COMT基因多态性与惊恐障碍临床疗效的关联研究

COMT gene polymorphism is associated with treatment response in panic disorder

目的探索惊恐障碍患者儿茶酚胺-O-甲基转移酶(catechol-O-methyltransferase,COMT)基因多态性(rs4680、rs740603)与艾司酞普兰疗效的关系。方法纳入惊恐障碍患者69例,正常对照78名。患者组使用艾司西酞普兰固定剂量10 mg/d连续治疗8周,分别在基线及第2、4、8周使用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评估焦虑症状。采用基质辅助激光解吸飞行时间质谱(MALDI-TOF-MS)对所有被试COMT基因rs4680、rs740603位点进行基因分型。结果患者组与对照组两位点基因型和等位基因分布无统计学差异(P>0.05)。患者治疗第8周时,rs4680的G/G基因型患者HAMA减分率(72.52%±11.38%)大于A/G基因型患者(60.70%±16.25%),差异有统计学意义(P<0.05)。在第2、8周时rs4680不同基因型患者焦虑症状治疗有效率差异有统计学意义(P<0.05)。rs740603不同基因型患者HAMA减分率无统计学差异(P>0.05)。结论COMT基因多态性在艾司西酞普兰对惊恐障碍焦虑症状改善中可能有作用。

Objective To explore the association of catechol-O-methyltransferase(COMT)(rs4680,rs740603)gene polymorphisms and treatment response to escitalopram in panic disorder(PD).Methods This case-controlled study included 69 PD patients and 78 healthy controls(HCs).PD patients were treated only by escitalopram with a fixed dose of 10 mg/d for 8 weeks.Hamilton anxiety rating scale(HAMA-14)were used to assess anxiety symptoms and severity at baseline,week 2,week 4,and week 8,respectively.Peripheral blood was drawn from all participants after enrollment.Genotyping for was carried out by primer extension of products and detected by matrix-assisted laser desorption time-offlight mass spectrometry(MALDI-TOF MS).Results There was no significant difference in genotype and allele distribution between the PD group and the HC group at two loci.PD patients with rs4680 G/G carrier had a higher reduction rate in HAMA-14 compared with those with A/G carrier after 8 week's treatment(72.52%±11.38%vs.60.70%±16.25%,P<0.05).There was a significant difference in treatment response among patients with different genotypes of rs4680 at week 2 and 8(P<0.05).The reduction rate was not significant among different rs740603 gene polymorphisms(P>0.05).Conclusion The findings suggest the potential role of COMT gene plays in treatment response to escitalopram in PD patients.