play an influential role in treatment response or the severity of side effects associated with ATX in ADHD patients.

摘要

背景

目前尚缺乏可复制的数据来确定 SLC6A2 和 CYP2D6 多态性与 ADHD 患者托莫西汀(ATX)治疗反应之间的关系。我们专注于评估 SLC6A2 和 CYP2D6 中一线单核苷酸多态性(SNPs)对注意缺陷多动障碍(ADHD)中 ATX 治疗反应的影响。

方法

在 160 份患者记录中,评估了 34 名符合纳入标准的患者,以确定 10 个 SNPs(SLC6A2 中的 6 个和 CYP2D6 中的 4 个)的基因型与 ATX 治疗反应之间的关系。此外,在包括 34 名研究患者在内的 37 名患者中分析了 CYP2D6 的 SNPs 与 ATX 相关副作用严重程度之间的关系,还有 3 名患者因 ATX 依赖性副作用而停药。

结果

我们研究的 SLC6A2 中的所有 6 个多态性均与 ATX 的治疗反应相关。在 ADHD 患者中,仅观察到携带 rs3785143 同型“C”等位基因的患者的对立违抗性障碍症状有临床改善(p=0.026)。我们发现 CYP2D6 中 rs1065852 多态性的“TT”基因型与 CGI-副作用严重程度评分较高之间存在关联(p=0.043)。

结论

本研究结果表明,SLC6A2 和 CYP2D6 内的多态性基因型可能在 ADHD 患者 ATX 治疗反应或与 ATX 相关的副作用严重程度中起重要作用。

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