CYP2D6基因多态性与托莫西汀治疗ADHD疗效的关联性研究进展

托莫西汀是目前治疗ADHD的主要药物之一,主要经细胞色素P450酶代谢,是CYP2D6酶的底物。CYP2D6酶具有显著的基因多态性,不同个体CYP2D6酶对托莫西汀代谢能力有所差异,从而影响临床治疗ADHD的效果。查阅近年来国内外相关文献,对CYP2D6基因多态性与托莫西汀治疗ADHD疗效的关联性研究进展进行归纳总结。CYP2D6基因多态性可影响托莫西汀的疗效,CYP2D6慢代谢型患者需要更高的治疗剂量,发生不良反应的风险更高。CYP2D6基因型和表型对托莫西汀体内代谢和临床疗效的影响有待于进一步深入研究,ADHD患者CYP2D6基因多态性分布的全面系统调查也有待于开展,这将有利于托莫西汀治疗ADHD个体化用药的开展。

Research progress of relationship between CYP2D6 gene polymorphism and therapeutic effect of tomoxetine in the treatment of ADHD

Tomoxetine is one of the main drugs for the treatment of ADHD, which is mainly matabolized by the cytochrome P450 enzyme, and is the substrate of CYP2D6 enzyme. CYP2D6 enzyme has a significant genetic polymorphism. Different CYP2D6 enzymes vary in their ability to metabolize tomoxetine, thereby affecting the clinical efficacy of ADHD. The related literature at home and abroad in recent years is retrieved, and the research progress of the association between CYP2D6 gene polymorphism and therapeutic effect of tomoxetine on ADHD is summarized. CYP2D6 gene polymorphism can affect the efficacy of tomoxetine, and the patients with slow metabolism of CYP2D6 need higher doses. The risk of adverse reactions is higher. The effect of CYP2D6 genotype and phenotype on the metabolism and clinical efficacy of tomoxetine remains to be further studied. A comprehensive and systematic investigation of the distribution of CYP2D6 polymorphism in ADHD patients remains to be carried out. This will be beneficial to the development of individualized dosage of tomoxetine in the treatment of ADHD.