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Genetics of nonpharmacological treatments of depression. 抑郁症非药物治疗的遗传学。
IF 0.9 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2023-02-01 DOI: 10.1097/YPG.0000000000000332
Raffaella Zanardi, Matteo Carminati, Francesco Attanasio, Chiara Fabbri, Alessandro Serretti

Nonpharmacological antidepressant treatments are effective and well tolerated in selected patients. However, response is heterogeneous and validated biomarkers would be precious to aid treatment choice. We searched Pubmed, Scopus, and Google Scholar until May 2022 for original articles evaluating the association of genetic variables with the efficacy of nonpharmacological treatments for major depressive episodes. Most studies analyzed small sample sizes using the candidate gene approach, leading to poorly replicated findings that need to be interpreted cautiously. The few available methylome-wide and genome-wide association studies (GWASs) considered only electroconvulsive therapy (ECT) and cognitive-behavioral therapy in small samples, providing interesting findings by using polygenic risk scores. A deeper knowledge of the genetic factors implicated in treatment response may lead to a better understanding of the neurobiological mechanisms of nonpharmacological therapies for depression, and depression itself. Future GWAS are going to expand their sample size, thanks to consortia such as the gen-ECT-ic consortium.

非药物抗抑郁治疗在选定的患者中是有效且耐受性良好的。然而,反应是异质性的,经过验证的生物标志物对于帮助治疗选择将是宝贵的。我们检索了Pubmed, Scopus和Google Scholar,直到2022年5月,以评估遗传变量与非药物治疗重度抑郁症发作疗效的关联的原始文章。大多数研究使用候选基因方法分析小样本量,导致重复性差的研究结果需要谨慎解释。少数可用的全甲基组和全基因组关联研究(GWASs)只考虑小样本的电休克治疗(ECT)和认知行为治疗,通过使用多基因风险评分提供了有趣的发现。对治疗反应中涉及的遗传因素的深入了解可能会导致对抑郁症非药物治疗的神经生物学机制和抑郁症本身的更好理解。未来的GWAS将扩大他们的样本量,这要感谢像gen-ECT-ic联盟这样的联盟。
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引用次数: 0
Mediating effect of genome-wide DNA methylation on suicidal ideation induced by stressful events. 全基因组DNA甲基化对应激事件诱导的自杀意念的中介作用。
IF 0.9 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2023-02-01 DOI: 10.1097/YPG.0000000000000331
Vincenzo De Luca, Nzaar Al-Chalabi, Zanib Chaudhary, Jessica Qian, Carol Borlido, Araba Chintoh, Philip Gerretsen, Ariel Graff, Gary Remington, Marcos Sanches, Marco Battaglia

Objective: Schizophrenia is a debilitating disease that is associated with higher rates of death by unnatural causes including suicide. Exposure to stressful events is an important risk factor for suicidal ideation (SI); however, the mechanisms that link stress, SI, and suicide remain unclear. Epigenetic processes are involved in both vulnerability to suicidal behavior and stress. Therefore, we sought to study the relationship between epigenetic modifications and suicidal behavior and stress.

Methods: This pilot study was conducted on 39 patients diagnosed with schizophrenia (54% men and age 45.5 ± 12.7). We analyzed the effects of (a) stress exposure and (b) the mediation of DNA methylation [via an epigenetic wide association study (EWAS) of more than 450 000 CpG sites across the genome] on SI severity.

Results: The top CpG site mediating the effect of global stress exposure on SI was cg27660192 located in an intergenic region on chromosome 11, exerting a facilitating effect on worsening SI through DNA hypomethylation.

Conclusion: These preliminary results indicate that DNA methylation in peripheral tissues can shed light on the complex relationship between stress and SI in schizophrenia.

目的:精神分裂症是一种使人衰弱的疾病,与包括自杀在内的非自然原因死亡率较高有关。暴露于压力事件是自杀意念(SI)的重要危险因素;然而,将压力、自杀和自杀联系起来的机制仍不清楚。表观遗传过程涉及自杀行为和压力的脆弱性。因此,我们试图研究表观遗传修饰与自杀行为和压力之间的关系。方法:本初步研究纳入39例精神分裂症患者(男性54%,年龄45.5±12.7岁)。我们分析了(a)应激暴露和(b) DNA甲基化介导[通过对基因组中超过45万个CpG位点的表观遗传广泛关联研究(EWAS)]对SI严重程度的影响。结果:介导全局胁迫对SI影响的CpG位点顶端为cg27660192,位于11号染色体的基因间区,通过DNA低甲基化对SI恶化起促进作用。结论:这些初步结果提示外周组织DNA甲基化可能揭示精神分裂症患者应激与SI之间的复杂关系。
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引用次数: 0
Applications of Mendelian randomization in psychiatry: a comprehensive systematic review. 孟德尔随机化在精神病学中的应用:一项全面的系统综述。
IF 1.5 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2022-12-01 Epub Date: 2022-10-20 DOI: 10.1097/YPG.0000000000000327
Luigi F Saccaro, Simone Gasparini, Grazia Rutigliano

Psychiatric diseases exact a heavy socioeconomic toll, and it is particularly difficult to identify their risk factors and causative mechanisms due to their multifactorial nature, the limited physiopathological insight, the many confounding factors, and the potential reverse causality between the risk factors and psychiatric diseases. These characteristics make Mendelian randomization (MR) a precious tool for studying these disorders. MR is an analytical method that employs genetic variants linked to a certain risk factor, to assess if an observational association between that risk factor and a health outcome is compatible with a causal relationship. We report the first systematic review of all existing applications and findings of MR in psychiatric disorders, aiming at facilitating the identification of risk factors that may be common to different psychiatric diseases, and paving the way to transdiagnostic MR studies in psychiatry, which are currently lacking. We searched Web of Knowledge, Scopus, and Pubmed databases (until 3 May 2022) for articles on MR in psychiatry. The protocol was preregistered in PROSPERO (CRD42021285647). We included methodological details and results from 50 articles, mainly on schizophrenia, major depression, autism spectrum disorders, and bipolar disorder. While this review shows how MR can offer unique opportunities for unraveling causal links in risk factors and etiological elements of specific psychiatric diseases and transdiagnostically, some methodological flaws in the existing literature limit reliability of results and probably underlie their heterogeneity. We highlight perspectives and recommendations for future works on MR in psychiatry.

精神疾病造成了沉重的社会经济损失,由于其多因素性质、有限的生理病理洞察力、许多混杂因素以及风险因素与精神疾病之间潜在的反向因果关系,特别难以确定其风险因素和致病机制。这些特征使得孟德尔随机化(MR)成为研究这些疾病的宝贵工具。MR是一种分析方法,它利用与某个风险因素相关的基因变异来评估该风险因素与健康结果之间的观察相关性是否符合因果关系。我们报告了对MR在精神疾病中的所有现有应用和发现的首次系统综述,旨在促进识别不同精神疾病可能常见的风险因素,并为目前缺乏的精神病学中的跨诊断MR研究铺平道路。我们搜索了知识网、Scopus和Pubmed数据库(至2022年5月3日),以查找有关精神病学中MR的文章。该方案已在PROSPERO中预先注册(CRD42021285647)。我们纳入了50篇文章的方法细节和结果,主要是关于精神分裂症、严重抑郁症、自闭症谱系障碍和双相情感障碍。虽然这篇综述展示了MR如何为揭示特定精神疾病的风险因素和病因因素之间的因果关系和跨诊断提供独特的机会,但现有文献中的一些方法学缺陷限制了结果的可靠性,并可能是其异质性的基础。我们强调了对MR在精神病学中的未来工作的看法和建议。
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引用次数: 0
Mendelian randomization study on the effect of tumor necrosis factor on schizophrenia. 肿瘤坏死因子对精神分裂症影响的孟德尔随机化研究。
IF 0.9 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2022-12-01 DOI: 10.1097/YPG.0000000000000329
Ning Ma, Renxi Wang

Objective: Previous observational studies have shown that the levels of tumor necrosis factor (TNF) increased in patients with schizophrenia. The present two-sample Mendelian randomization (MR) study aims to identify the causal link between TNF and schizophrenia.

Methods: To date, the largest genome-wide association study (GWAS) for TNF (n = 23 141) and for schizophrenia (53 386 cases and 77 258 controls) was used. All participants were of European ancestry. The MR-egger_intercept test and Cochran's Q statistic were used to determine the pleiotropy and heterogeneity, respectively. Weighted median and inverse variance weighted (IVW) were used to evaluate the causal association of TNF with schizophrenia.

Results: We found no significant pleiotropy or heterogeneity of all three selected plasma TNF genetic instrumental variants in breast cancer GWAS. Interestingly, the odds ratio (OR) = 1.517 with 95% confidence interval (CI), 1.006-2.288 and P = 0.047 of schizophrenia correspond to one unit increase in natural log-transformed TNF levels using IVW method. The increased trend was further proven using weighted median (OR = 1.585; 95% CI, 1.017-2.469; P = 0.042). Reverse MR analysis shows no causal effect of schizophrenia on plasma TNF levels.

Conclusions: Our analysis suggested a causal association between genetically increased TNF signaling and increased risk of schizophrenia in the European population. Thus, TNF may be a potential risk for schizophrenia.

目的:以往的观察性研究表明,精神分裂症患者的肿瘤坏死因子(TNF)水平升高。目前的两样本孟德尔随机化(MR)研究旨在确定TNF和精神分裂症之间的因果关系。方法:迄今为止,使用了TNF (n = 23 141)和精神分裂症(53 386例和77 258例对照)的最大全基因组关联研究(GWAS)。所有的参与者都有欧洲血统。采用MR-egger_intercept检验和Cochran’s Q统计量分别确定多效性和异质性。使用加权中位数和反方差加权(IVW)来评估TNF与精神分裂症的因果关系。结果:我们发现乳腺癌GWAS中所有三种选择的血浆TNF遗传工具变异均无显著的多效性或异质性。有趣的是,使用IVW方法,精神分裂症的比值比(OR) = 1.517, 95%置信区间(CI), 1.006-2.288和P = 0.047对应于自然对数转化TNF水平增加一个单位。使用加权中位数(OR = 1.585;95% ci, 1.017-2.469;p = 0.042)。反向磁共振分析显示,精神分裂症对血浆TNF水平无因果影响。结论:我们的分析表明,在欧洲人群中,遗传增加的TNF信号和增加的精神分裂症风险之间存在因果关系。因此,TNF可能是精神分裂症的潜在风险。
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引用次数: 1
Genome-wide methylation analysis of early-onset schizophrenia. 早发性精神分裂症的全基因组甲基化分析
IF 0.9 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2022-12-01 DOI: 10.1097/YPG.0000000000000317
Anil Srivastava, Zanib Chaudhary, Jessica Qian, Nzaar Al Chalabi, Amer M Burhan, Corinne E Fischer, Philip Gerretsen, Nathan J Kolla, Ariel Graff, Gary Remington, Vincenzo De Luca

Objective: Schizophrenia (SCZ) is a debilitating disease with a complex genetic cause in which age at onset may reflect genetic vulnerability. Though there has been some association between genetic polymorphisms and age of onset, there has been little exploration of the role of epigenetic processes. We sought to explore the influence of DNA methylation, a key epigenetic mechanism, and its association with the age of onset of illness.

Methods: One hundred thirty-eight participants aged 18-75 years and previously diagnosed with SCZ spectrum disorders by the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID DSM-5) were recruited. Venous blood was collected and genome-wide DNA methylation was quantified using the Illumina Infinium HumanMethylation450 BeadChip array. Individual CpG sites and regions of differential methylation were explored by the age of onset; covariates included age, sex, as well as white blood cell composition.

Results: Binary grouping (early vs. late onset) revealed four intergenic CpG sites on chromosome 2 that were above the expected P-value threshold, with hypermethylation of the CpG site cg10392614 most strongly associated with early-onset SCZ. The four most strongly associated CpG sites, including cg 10392614, were intergenic. Continuous analysis revealed the top CpG site to be cg11723066 , which is linked to the JAM3 gene, with hypomethylation associated with earlier onset; however, results were below the expected P-value threshold.

Conclusion: Studies on DNA methylation in the first-episode psychosis population may help further our understanding of the role of epigenetics in the age of onset of SCZ.

目的:精神分裂症(SCZ)是一种具有复杂遗传原因的衰弱性疾病,发病年龄可能反映遗传易感性。虽然遗传多态性与发病年龄之间存在一定的联系,但对表观遗传过程的作用的探索却很少。我们试图探索DNA甲基化(一种关键的表观遗传机制)的影响及其与发病年龄的关系。方法:采用《精神障碍诊断与统计手册》(SCID - DSM-5)结构化临床访谈法,招募年龄在18-75岁之间、既往诊断为SCZ谱系障碍的138名参与者。采集静静脉血液,使用Illumina Infinium HumanMethylation450 BeadChip阵列对全基因组DNA甲基化进行量化。不同发病年龄的个体CpG位点和差异甲基化区域进行了研究;协变量包括年龄、性别以及白细胞组成。结果:二元分组(早发与晚发)显示,2号染色体上有4个基因间CpG位点高于预期的p值阈值,CpG位点cg10392614的高甲基化与早发性SCZ的相关性最强。4个最密切相关的CpG位点,包括cg 10392614,是基因间的。连续分析显示,顶部CpG位点为cg11723066,与JAM3基因相关,低甲基化与早期发病相关;然而,结果低于预期的p值阈值。结论:对首发精神病人群DNA甲基化的研究可能有助于我们进一步了解表观遗传学在SCZ发病年龄中的作用。
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引用次数: 1
Treatment-resistant manic episode in a patient diagnosed with bipolar affective disorder. 诊断为双相情感障碍患者的治疗抵抗性躁狂发作。
IF 0.9 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2022-12-01 DOI: 10.1097/YPG.0000000000000324
Nikolaos Papadimitriou, Diomidis Antoniadis, Athina Ververi

A considerable group of patients suffering from mental health disorders do not respond adequately to pharmacological treatment. For the purposes of precision and personalized medicine, pharmacogenomics has been developed as a valuable and promising tool. The technology of identifying single nucleotide polymorphisms and genotyping supplies clinicians, and therefore their patients, with the opportunity of avoiding long-lasting 'trial and error' periods, reducing the risk of manifesting disturbing adverse effects during treatment. Consequently, better adherence to treatment and clinical response can be achieved, contributing to personalized treatment planning, according to a person's genetic profile and needs. In the present report, we present a case of an individual diagnosed with bipolar affective disorder type I, who showed resistance to pharmacological treatment and underwent through pharmacogenomic investigations, in order to identify the appropriate medication for the best possible clinical response.

相当多的精神疾病患者对药物治疗反应不充分。药物基因组学已成为一种有价值和有前途的工具,用于精确和个性化医疗。识别单核苷酸多态性和基因分型技术为临床医生及其患者提供了避免长期“试错”期的机会,从而降低了在治疗期间出现令人不安的不良反应的风险。因此,可以实现更好的治疗依从性和临床反应,有助于根据个人的遗传概况和需求制定个性化的治疗计划。在本报告中,我们报告了一个被诊断为双相情感障碍I型的个体病例,他对药物治疗表现出耐药性,并通过药物基因组学研究,以确定最佳临床反应的适当药物。
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引用次数: 0
Mapping, clustering, and analysis of research in psychiatric genomics. 精神病学基因组学研究的制图、聚类和分析。
IF 0.9 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2022-12-01 DOI: 10.1097/YPG.0000000000000325
Sabita Yadav, Ayushi Chhabra, G Mahesh

Introduction: The distribution pattern and knowledge structure of psychiatric genomics were surveyed based on literature dealing with both psychiatry and genomics/genetics. Coword analysis and bibliographic coupling of the records retrieved from Scopus and PubMed for 2016-2020 revealed the subsurface research aspects.

Method: The data were analyzed using coword analysis and clustering methods using Sci2 and VOSviewer.

Result: Analysis of ~3800 records showed that psychiatric genomics is, as expectedly, covered largely under biomedical subjects with a visible interest in other disciplines such as humanities and ethics. A coword analysis was done for all the years, followed by a year-wise analysis based on the keywords, and then a bibliographic coupling based on the cited references. This led to the generation of different clusters of prevalent research areas. The centrality values described the position of each component.

Discussion: 'Schizophrenia', 'depression', 'pharmacogenomics', and 'immunopathogenesis' were the research topics of overarching interest. 'Gut-brain axis' and 'gene-environment interaction' were the emerging topics, whereas certain topics such as 'child and adolescent psychiatry' remained priorities when compared to earlier studies. The keywords and research focus were diverse. They ranged from genetics to transcriptomics and epigenetics to proteomics of psychiatric disorders. We found a stagnation of science communication in the field with only 0.2% of the articles from the entire corpus relevant to it. The research categories identified in this study reflect the current publication and research trends in psychiatric genomics.

前言:通过对精神病学和基因组学/遗传学相关文献的梳理,调查了精神病学基因组学的分布格局和知识结构。对2016-2020年Scopus和PubMed检索的文献进行Coword分析和书目耦合,揭示了地下研究方面的问题。方法:使用Sci2和VOSviewer软件对数据进行码字分析和聚类分析。结果:对约3800份记录的分析表明,正如预期的那样,精神病学基因组学主要涵盖在生物医学学科中,而在其他学科如人文和伦理学中也有明显的兴趣。对所有年份进行coword分析,然后根据关键词进行年度分析,然后根据引用的参考文献进行书目耦合。这导致了不同的流行研究领域集群的产生。中心性值描述了每个组件的位置。讨论:“精神分裂症”、“抑郁症”、“药物基因组学”和“免疫发病机制”是我们最感兴趣的研究课题。“肠-脑轴”和“基因-环境相互作用”是新兴的主题,而“儿童和青少年精神病学”等某些主题与早期的研究相比仍然是优先考虑的。关键词和研究重点多种多样。他们的研究范围从遗传学到转录组学,从表观遗传学到精神疾病的蛋白质组学。我们发现该领域的科学传播停滞不前,整个语料库中只有0.2%的文章与之相关。本研究确定的研究类别反映了当前精神病学基因组学的出版和研究趋势。
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引用次数: 0
In-depth investigations of the molecular basis underlying sex differences among middle-aged and elderly schizophrenia populations. 深入研究中老年精神分裂症人群性别差异的分子基础。
IF 0.9 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2022-10-01 DOI: 10.1097/YPG.0000000000000322
Yatang Chen, Lei Yu, Yilin Liu, Qing Long, Xu You, Jianping Liu, Yong Zeng

Sex can influence almost all aspects of schizophrenia. However, the molecular mechanisms underlying sex differences in schizophrenia remain poorly understood. In this project, the dataset GSE107638 containing neuronal RNA-seq data and age/sex information of individuals with or without schizophrenia were retrieved. Schizophrenia samples were divided into young male (M-1), young female (F-1), middle-aged and elderly male (M-2) and middle-aged and elderly female (F-2) groups. Next, green/yellow/turquoise modules related to the M-2 trait and turquoise module correlated with the F-2 trait were identified by weighted correlation network analysis (WGCNA) analysis (soft thresholding power: 13; min module size: 200). Crucial genes in the M-2 green, M-2 turquoise and F-2 turquoise modules were identified by WGCNA, gene significance/module membership, and protein-protein interaction (PPI) analysis. Moreover, 2067 and 934 differentially expressed genes (|log2 fold-change| ≥0.58 and P-value < 0.05) in M-2 and F-2 schizophrenia subgroups versus same-age and same-sex counterparts were identified, respectively. Additionally, 82 core genes in the M-2 turquoise module and 4 hub genes in the F-2 turquoise module were differentially expressed in M-2 and F-2 schizophrenia subgroups versus their counterparts, respectively. Among the 82 hub genes, 15 genes were found to be correlated with neuronal development by the Kyoto Encyclopedia of Genes and Genomes enrichment analysis. Also, 2 potential PPI networks related to neuronal development were identified. Taken together, multiple potential hub genes and 2 potential neurobiological networks related to schizophrenia sex differences and disease progression were identified among middle-aged and elderly schizophrenia populations.

性几乎可以影响精神分裂症的所有方面。然而,精神分裂症性别差异背后的分子机制仍然知之甚少。在本项目中,检索了包含有或没有精神分裂症个体的神经元RNA-seq数据和年龄/性别信息的数据集GSE107638。精神分裂症样本分为青年男性(M-1)、青年女性(F-1)、中老年男性(M-2)和中老年女性(F-2)组。其次,通过加权相关网络分析(WGCNA)对M-2性状相关的绿/黄/绿松石色模块和F-2性状相关的绿松石色模块进行鉴定(软阈值功率:13;最小模块尺寸:200)。通过WGCNA、基因显著性/模块隶属度和蛋白蛋白相互作用(PPI)分析,鉴定了M-2绿色、M-2绿松石和F-2绿松石模块中的关键基因。差异表达基因2067个,差异表达基因934个(log2 fold-change|≥0.58,p值≥0.58)
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引用次数: 0
Novel RPS6KA3 mutations cause Coffin-Lowry syndrome in two patients and concurrent compulsive eyebrow-pulling behavior in one of them. 新的RPS6KA3突变导致两名患者出现Coffin-Lowry综合征,其中一名患者同时出现强迫性拉眉毛行为。
IF 0.9 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2022-10-01 DOI: 10.1097/YPG.0000000000000323
Semra Gürsoy, Filiz Hazan, Elif Çetinoğlu

Coffin-Lowry syndrome (CLS) is a rare X-linked disorder that, usually affects males, presenting with intellectual disability, short stature, growth retardation, short hands, hyperextensible fingers and progressive kyphoscoliosis. Due to skewed X chromosome inactivation, the clinical presentations of the affected females vary greatly and clinical manifestations could range from mild intellectual disability to typical features of CLS in males. Here, we reported two different novel RPS6KA3 gene mutations in two unrelated CLS patients and also described concomitant compulsive eyebrow-pulling behavior in one of these cases for the first time in the literature.

Coffin-Lowry综合征(CLS)是一种罕见的x连锁疾病,通常影响男性,表现为智力残疾、身材矮小、生长迟缓、手短、手指过度伸展和进行性脊柱后凸。由于X染色体失活偏斜,女性患者的临床表现差异很大,临床表现从轻度智力残疾到男性CLS的典型特征不等。在这里,我们报道了两个不相关的CLS患者中两种不同的新型RPS6KA3基因突变,并首次在文献中描述了其中一个病例中伴随的强迫性拉眉毛行为。
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引用次数: 0
Genetic determinants associated with response to clozapine in schizophrenia: an umbrella review. 与精神分裂症患者对氯氮平反应相关的遗传决定因素:综述。
IF 1.5 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2022-10-01 Epub Date: 2022-07-20 DOI: 10.1097/YPG.0000000000000320
Marte Z van der Horst, Georgia Papadimitriou, Jurjen J Luykx

Objective: Clozapine response varies widely from person to person, which may be due to inter-individual genetic variability. This umbrella review aims to summarize the current evidence on associations between pharmacodynamic genes and response to clozapine treatment.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology, a systematic literature search was conducted in the PubMed and EMBASE databases from inception to November 2021 to identify systematic reviews and meta-analyses of studies that examined genetic determinants of clozapine response. The quality of the reviews was assessed with the AMSTAR-2 tool.

Results: From a total of 128 records, 10 studies representing nine systematic reviews and one meta-analysis met our inclusion criteria. The overall quality of the included studies was poor. All systematic reviews concluded that the results of primary studies were largely negative or conflicting. Most evidence was found for an association with clozapine response and rs6313 and rs6314 within HTR2A and rs1062613 within HTR3A in the serotonergic system.

Conclusions: Conclusive evidence for associations between genetic variants and clozapine response is still lacking. Hypothesis-generating genetic studies in large, well-characterized study populations are urgently needed to obtain more consistent and clinically informative results. Future studies may also include multi-omics approaches to identify novel genetic determinants associated with clozapine response.

目的:对氯氮平的反应因人而异,这可能是由于个体间的基因差异造成的。本综述旨在总结药效学基因与氯氮平治疗反应之间关系的现有证据:方法:按照《系统综述和荟萃分析首选报告项目》的方法,在 PubMed 和 EMBASE 数据库中进行了系统文献检索(从开始到 2021 年 11 月),以确定研究氯氮平反应基因决定因素的系统综述和荟萃分析。采用AMSTAR-2工具对综述的质量进行评估:在总共 128 条记录中,有 10 项研究(代表 9 篇系统综述和 1 篇荟萃分析)符合我们的纳入标准。纳入研究的总体质量较差。所有系统综述的结论都是,主要研究的结果大多是负面的或相互矛盾的。大多数证据表明,氯氮平反应与血清素能系统中 HTR2A 的 rs6313 和 rs6314 以及 HTR3A 的 rs1062613 有关:目前仍缺乏基因变异与氯氮平反应相关的确凿证据。为了获得更一致、更有临床参考价值的结果,迫切需要在大规模、特征明确的研究人群中开展假设性遗传研究。未来的研究还可能包括多组学方法,以确定与氯氮平反应相关的新型基因决定因素。
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引用次数: 0
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Psychiatric Genetics
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