5-羟色胺2A受体基因多态性与帕利哌酮治疗精神分裂症临床效果的关系

目的：探讨5-羟色胺2A受体（5-HT2AR）基因T102C、A-1438G多态性与帕利哌酮治疗精神分裂症临床效果的关系。方法选择112例首发精神分裂症患者，检测外周血5-HT2AR基因T102C、A-1438G并进行基因分型，按5-HT2AR基因T102C、A-1438G多态性分组。所有患者均给予帕利哌酮治疗，在治疗前和治疗1个月后，采用阳性和阴性症状评定量表（ PANSS）评估临床疗效，计算PANSS评分的减分率。结果5-HT2AR基因T102C基因型C／C共14例（ C／C组）、T／C型60例（T／C组）、T／T型38例（T／T组）；5-HT2AR基因A-1438G基因型A／A型70例（A／A组）、A／G型26例（A／G组）、G／G型16例（G／G型）。治疗1个月后，5-HT2AR基因T102C、A-1438G各基因型组患者 PANSS的阳性症状评分、阴性症状评分、一般病理评分及总分均较治疗前下降（P＜0．05）。5-HT2AR基因T102C C／C 基因型患者一般病理评分的减分率低于T／C、T／T基因型（P ＜0．05），5-HTR2AR 基因 A-1438G G／G 基因型患者阴性症状评分的减分率低于 A／A、A／G 基因型（P＜0．05）。结论帕利哌酮治疗5-HT2AR 基因的各个基因亚型的精神分裂症患者均有效，但是对于5-HT2AR 基因T102C C／C基因型患者、A-1438G G／G基因型患者治疗效果比较差。

Association between polymorphism of 5-hydroxytryptamine 2A receptor gene and the clinical efficacy of paliperidone in schizophrenia

Objective To explore the association between the polymorphisms of 5-hydroxytryptamine 2A receptor (5-HT2AR) gene and the clinical efficacy of paliperidone in schizophrenia .Methods A total of 112 patients with first episode schizophrenia were selected.5-HT2AR gene T102C and A-1438G of peripheral blood were detected ,and genotyping was conducted .The patients were grouped according to the polymorphisms of 5-HT2AR gene T102C and A-1438G.All patients were treated with paliperidone .Before treatment and after one month of treatment ,positive and negative syndrome scale ( PANSS) was used to assess the clinical efficacy .The reduction rate of PANSS score was calculated.Results Genotype C/C(C/C group),T/C(T/C group),and T/T(T/T group) of 5-HT2AR gene T102C were found in 14,60,and 38 cases,respectively.Genotype A/A(A/A group),A/G(A/G group),and G/G(G/G group) of 5-HT2AR gene A-1438G were found in 70,26,and 16 cases,respectively.After 1 month of treatment,the scores of positive symptom,negative symptom, general pathology ,and total score in each genotype group of 5-HT2AR gene T102C and A-1438G decreased compared to the scores before the treatment(P<0.05).The reduction rate of the general pathology scale in patients with genotype C /C of 5-HT2AR gene T102C was lower than that in patients with genotype T/C or T/T(P<0.05).The reduction rate of the negative symptom score in patients with genotype G /G of 5-HT2AR gene T102C was lower than that in patients with genotype A/A or A/G(P<0.05).Conclusion Paliperidone is effective for asschizophrenia patients with various genotypes of 5-HT2AR gene,but is less effective for the patients with genotype C/C of 5-HT2AR gene T102C or genotype G/G of A-1438G.