Hatoum Alexander S, Gorelik Aaron J, Blaydon Lauren, Huggett Spencer B, Chi Tingying, Baranger David A A, Miller Alex P, Johnson Emma C, Agrawal Arpana, Bogdan Ryan
Washington University in St. Louis, Department of Psychological & Brain Sciences, St. Louis, MO, USA.
Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA.
Commun Med (Lond). 2025 May 16;5(1):176. doi: 10.1038/s43856-025-00877-9.
Innovation in psychiatric therapeutics has stagnated on known mechanisms. Psychiatric genome-wide association studies (GWAS) have identified hundreds of genome-wide significant (GWS) loci that have rapidly advanced our understanding of disease etiology. However, whether these results can be leveraged to improve clinical treatment for specific psychiatric disorders remains poorly understood.
In this proof-of-principal evaluation of GWAS clinical utility, we test whether the targets of drugs used to treat Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder (BiP), Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD), Schizophrenia (SCZ), Substance Use Disorders (SUDs), and insomnia (INS), are enriched for GWAS meta-analysis findings.
The genes coding for treatment targets of medications used to SCZ, BiP, MDD, and SUDs (but not ADHD, PTSD, GAD, or INSOM) are enriched for GWS loci identified in their respective GWAS (ORs: 2.78-27.63; all ps <1.15e-3). Enrichment is largely driven by the presence of a GWS locus or loci within a gene coding for a drug target (i.e., proximity matching). Broadly, additional annotation (i.e., functional: Combined Annotation Dependent Depletion [CADD] scores, regulomeDB scores, eQTL, chromatin loop, and gene region; statistical: effect size of genome-wide significant SNPs; Z-score of SNPs; number of drug targets implicated by GWAS), with the exception of weighting by the largest SNP effect size, does not further improve enrichment across disorders. Evaluation of prior smaller GWAS reveal that more recent larger GWAS improve enrichment.
GWAS results may assist in the prioritization of medications for future psychopharmaceutical research.
精神治疗学在已知机制方面的创新已经停滞不前。精神疾病全基因组关联研究(GWAS)已经确定了数百个全基因组显著(GWS)位点,这些位点迅速推进了我们对疾病病因的理解。然而,这些结果是否能够用于改善特定精神疾病的临床治疗仍知之甚少。
在这项GWAS临床效用的原理验证评估中,我们测试用于治疗注意力缺陷多动障碍(ADHD)、双相情感障碍(BiP)、广泛性焦虑症(GAD)、重度抑郁症(MDD)、创伤后应激障碍(PTSD)、精神分裂症(SCZ)、物质使用障碍(SUDs)和失眠症(INS)的药物靶点,是否在GWAS荟萃分析结果中富集。
用于SCZ、BiP、MDD和SUDs(但不包括ADHD、PTSD、GAD或INSOM)的药物治疗靶点编码基因,在各自的GWAS中富集了GWS位点(OR值:2.78 - 27.63;所有p值<1.15e - 3)。富集主要由药物靶点编码基因内一个或多个GWS位点的存在驱动(即邻近匹配)。总体而言,除了按最大SNP效应大小加权外,其他注释(即功能注释:联合注释依赖损耗[CADD]分数、调控组数据库分数、eQTL、染色质环和基因区域;统计注释:全基因组显著SNP的效应大小、SNP的Z分数、GWAS涉及的药物靶点数量)并不能进一步改善各疾病的富集情况。对先前较小规模GWAS的评估表明,近期较大规模的GWAS能改善富集情况。
GWAS结果可能有助于为未来精神药物研究确定药物的优先次序。