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LaFond M, DeAngelis B, al'Absi M. Hypothalamic pituitary adrenal and autonomic nervous system biomarkers of stress and tobacco relapse: Review of the research. Biol Psychol 2024; 192:108854. [PMID: 39151748 DOI: 10.1016/j.biopsycho.2024.108854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 08/01/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024]
Abstract
Tobacco smoking is a risk factor for countless diseases, and smoking relapse remains a major public health concern. Subjective reports of stress by smokers are a common theme for relapse, however, the role of objective stress-related biomarkers in predicting tobacco relapse risk has been less studied. The aim of this manuscript was to review existing literature on the connection between biomarkers of stress and smoking relapse. Overall, trends indicate that blunted hypothalamic-pituitary-adrenal (HPA) responses to acute stress, larger reductions in HPA biomarkers during the initial days of abstinence during cessation (compared to pre-cessation levels), and exaggerated autonomic responses to stress predict increased risk of relapse. In addition, successful cessation is followed by changes in stress biomarkers (e.g., reductions in cortisol and heart rate, HR). This review also identifies potential modifiers, such as methodological differences, biological sex, and chronic stress, to account for heterogeneity of findings within and across studies. In addition, we identify gaps in the literature and suggest future research directions focusing on the roles of genetics and gene expression as well as the influence of neurobiological mechanisms on stress and relapse risk. Future clinical implications of this research include identifying reliable indicators of relapse risk and the potential of pharmacotherapeutic treatments to target stress response systems to correct dysregulation and potentially reduce stress-related risk of relapse.
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Affiliation(s)
- Madeleine LaFond
- Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN 55812, USA
| | - Briana DeAngelis
- Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN 55812, USA
| | - Mustafa al'Absi
- Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN 55812, USA.
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Prom-Wormley EC, Wells JL, Landes L, Edmondson AN, Sankoh M, Jamieson B, Delk KJ, Surya S, Bhati S, Clifford J. A scoping review of smoking cessation pharmacogenetic studies to advance future research across racial, ethnic, and ancestral populations. Front Genet 2023; 14:1103966. [PMID: 37359362 PMCID: PMC10285878 DOI: 10.3389/fgene.2023.1103966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/25/2023] [Indexed: 06/28/2023] Open
Abstract
Abstinence rates among smokers attempting to quit remain low despite the wide availability and accessibility of pharmacological smoking cessation treatments. In addition, the prevalence of cessation attempts and abstinence differs by individual-level social factors such as race and ethnicity. Clinical treatment of nicotine dependence also continues to be challenged by individual-level variability in effectiveness to promote abstinence. The use of tailored smoking cessation strategies that incorporate information on individual-level social and genetic factors hold promise, although additional pharmacogenomic knowledge is still needed. In particular, genetic variants associated with pharmacological responses to smoking cessation treatment have generally been conducted in populations with participants that self-identify as White race or who are determined to be of European genetic ancestry. These results may not adequately capture the variability across all smokers as a result of understudied differences in allele frequencies across genetic ancestry populations. This suggests that much of the current pharmacogenetic study results for smoking cessation may not apply to all populations. Therefore, clinical application of pharmacogenetic results may exacerbate health inequities by racial and ethnic groups. This scoping review examines the extent to which racial, ethnic, and ancestral groups that experience differences in smoking rates and smoking cessation are represented in the existing body of published pharmacogenetic studies of smoking cessation. We will summarize results by race, ethnicity, and ancestry across pharmacological treatments and study designs. We will also explore current opportunities and challenges in conducting pharmacogenomic research on smoking cessation that encourages greater participant diversity, including practical barriers to clinical utilization of pharmacological smoking cessation treatment and clinical implementation of pharmacogenetic knowledge.
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Affiliation(s)
- Elizabeth C. Prom-Wormley
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Jonathan L. Wells
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Lori Landes
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Amy N. Edmondson
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Mariam Sankoh
- Department of Integrative Life Sciences, Virginia Commonwealth University, Richmond, VA, United States
| | - Brendan Jamieson
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Kayla J. Delk
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Sanya Surya
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Shambhavi Bhati
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - James Clifford
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, United States
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Konjevod M, Nikolac Perkovic M, Svob Strac D, Uzun S, Nedic Erjavec G, Kozumplik O, Tudor L, Mimica N, Hirasawa-Fujita M, Domino EF, Pivac N. Significant association of mu-opioid receptor 1 haplotype with tobacco smoking in healthy control subjects but not in patients with schizophrenia and alcohol dependence. Psychiatry Res 2020; 291:113278. [PMID: 32763540 DOI: 10.1016/j.psychres.2020.113278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 10/23/2022]
Abstract
Tobacco smoking is highly prevalent in patients with schizophrenia and alcohol dependence. The underlying neurobiology of nicotine addiction is complex. Rewarding effects of nicotine from cigarettes are associated, among others, with mu-opioid receptors encoded by the OPRM1 gene. The aim of the study was to evaluate the association between two OPRM1 gene polymorphisms, rs1799971 and rs510769, and tobacco smoking in Caucasian patients with schizophrenia, alcohol dependence, and healthy control subjects. The study included 1058 Caucasians (277 patients with schizophrenia, 359 patients with alcohol dependence, and 422 healthy control subjects), subdivided according to the nicotine dependence into smokers (i.e. current smokers) and non-smokers. A significant association was found between the GC haplotype (OPRM1 rs1799971 and rs510769) and smoking in healthy controls, but not in patients with schizophrenia and alcohol dependence. A nominal association was detected in all cases/controls, but this significance did not survive the correction for the multiple testing. This is the first study to reveal that nicotine dependence is associated with the GC haplotype of the OPRM1 rs1799971 and rs510769 in all subjects or specifically in healthy controls. These results did not confirm the strong connection between OPRM1 polymorphisms and nicotine dependence in schizophrenia or alcohol dependence.
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Affiliation(s)
- Marcela Konjevod
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Zagreb, Croatia
| | - Matea Nikolac Perkovic
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Zagreb, Croatia
| | - Dubravka Svob Strac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Zagreb, Croatia
| | - Suzana Uzun
- Department of Biological Psychiatry and Psychogeriatry, University Psychiatric Hospital Vrapce, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Gordana Nedic Erjavec
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Zagreb, Croatia
| | - Oliver Kozumplik
- Department of Biological Psychiatry and Psychogeriatry, University Psychiatric Hospital Vrapce, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Lucija Tudor
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Zagreb, Croatia
| | - Ninoslav Mimica
- Department of Biological Psychiatry and Psychogeriatry, University Psychiatric Hospital Vrapce, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Mika Hirasawa-Fujita
- Department of Pharmacology, University of Michigan, Ann Arbor, MI 48109-5632, United States
| | - Edward F Domino
- Department of Pharmacology, University of Michigan, Ann Arbor, MI 48109-5632, United States
| | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Zagreb, Croatia.
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Roche DJO, Trela CJ, Argos M, Jasmine F, Kibriya MG, Ahsan H, King AC. Lack of Association between Opioid-Receptor Genotypes and Smoking Cessation Outcomes in a Randomized, Controlled Naltrexone Trial. Alcohol Alcohol 2019; 54:559-565. [PMID: 31206155 PMCID: PMC7963143 DOI: 10.1093/alcalc/agz046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 05/08/2019] [Accepted: 05/18/2019] [Indexed: 02/01/2023] Open
Abstract
AIMS The present study examined how variation in mu- (OPRM1), kappa- (OPRK), and delta- (OPRD) opioid receptor genes may influence the efficacy of naltrexone in the context of a smoking cessation trial. METHODS The study's primary objective was to examine the association of the Asn40Asp OPRM1 single nucleotide polymorphism (SNP) with naltrexone's effects on smoking quit rate, weight gain, and heavy drinking behavior during a double-blind, randomized clinical trial in 280 adult DSM-IV nicotine-dependent participants. The secondary goal of the study was to examine the relationship of 20 additional SNPs of OPRM1, OPRK, and OPRD with the aforementioned outcomes. RESULTS Results indicated a null association between any opioid-receptor gene SNP and naltrexone's effects on smoking quit rate, weight gain, and heavy drinking behavior in this sample of nicotine dependent participants. CONCLUSIONS In sum, these results do not suggest that genetic variation in opioid-receptors is related to treatment responses to naltrexone in a smoking cessation trial.
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Affiliation(s)
- Daniel J O Roche
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Constantine J Trela
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA
| | - Farzana Jasmine
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA
- Department of Public Health Studies, University of Chicago, Chicago, IL 60637, USA
| | - Muhammad G Kibriya
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA
| | - Habibul Ahsan
- Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA
| | - Andrea C King
- Department of Psychiatry and Behavioral Sciences, University of Chicago, Chicago, IL 60637, USA
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Salloum NC, Buchalter ELF, Chanani S, Espejo G, Ismail MS, Laine RO, Nageeb M, Srivastava AB, Trapp N, Trillo L, Vance E, Wenzinger M, Hartz SM, David SP, Chen LS. From genes to treatments: a systematic review of the pharmacogenetics in smoking cessation. Pharmacogenomics 2018; 19:861-871. [PMID: 29914292 PMCID: PMC6219447 DOI: 10.2217/pgs-2018-0023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 04/30/2018] [Indexed: 12/12/2022] Open
Abstract
Smoking cessation treatment outcomes may be heavily influenced by genetic variations among smokers. Therefore, identifying specific variants that affect response to different pharmacotherapies is of major interest to the field. In the current study, we systematically review all studies published in or after the year 1990 which examined one or more gene-drug interactions for smoking cessation treatment. Out of 644 citations, 46 articles met the inclusion criteria for the systematic review. We summarize evidence on several genetic polymorphisms (CHRNA5-A3-B4, CYP2A6, DBH, CHRNA4, COMT, DRD2, DRD4 and CYP2B6) and their potential moderating pharamacotherarpy effects on patient cessation efficacy rates. These findings are promising and call for further research to demonstrate the effectiveness of genetic testing in personalizing treatment decision-making and improving outcome.
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Affiliation(s)
- Naji C Salloum
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Erica LF Buchalter
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Swati Chanani
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Gemma Espejo
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Mahjabeen S Ismail
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Randy O Laine
- Department of Medicine, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Maysaa Nageeb
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - A Benjamin Srivastava
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Nicholas Trapp
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Ludwig Trillo
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Erica Vance
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Michael Wenzinger
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Sarah M Hartz
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Sean P David
- Department of Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
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Schuit E, Panagiotou OA, Munafò MR, Bennett DA, Bergen AW, David SP. Pharmacotherapy for smoking cessation: effects by subgroup defined by genetically informed biomarkers. Cochrane Database Syst Rev 2017; 9:CD011823. [PMID: 28884473 PMCID: PMC6483659 DOI: 10.1002/14651858.cd011823.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Smoking cessation therapies are not effective for all smokers, and researchers are interested in identifying those subgroups of individuals (e.g. based on genotype) who respond best to specific treatments. OBJECTIVES To assess whether quit rates vary by genetically informed biomarkers within pharmacotherapy treatment arms and as compared with placebo. To assess the effects of pharmacotherapies for smoking cessation in subgroups of smokers defined by genotype for identified genome-wide significant polymorphisms. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group specialised register, clinical trial registries, and genetics databases for trials of pharmacotherapies for smoking cessation from inception until 16 August 2016. SELECTION CRITERIA We included randomised controlled trials (RCTs) that recruited adult smokers and reported pharmacogenomic analyses from trials of smoking cessation pharmacotherapies versus controls. Eligible trials included those with data on a priori genome-wide significant (P < 5 × 10-8) single-nucleotide polymorphisms (SNPs), replicated non-SNPs, and/or the nicotine metabolite ratio (NMR), hereafter collectively described as biomarkers. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. The primary outcome was smoking abstinence at six months after treatment. The secondary outcome was abstinence at end of treatment (EOT). We conducted two types of meta-analyses- one in which we assessed smoking cessation of active treatment versus placebo within genotype groups, and another in which we compared smoking cessation across genotype groups within treatment arms. We carried out analyses separately in non-Hispanic whites (NHWs) and non-Hispanic blacks (NHBs). We assessed heterogeneity between genotype groups using T², I², and Cochrane Q statistics. MAIN RESULTS Analyses included 18 trials including 9017 participants, of whom 6924 were NHW and 2093 NHB participants. Data were available for the following biomarkers: nine SNPs (rs1051730 (CHRNA3); rs16969968, rs588765, and rs2036527 (CHRNA5); rs3733829 and rs7937 (in EGLN2, near CYP2A6); rs1329650 and rs1028936 (LOC100188947); and rs215605 (PDE1C)), two variable number tandem repeats (VNTRs; DRD4 and SLC6A4), and the NMR. Included data produced a total of 40 active versus placebo comparisons, 16 active versus active comparisons, and 64 between-genotype comparisons within treatment arms.For those meta-analyses showing statistically significant heterogeneity between genotype groups, we found the quality of evidence (GRADE) to be generally moderate. We downgraded quality most often because of imprecision or risk of bias due to potential selection bias in genotyping trial participants. Comparisons of relative treatment effects by genotypeFor six-month abstinence, we found statistically significant heterogeneity between genotypes (rs16969968) for nicotine replacement therapy (NRT) versus placebo at six months for NHB participants (P = 0.03; n = 2 trials), but not for other biomarkers or treatment comparisons. Six-month abstinence was increased in the active NRT group as compared to placebo among participants with a GG genotype (risk ratio (RR) 1.47, 95% confidence interval (CI) 1.07 to 2.03), but not in the combined group of participants with a GA or AA genotype (RR 0.43, 95% CI 0.15 to 1.26; ratio of risk ratios (RRR) GG vs GA or AA of 3.51, 95% CI 1.19 to 10.3). Comparisons of treatment effects between genotype groups within pharmacotherapy randomisation armsFor those receiving active NRT, treatment was more effective in achieving six-month abstinence among individuals with a slow NMR than among those with a normal NMR among NHW and NHB combined participants (normal NMR vs slow NMR: RR 0.54, 95% CI 0.37 to 0.78; n = 2 trials). We found no such differences in treatment effects between genotypes at six months for any of the other biomarkers among individuals who received pharmacotherapy or placebo. AUTHORS' CONCLUSIONS We did not identify widespread differential treatment effects of pharmacotherapy based on genotype. Some genotype groups within certain ethnic groups may benefit more from NRT or may benefit less from the combination of bupropion with NRT. The reader should interpret these results with caution because none of the statistically significant meta-analyses included more than two trials per genotype comparison, many confidence intervals were wide, and the quality of this evidence (GRADE) was generally moderate. Although we found evidence of superior NRT efficacy for NMR slow versus normal metabolisers, because of the lack of heterogeneity between NMR groups, we cannot conclude that NRT is more effective for slow metabolisers. Access to additional data from multiple trials is needed, particularly for comparisons of different pharmacotherapies.
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Affiliation(s)
- Ewoud Schuit
- Stanford UniversityMeta‐Research Innovation Center at Stanford (METRICS)StanfordCAUSA
- University Medical Center UtrechtCochrane NetherlandsUtrechtNetherlands
- University Medical Center UtrechtJulius Center for Health Sciences and Primary CareUtrechtNetherlands
| | - Orestis A. Panagiotou
- School of Public Health, Brown UniversityDepartment of Health Services, Policy & Practice121 S. Main StreetProvidenceRIUSA02903
| | - Marcus R Munafò
- University of BristolSchool of Experimental Psychology and MRC Integrative Epidemiology Unit8 Woodland RoadBristolUKBS8 1TN
| | - Derrick A Bennett
- University of OxfordClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population HealthRichard Doll BuildingOld Road CampusOxfordUKOX3 7LF
| | | | - Sean P David
- Stanford UniversityDivision of Primary Care and Population Health, Department of MedicineStanfordCaliforniaUSA94304‐5559
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Hirasawa-Fujita M, Bly MJ, Ellingrod VL, Dalack GW, Domino EF. Genetic Variation of the Mu Opioid Receptor (OPRM1) and Dopamine D2 Receptor (DRD2) is Related to Smoking Differences in Patients with Schizophrenia but not Bipolar Disorder. CLINICAL SCHIZOPHRENIA & RELATED PSYCHOSES 2017; 11:39-48. [PMID: 28548579 PMCID: PMC4366347 DOI: 10.3371/1935-1232-11.1.39] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
It is not known why mentally ill persons smoke excessively. Inasmuch as endogenous opioid and dopaminergic systems are involved in smoking reinforcement, it is important to study mu opioid receptor (OPRM1) A118G (rs1799971), dopamine D2 receptor (DRD2) Taq1A (rs1800497) genotypes, and sex differences among patients with schizophrenia or bipolar disorder. Smokers and nonsmokers with schizophrenia (n=177) and bipolar disorder (n=113) were recruited and genotyped. They were classified into three groups: current smoker, former smoker, and never smoker by tobacco smoking status self-report. The number of cigarettes smoked per day was used as the major tobacco smoking parameter. In patients with schizophrenia, tobacco smoking prevalence was greater in males than in females as expected, but women had greater daily cigarette consumption (p<0.01). Subjects with schizophrenia who had the OPRM1 *G genotype smoked more cigarettes per day than the AA allele carriers with schizophrenia (p<0.05). DRD2 Taq1A genotype differences had no effect on the number of cigarettes smoked per day. However, female smokers with schizophrenia who were GG homozygous of the DRD2 receptor smoked more than the *A male smokers with schizophrenia (p<0.05). In bipolar patients, there were no OPRM1 and DRD2 Taq1A genotype differences in smoking status. There also were no sex differences for smoking behavior among the bipolar patients. The results of this study indicate that single nucleotide polymorphism (SNP) of the less functional mu opioid receptor increases tobacco smoking in patients with schizophrenia. Alteration of DRD2 receptor function also increased smoking behavior in females with schizophrenia.
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Converging findings from linkage and association analyses on susceptibility genes for smoking and other addictions. Mol Psychiatry 2016; 21:992-1008. [PMID: 27166759 PMCID: PMC4956568 DOI: 10.1038/mp.2016.67] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 03/05/2016] [Accepted: 03/09/2016] [Indexed: 12/18/2022]
Abstract
Experimental approaches to genetic studies of complex traits evolve with technological advances. How do discoveries using different approaches advance our knowledge of the genetic architecture underlying complex diseases/traits? Do most of the findings of newer techniques, such as genome-wide association study (GWAS), provide more information than older ones, for example, genome-wide linkage study? In this review, we address these issues by developing a nicotine dependence (ND) genetic susceptibility map based on the results obtained by the approaches commonly used in recent years, namely, genome-wide linkage, candidate gene association, GWAS and targeted sequencing. Converging and diverging results from these empirical approaches have elucidated a preliminary genetic architecture of this intractable psychiatric disorder and yielded new hypotheses on ND etiology. The insights we obtained by putting together results from diverse approaches can be applied to other complex diseases/traits. In sum, developing a genetic susceptibility map and keeping it updated are effective ways to keep track of what we know about a disease/trait and what the next steps may be with new approaches.
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Kasai S, Nishizawa D, Hasegawa J, Sato N, Tanioka F, Sugimura H, Ikeda K. Nociceptin/orphanin FQ receptor gene variation is associated with smoking status in Japanese. Pharmacogenomics 2016; 17:1441-51. [DOI: 10.2217/pgs.15.184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The endogenous opioid system has been reportedly implicated in tobacco/nicotine dependence. Materials & methods: We examined the genetic effects of eight SNPs in opioid receptor-related genes on smoking status and smoking-related traits in Japanese. Results: The genotypic and allelic variations of the rs2229205 SNP in the OPRL1 gene were significantly associated with smoking status, but no significant differences were found in the genetic variations of any of the SNPs with regard to smoking-related traits. The rs2229205 SNP did not show high linkage disequilibrium with the other SNPs in the linkage disequilibrium block that contained the SNP. Conclusion: The rs2229205 SNP in the OPRL1 gene may be a genetic factor that contributes to individual differences in the vulnerability to smoking in Japanese individuals.
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Affiliation(s)
- Shinya Kasai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Naomi Sato
- First Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan
| | - Fumihiko Tanioka
- Division of Pathology, Iwata City Hospital, 512-3 Ookubo, Iwata, Shizuoka 438-8550, Japan
| | - Haruhiko Sugimura
- First Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
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Park SJ, Yi B, Lee HS, Oh WY, Na HK, Lee M, Yang M. To quit or not: Vulnerability of women to smoking tobacco. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, ENVIRONMENTAL CARCINOGENESIS & ECOTOXICOLOGY REVIEWS 2016; 34:33-56. [PMID: 26669465 DOI: 10.1080/10590501.2015.1131539] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Tobacco smoking is currently on the rise among women, and can pose a greater health risk. In order to understand the nature of the increase in smoking prevalence among women, we focused on the vulnerability of women to smoking behaviors--smoking cessation or tobacco addiction--and performed a systematic review of the socioeconomic and intrinsic factors as well as tobacco ingredients that affect women's susceptibility to smoking tobacco. We observed that nicotine and other tobacco components including cocoa-relatives, licorice products, and menthol aggravate tobacco addiction in women rather than in men. Various genetic and epigenetic alterations in dopamine pathway and the pharmaco-kinetics and -dynamic factors of nicotine also showed potential evidences for high susceptibility to tobacco addiction in women. Therefore, we suggest systemic approaches to prevent tobacco smoking-related health risks, considering gene-environment-gender interaction.
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Affiliation(s)
- Se-Jung Park
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Bitna Yi
- b Department of Neurosurgery , Stanford University School of Medicine , Stanford , California , USA
| | - Ho-Sun Lee
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Woo-Yeon Oh
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Hyun-Kyung Na
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Minjeong Lee
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
| | - Mihi Yang
- a Research Center for Cell Fate Control, College of Pharmacy, Sookmyung Women's University , Seoul , Republic of Korea
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A review of pharmacogenetic studies of substance-related disorders. Drug Alcohol Depend 2015; 152:1-14. [PMID: 25819021 PMCID: PMC4458176 DOI: 10.1016/j.drugalcdep.2015.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/05/2015] [Accepted: 03/02/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Substance-related disorders (SRDs) are a major cause of morbidity and mortality worldwide. Family, twin, and adoption studies have demonstrated the substantial heritability of SRDs. To determine the impact of genetic variation on risk for SRD and the response to treatment, researchers have conducted a number of secondary data analyses and quasi-experimental studies that target one or more candidate gene variants. METHODS This review examines studies in which candidate polymorphisms were examined as mediator variables to identify pharmacogenetic effects on subjective responses to drug administration or cues or outcomes of medication trials for SRDs. Efforts to use a meta-analytic approach to quantify these effects are premature because the number of available studies using similar methods and outcomes is limited, so the present review is qualitative. RESULTS Findings from these studies provide preliminary evidence of clinically relevant pharmacogenetic effects. However, independent replication of these findings has been sparse. CONCLUSIONS Although this growing body of literature has produced conflicting results, improved statistical controls may help to clarify the findings. Additionally, the use of empirically derived sub-phenotypes (i.e., which serve to differentiate distinct groups of affected individuals) may also help to identify genetic mediators of pharmacologic response in relation to SRDs. The identification of genetic mediators can inform clinical care both by identifying risk factors for SRDs and predicting adverse events and therapeutic outcomes associated with specific pharmacotherapies.
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Cieślińska A, Sienkiewicz-Szłapka E, Kostyra E, Fiedorowicz E, Snarska J, Wroński K, Tenderenda M, Jarmołowska B, Matysiewicz M. μ-Opioid receptor gene (OPRM1) polymorphism in patients with breast cancer. Tumour Biol 2015; 36:4655-60. [PMID: 25618602 PMCID: PMC4529459 DOI: 10.1007/s13277-015-3113-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 01/14/2015] [Indexed: 12/20/2022] Open
Abstract
Structure-dependent μ-opioid receptor (MOR) activity is an important element in cancer opioid analgesic effectiveness. It is widely accepted that guanine (G) substitution for adenine (A) at OPRM1 gene sequence position 118 changes receptor glycosylation pattern. This is associated with decreased binding ability in both exogenous and endogenous opioids, resulting in increased human pain resistance. The endogenous opioid system's function in body homeostasis maintenance is considered mainly regulatory, so its participation in breast tumor formation and progression is identified herein. We examine the association of the most frequent MOR (A118G) gene polymorphism on breast cancer risk in a Northeastern Polish population by PCR-RFLP comparison of A and G allele frequency at OPRM1 gene A118G polymorphic site in breast cancer-diagnosed patients with healthy control group frequencies. Our results highlight a strong association between G allele presence at μ-opioid receptor A118G and increased breast cancer incidence (OR = 3.3, 95 % CI 2.2-5.0, p < 0.0001) and female gender (OR = 2.0, 95 % CI 1.4-2.9, p = 0.0004). Consequently, OPRM1 G allele presence at that site is a highly significant risk factor in breast cancer development.
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Affiliation(s)
- Anna Cieślińska
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, Oczapowskiego 1A Street, 10-719 Olsztyn, Poland
| | - Edyta Sienkiewicz-Szłapka
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, Oczapowskiego 1A Street, 10-719 Olsztyn, Poland
| | - Elżbieta Kostyra
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, Oczapowskiego 1A Street, 10-719 Olsztyn, Poland
| | - Ewa Fiedorowicz
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, Oczapowskiego 1A Street, 10-719 Olsztyn, Poland
| | - Jadwiga Snarska
- Department of General Surgery, Faculty of Medical Sciences, University of Warmia and Mazury, Wojska Polskiego 37 Street, 10-228 Olsztyn, Poland
| | - Konrad Wroński
- Department of Oncology, Faculty of Medical Sciences, University of Warmia and Mazury, Wojska Polskiego 37 Street, 10-228 Olsztyn, Poland
| | - Michał Tenderenda
- Department of General and Minimally Invasive Surgery, Faculty of Medical Sciences, University of Warmia and Mazury, Niepodległości 44 Street, 11-041 Olsztyn, Poland
| | - Beata Jarmołowska
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, Oczapowskiego 1A Street, 10-719 Olsztyn, Poland
| | - Michał Matysiewicz
- Department of Biochemistry, Faculty of Biology and Biotechnology, University of Warmia and Mazury, Oczapowskiego 1A Street, 10-719 Olsztyn, Poland
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Woodcock EA, Lundahl LH, Burmeister M, Greenwald MK. Functional mu opioid receptor polymorphism (OPRM1 A(118) G) associated with heroin use outcomes in Caucasian males: A pilot study. Am J Addict 2015; 24:329-35. [PMID: 25911999 DOI: 10.1111/ajad.12187] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 10/15/2014] [Accepted: 11/16/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Heroin's analgesic, euphoric and dependence-producing effects are primarily mediated by the mu opioid receptor (MOR). A single gene, OPRM1, encodes the MOR. The functional polymorphism A(118)G, located in exon 1 of the OPRM1 gene, results in anatomically-specific reductions in MOR expression, which may alter an individual's response to heroin. In prior studies 118G (rare allele) carriers demonstrated significantly greater opioid tolerance, overdose vulnerability, and pain sensitivity than 118AA homozygotes. Those findings suggest OPRM1 genotype may impact characteristics of heroin use. METHODS The present pilot study characterized the impact of OPRM1 genotype (rs1799971, 118G allele carriers vs. 118AA homozygotes) on heroin-use phenotypes associated with heroin dependence severity in a sample of male, Caucasian chronic heroin users (n = 86). RESULTS Results indicate that 118G allele carriers reported significantly more heroin use-related consequences and heroin-quit attempts, and were more likely to have sought treatment for their heroin use than 118AA homozygotes. CONCLUSIONS These preliminary findings, consistent with extant data, illustrate a role for OPRM1 allelic variation on heroin use characteristics, and provide support for considering genotype in heroin treatment and relapse prevention.
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Affiliation(s)
- Eric A Woodcock
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan; Translational Neuroscience Program, Wayne State University, Detroit, Michigan
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Jackson KJ, Muldoon PP, De Biasi M, Damaj MI. New mechanisms and perspectives in nicotine withdrawal. Neuropharmacology 2014; 96:223-34. [PMID: 25433149 DOI: 10.1016/j.neuropharm.2014.11.009] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/21/2014] [Accepted: 11/17/2014] [Indexed: 02/08/2023]
Abstract
Diseases associated with tobacco use constitute a major health problem worldwide. Upon cessation of tobacco use, an unpleasant withdrawal syndrome occurs in dependent individuals. Avoidance of the negative state produced by nicotine withdrawal represents a motivational component that promotes continued tobacco use and relapse after smoking cessation. With the modest success rate of currently available smoking cessation therapies, understanding mechanisms involved in the nicotine withdrawal syndrome are crucial for developing successful treatments. Animal models provide a useful tool for examining neuroadaptative mechanisms and factors influencing nicotine withdrawal, including sex, age, and genetic factors. Such research has also identified an important role for nicotinic receptor subtypes in different aspects of the nicotine withdrawal syndrome (e.g., physical vs. affective signs). In addition to nicotinic receptors, the opioid and endocannabinoid systems, various signal transduction pathways, neurotransmitters, and neuropeptides have been implicated in the nicotine withdrawal syndrome. Animal studies have informed human studies of genetic variants and potential targets for smoking cessation therapies. Overall, the available literature indicates that the nicotine withdrawal syndrome is complex, and involves a range of neurobiological mechanisms. As research in nicotine withdrawal progresses, new pharmacological options for smokers attempting to quit can be identified, and treatments with fewer side effects that are better tailored to the unique characteristics of patients may become available. This article is part of the Special Issue entitled 'The Nicotinic Acetylcholine Receptor: From Molecular Biology to Cognition'.
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Affiliation(s)
- K J Jackson
- Department of Psychiatry, Virginia Commonwealth University, 800 E. Leigh St., Richmond, VA 23219, USA
| | - P P Muldoon
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 1220 E. Marshall St., Richmond, VA 23219, USA
| | - M De Biasi
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - M I Damaj
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, 1220 E. Marshall St., Richmond, VA 23219, USA.
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Weerts EM, Wand GS, Kuwabara H, Xu X, Frost JJ, Wong DF, McCaul ME. Association of smoking with μ-opioid receptor availability before and during naltrexone blockade in alcohol-dependent subjects. Addict Biol 2014; 19:733-42. [PMID: 23252742 DOI: 10.1111/adb.12022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Persons with a history of alcohol dependence are more likely to use tobacco and to meet criteria for nicotine dependence compared with social drinkers or non-drinkers. The high levels of comorbidity of nicotine and alcohol use and dependence are thought to be related to interactions between nicotinic, opioid and dopamine receptors in mesolimbic regions. The current study examined whether individual differences in regional μ-opioid receptor (MOR) availability were associated with tobacco use, nicotine dependence and level of nicotine craving in 25 alcohol-dependent (AD) subjects. AD subjects completed an inpatient protocol, which included medically supervised alcohol withdrawal, monitored alcohol abstinence, transdermal nicotine maintenance (21 mg/day) and Positron Emission Tomography (PET) imaging using the MOR agonist [(11) C]-carfentanil (CFN) before (basal scan) and during treatment with 50 mg/day naltrexone (naltrexone scan). Subjects who had higher scores on the Fagerström Nicotine Dependence Test had significantly lower basal scan binding potential (BPND ) across mesolimbic regions, including the amygdala, cingulate, globus pallidus, thalamus and insula. Likewise, the number of cigarettes per day was negatively associated with basal scan BPND in mesolimbic regions. Higher nicotine craving was significantly associated with lower BPND in amygdala, globus pallidus, putamen, thalamus and ventral striatum. Although blunted during naltrexone treatment, the negative association was maintained for nicotine dependence and cigarettes per day, but not for nicotine craving. These findings suggest that intensity of cigarette smoking and severity of nicotine dependence symptoms are systematically related to reduced BPND across multiple brain regions in AD subjects.
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Affiliation(s)
- Elise M. Weerts
- Department of Psychiatry and Behavioral Sciences; The Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Gary S. Wand
- Department of Psychiatry and Behavioral Sciences; The Johns Hopkins University School of Medicine; Baltimore MD USA
- Department of Medicine; The Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Hiroto Kuwabara
- Department of Radiology; The Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Xiaoqiang Xu
- Department of Psychiatry and Behavioral Sciences; The Johns Hopkins University School of Medicine; Baltimore MD USA
| | - J. James Frost
- Department of Radiology; The Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Dean F. Wong
- Department of Psychiatry and Behavioral Sciences; The Johns Hopkins University School of Medicine; Baltimore MD USA
- Department of Radiology; The Johns Hopkins University School of Medicine; Baltimore MD USA
- Department of Neuroscience; The Johns Hopkins University School of Medicine; Baltimore MD USA
- Department of Environmental Health Sciences; The Johns Hopkins University School of Medicine; Baltimore MD USA
| | - Mary E. McCaul
- Department of Psychiatry and Behavioral Sciences; The Johns Hopkins University School of Medicine; Baltimore MD USA
- Department of Medicine; The Johns Hopkins University School of Medicine; Baltimore MD USA
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Hirasawa-Fujita M, Bly MJ, Ellingrod VL, Dalack GW, Domino EF. Genetic Variation of the Mu Opioid Receptor (OPRM1) and Dopamine D2 Receptor (DRD2) is Related to Smoking Differences in Patients with Schizophrenia but not Bipolar Disorder. ACTA ACUST UNITED AC 2014. [DOI: 10.3371/csrp.mhmb.061314] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Crist RC, Berrettini WH. Pharmacogenetics of OPRM1. Pharmacol Biochem Behav 2013; 123:25-33. [PMID: 24201053 DOI: 10.1016/j.pbb.2013.10.018] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 09/19/2013] [Accepted: 10/23/2013] [Indexed: 12/23/2022]
Abstract
Pharmacogenetic research has the potential to explain the variation in treatment efficacy within patient populations. Understanding the interaction between genetic variation and medications may provide a method for matching patients to the most effective therapeutic options and improving overall patient outcomes. The OPRM1 gene has been a target of interest in a large number of pharmacogenetic studies due to its genetic and structural variation, as well as the role of opioid receptors in a variety of disorders. The mu-opioid receptor (MOR), encoded by OPRM1, naturally regulates the analgesic response to pain and also controls the rewarding effects of many drugs of abuse, including opioids, nicotine, and alcohol. Genetic variants in OPRM1, particularly the non-synonymous polymorphism A118G, have been repeatedly associated with the efficacy of treatments for pain and various types of dependence. This review focuses on the current understanding of the pharmacogenetic impact of OPRM1, primarily with regard to the treatment of pain and addiction.
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Affiliation(s)
- Richard C Crist
- Center for Neurobiology and Behavior, Department of Psychiatry, University of Pennsylvania School of Medicine, 125 South 31st St., Philadelphia, PA 19104, United States.
| | - Wade H Berrettini
- Center for Neurobiology and Behavior, Department of Psychiatry, University of Pennsylvania School of Medicine, 125 South 31st St., Philadelphia, PA 19104, United States
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Kleinjan M, Poelen EA, Engels RCME, Verhagen M. Dual growth of adolescent smoking and drinking: evidence for an interaction between the mu-opioid receptor (OPRM1) A118G polymorphism and sex. Addict Biol 2013; 18:1003-12. [PMID: 22260295 DOI: 10.1111/j.1369-1600.2011.00422.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Smoking and alcohol use often co-occur during adolescence, but little is known about the codevelopment of these substances. In the search for etiological factors that help to explain the development of adolescent substance use patterns, studies have revealed substantial heritability for both alcohol use and smoking. In this regard, the µ-opioid receptor gene (OPRM1, chromosome 6q24-q25) has been linked to both substances. This study examined the predictive relationships between initial level and growth of smoking and drinking in 311 early adolescents (13-15 years old) over a 4-year period. In addition, the effects of the A118G polymorphism of the OPRM1 gene on the initial values and the development over time of alcohol use and smoking were assessed. Finally, as prevalence and heritability estimates for both alcohol- and smoking-related behaviors differ between males and females, OPRM1 by sex interactions were tested. We found that high initial levels of early adolescent alcohol consumption were related to a stronger increase in smoking levels over time. In contrast, high initial levels of smoking were not related to growth of alcohol use. No main OPRM1 effects were found, but sex-specificity of the gene was found for smoking development. Male A-allele carriers showed a faster development in smoking behavior, whereas in females, the G-allele led to a faster development in smoking. Thus, in addition to high levels of alcohol as a risk factor for the development of smoking behavior, sex-specific effects exist for OPRM1, which may additionally have consequences for the development of adolescent smoking.
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Affiliation(s)
- Marloes Kleinjan
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands
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de Viron S, Malats N, Van der Heyden J, Van Oyen H, Brand A. Environmental and Genomic Factors as well as Interventions Influencing Smoking Cessation: A Systematic Review of Reviews and a Proposed Working Model. Public Health Genomics 2013; 16:159-73. [DOI: 10.1159/000351453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 04/18/2013] [Indexed: 11/19/2022] Open
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OPRM1 genetic polymorphisms are associated with the plasma nicotine metabolite cotinine concentration in methadone maintenance patients: a cross sectional study. J Hum Genet 2012; 58:84-90. [DOI: 10.1038/jhg.2012.139] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Munafò MR, Johnstone EC, Aveyard P, Marteau T. Lack of association of OPRM1 genotype and smoking cessation. Nicotine Tob Res 2012; 15:739-44. [PMID: 22990223 DOI: 10.1093/ntr/nts174] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Previous studies have reported an association between μ-opioid receptor (OPRM1) genotype and smoking cessation, with some evidence that the strength of this association depends on dose of nicotine replacement therapy (NRT). We examined whether a single-nucleotide polymorphism in the OPRM1 gene is associated with cessation and whether this variant moderates the effects of higher doses of NRT on abstinence. METHODS Participants were recruited from the practices of primary care physicians in the United Kingdom. Patients smoking an average of at least 10 cigarettes a day, who wanted to quit and were 18 years or older were eligible for inclusion. A total of N = 633 participants were recruited into the original trial, of whom complete data for pharmacogenetic analyses were available on n = 598. Logistic regression was used to test for the effects of OPRM1 genotype and NRT dose, including the genotype × dose interaction term, on smoking status at 4-week, and 26-week follow-up. Analyses were adjusted for potential confounders. RESULTS There was no evidence of a genotype effect at either follow-up, and no evidence of a genotype × dose interaction effect. CONCLUSIONS OPRM1 genotype may not affect the likelihood of smoking cessation, and it may not influence response to high- versus low-dose NRT. OPRM1 may have at most only a modest role in explaining cigarette smoking and cessation.
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Affiliation(s)
- Marcus R Munafò
- School of Experimental Psychology, University of Bristol, Bristol, UK.
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Tobacco smoking produces greater striatal dopamine release in G-allele carriers with mu opioid receptor A118G polymorphism. Prog Neuropsychopharmacol Biol Psychiatry 2012; 38:236-40. [PMID: 22516252 DOI: 10.1016/j.pnpbp.2012.04.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 03/27/2012] [Accepted: 04/03/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine if carriers of the allelic expression of the G variant of the human mu opioid receptor (OPRM1) A118G polymorphism have greater increases in striatal dopamine (DA) release after tobacco smoking. METHODS Nineteen of 20 genotyped male tobacco smokers, after overnight abstinence, smoked denicotinized (denic) and average nicotine (nic) containing tobacco cigarettes in a PET brain imaging study using [(11)C]raclopride. RESULTS The right striatum had more free D(2) receptors than the left striatum pre- and post-tobacco smoking. After smoking the nic cigarettes, mean decreased DA binding was observed in the left dorsal caudate (-14 6 11; t=3.77), left and right ventral putamen (-26 3-8; t=4.27; 28 2 1; t=4.25, respectively), and right caudate (17 18 1; t=3.92). The effects of A118G genotype on the binding potentials for these four regions were then analyzed. Carriers of the G allele had larger magnitudes of DA release in response to nic smoking than those homozygous for the more prevalent AA allele in the right caudate and right ventral pallidum (t=3.03; p=0.008 and t=3.91; p=0.001). A voxel by voxel whole brain SPM analysis using an independent samples t test did not reveal any other differences between genotype groups. In addition, the venous plasma cortisol levels of the volunteers from 8:30 a.m. to 12:40 p.m. were lower in the AG/GG allele carriers. Nic smoking increased plasma cortisol in both groups, but they were higher in the AA group. CONCLUSION This preliminary study indicates a difference in both brain striatal DA release and plasma cortisol in A118G polymorphic male tobacco smokers.
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Falcone M, Gold AB, Wileyto EP, Ray R, Ruparel K, Newberg A, Dubroff J, Logan J, Zubieta JK, Blendy JA, Lerman C. μ-Opioid receptor availability in the amygdala is associated with smoking for negative affect relief. Psychopharmacology (Berl) 2012; 222:701-8. [PMID: 22389047 PMCID: PMC3670416 DOI: 10.1007/s00213-012-2673-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 02/16/2012] [Indexed: 11/29/2022]
Abstract
RATIONALE The perception that smoking relieves negative affect contributes to smoking persistence. Endogenous opioid neurotransmission, and the μ-opioid receptor (MOR) in particular, plays a role in affective regulation and is modulated by nicotine. OBJECTIVES We examined the relationship of MOR binding availability in the amygdala to the motivation to smoke for negative affect relief and to the acute effects of smoking on affective responses. METHODS Twenty-two smokers were scanned on two separate occasions after overnight abstinence using [¹¹C]carfentanil positron emission tomography imaging: after smoking a nicotine-containing cigarette and after smoking a denicotinized cigarette. Self-reports of smoking motives were collected at baseline, and measures of positive and negative affect were collected pre- and post- cigarette smoking. RESULTS Higher MOR availability in the amygdala was associated with motivation to smoke to relieve negative affect. However, MOR availability was unrelated to changes in affect after smoking either cigarette. CONCLUSIONS Increased MOR availability in amygdala may underlie the motivation to smoke for negative affective relief. These results are consistent with previous data highlighting the role of MOR neurotransmission in smoking behavior.
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Affiliation(s)
- Mary Falcone
- Department of Pharmacology, University of Pennsylvania, Philadelphia, PA 19104,Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
| | - Allison B. Gold
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
| | - E. Paul Wileyto
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
| | - Riju Ray
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
| | - Kosha Ruparel
- Brain Behavior Laboratory, Neuropsychiatry Department, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Department of Emergency Medicine and Radiology, Thomas Jefferson University, Philadelphia, PA 19107
| | - Jacob Dubroff
- Department of Nuclear Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
| | - Jean Logan
- Medical Department, Brookhaven National Laboratory, Upton, NY 11973
| | - Jon-Kar Zubieta
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI 48109
| | - Julie A. Blendy
- Department of Pharmacology, University of Pennsylvania, Philadelphia, PA 19104
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
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Verhagen M, Kleinjan M, Engels RCME. A systematic review of the A118G (Asn40Asp) variant of OPRM1 in relation to smoking initiation, nicotine dependence and smoking cessation. Pharmacogenomics 2012; 13:917-33. [DOI: 10.2217/pgs.12.76] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Candidate gene studies on smoking behaviors mainly focused on dopaminergic and serotonergic genes, but genes within the µ-opioid system might also be involved. The A118G variant within the OPRM1 gene has been most often examined in relation to smoking, yielding inconsistent findings. It is largely unknown which of the alleles increases susceptibility for smoking behaviors. The aim of this review was to merge findings of OPRM1 gene studies in relation to smoking behaviors and to elaborate on the underlying biological mechanism of the A118G variant. It appeared that A118 was more likely to increase susceptibility to smoking behaviors than 118G, especially with regard to nicotine dependence, but less with smoking initiation and cessation. The proposed functioning of the OPRM1 gene is further explained.
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Affiliation(s)
- Maaike Verhagen
- Behavioural Science Institute, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Marloes Kleinjan
- Behavioural Science Institute, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Rutger CME Engels
- Behavioural Science Institute, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, The Netherlands
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Marteau TM, Aveyard P, Munafò MR, Prevost AT, Hollands GJ, Armstrong D, Sutton S, Hill C, Johnstone E, Kinmonth AL. Effect on adherence to nicotine replacement therapy of informing smokers their dose is determined by their genotype: a randomised controlled trial. PLoS One 2012; 7:e35249. [PMID: 22509402 PMCID: PMC3324463 DOI: 10.1371/journal.pone.0035249] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 03/12/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The behavioural impact of pharmacogenomics is untested. We tested two hypotheses concerning the behavioural impact of informing smokers their oral dose of NRT is tailored to analysis of DNA. METHODS AND FINDINGS We conducted an RCT with smokers in smoking cessation clinics (N = 633). In combination with NRT patch, participants were informed that their doses of oral NRT were based either on their mu-opioid receptor (OPRM1) genotype, or their nicotine dependence questionnaire score (phenotype). The proportion of prescribed NRT consumed in the first 28 days following quitting was not significantly different between groups: (68.5% of prescribed NRT consumed in genotype vs 63.6%, phenotype group, difference = 5.0%, 95% CI -0.9,10.8, p = 0.098). Motivation to make another quit attempt among those (n = 331) not abstinent at six months was not significantly different between groups (p = 0.23). Abstinence at 28 days was not different between groups (p = 0.67); at six months was greater in genotype than phenotype group (13.7% vs 7.9%, difference = 5.8%, 95% CI 1.0,10.7, p = 0.018). CONCLUSIONS Informing smokers their oral dose of NRT was tailored to genotype not phenotype had a small, statistically non-significant effect on 28-day adherence to NRT. Among those still smoking at six months, there was no evidence that saying NRT was tailored to genotype adversely affected motivation to make another quit attempt. Higher abstinence rate at six months in the genotype arm requires investigation. TRIAL REGISTRATION Controlled-Trials.com ISRCTN14352545.
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Affiliation(s)
- Theresa M Marteau
- Psychology Department at Guy's, Health Psychology Section, King's College London, London, United Kingdom.
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Abstract
The application of genomic medicine to the treatment of nicotine dependence holds great promise for revitalizing the steady decline in smoking rates witnessed in the USA over the past several decades. This paper examines the current knowledge base concerning the use of biomarkers to guide the selection of nicotine dependence treatments. First, we review the neurobiology of nicotine dependence and present evidence that supports its heritability. We then discuss the various studies of pharmacokinetic and pharmacodynamic genes related to therapeutic response. Current evidence suggests that biomarkers of genetic variability in both nicotine metabolism, referred to as the nicotine metabolite ratio, and dopamine genotypes may be useful for guiding treatment selection for nicotine dependence. Barriers to the translation of this research to clinical practice are discussed, as are directions for future research.
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Affiliation(s)
- Robert A Schnoll
- Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, Presbyterian Medical Center -1 PHI, 51 N 39th Street, Philadelphia, PA 19104, USA.
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Vasic N, Wolf RC, Wolf N, Connemann BJ, Sosic-Vasic Z. [Pharmacotherapeutic treatment strategies for smoking cessation]. DER NERVENARZT 2011; 82:1449-1459. [PMID: 21207000 DOI: 10.1007/s00115-010-3203-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Regular tobacco smoking occurs in about 35% of the male and 25% of the female German population. Individual attempts to independently quit smoking and to remain abstinent for 1 year have been shown to be successful in less than 5% of cases. This rate can be doubled by means of individual consulting and cognitive-behavioral interventions and additional pharmacological treatment might increase abstinence rates up to 25%. Apart from nicotine substitution (e.g. transdermal, oral and inhalative applications) and bupropion, recent studies have shown beneficial effects of varenicline for smoking cessation and abstinence. Varenicline, a selective partial nicotinergic agonist, has been specifically developed for the purpose of smoking cessation. Currently available data suggest that varenicline is more effective compared to nicotine substitution therapy and bupropion, increasing the abstinence likelihood by a factor of 2.3 compared to a placebo. Recent data regarding anti-nicotine vaccines suggest that this approach might yield a comparable treatment outcome and probably even better relapse-preventing effects than conventional psychopharmacological strategies. The first anti-nicotine vaccines are expected to be approved by national authorities within the forthcoming 1-2 years.
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Affiliation(s)
- N Vasic
- Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum, Ulm, Deutschland.
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Abstract
The µ-opioid receptor is a primary target for clinically important opioid analgesics, including morphine, fentanyl and methadone. Many genetic variations have been identified in the human µ-opioid receptor MOP gene (OPRM1), and their implications have been reported in the effects of opioid drugs and susceptibility to drug dependence. Interestingly, agonistic and antagonistic opioid effects are inversely associated with the A118G polymorphism genotype. The A118G polymorphism may also be associated with substance dependence and susceptibility to other disorders, including epilepsy and schizophrenia. The IVS1+A21573G, IVS1-T17286C, and TAA+A5359G polymorphisms in the OPRM1 gene may be associated with alcohol, opioid and tobacco dependence, respectively. However, some studies have failed to confirm the correlations between the polymorphisms and opioid effects and substance dependence. Further studies are needed to elucidate the molecular mechanisms underlying the effects of OPRM1 polymorphisms.
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Affiliation(s)
| | - Kazutaka Ikeda
- Research Project for Addictive Substances, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
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Sturgess JE, George TP, Kennedy JL, Heinz A, Müller DJ. Pharmacogenetics of alcohol, nicotine and drug addiction treatments. Addict Biol 2011; 16:357-76. [PMID: 21362114 DOI: 10.1111/j.1369-1600.2010.00287.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The numerous premature deaths, medical complications and socio-economic repercussions of drug and alcohol addiction suggest that improvements in treatment strategies for addictive disorders are warranted. The use of pharmacogenetics to predict response to medication, side effects and appropriate dosages is relatively new in the field of drug addiction. However, increasing our understanding of the genetic factors influencing these processes may improve the treatment of addiction in the future. We examined the available scientific literature on pharmacogenetic advancements in the field of drug addiction with a focus on alcohol and tobacco to provide a summary of genes implicated in the effectiveness of pharmacotherapy for addiction. In addition, we reviewed pharmacogenetic research on cocaine and heroin dependence. Thus far, the most promising results were obtained for polymorphisms in the OPRM1 and CYP2A6 genes, which have been effective in predicting clinical response to naltrexone in alcoholism and nicotine replacement therapy in smoking, respectively. Opinions differ as to whether pharmacogenetic testing should be implemented in the clinic at this time because clinical utility and cost-effectiveness require further investigation. However, the data summarized in this review demonstrate that pharmacogenetic factors play a role in response to addiction pharmacotherapy and have the potential to aid in the personalization of addiction treatments. Such data may lead to improved cessation rates by allowing physicians to select medications for individuals based, at least in part, on genetic factors that predispose to treatment success or failure rather than on a trial and error basis.
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Affiliation(s)
- Jessica E Sturgess
- Centre for Addiction and Mental Health, Pharmacogenetics Research Clinic, 250 College Street, Toronto, Ontario, Canada
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Ray R, Ruparel K, Newberg A, Wileyto EP, Loughead JW, Divgi C, Blendy JA, Logan J, Zubieta JK, Lerman C. Human Mu Opioid Receptor (OPRM1 A118G) polymorphism is associated with brain mu-opioid receptor binding potential in smokers. Proc Natl Acad Sci U S A 2011; 108:9268-73. [PMID: 21576462 PMCID: PMC3107291 DOI: 10.1073/pnas.1018699108] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Evidence points to the endogenous opioid system, and the mu-opioid receptor (MOR) in particular, in mediating the rewarding effects of drugs of abuse, including nicotine. A single nucleotide polymorphism (SNP) in the human MOR gene (OPRM1 A118G) has been shown to alter receptor protein level in preclinical models and smoking behavior in humans. To clarify the underlying mechanisms for these associations, we conducted an in vivo investigation of the effects of OPRM1 A118G genotype on MOR binding potential (BP(ND) or receptor availability). Twenty-two smokers prescreened for genotype (12 A/A, 10 */G) completed two [(11)C]carfentanil positron emission tomography (PET) imaging sessions following overnight abstinence and exposure to a nicotine-containing cigarette and a denicotinized cigarette. Independent of session, smokers homozygous for the wild-type OPRM1 A allele exhibited significantly higher levels of MOR BP(ND) than smokers carrying the G allele in bilateral amygdala, left thalamus, and left anterior cingulate cortex. Among G allele carriers, the extent of subjective reward difference (denicotinized versus nicotine cigarette) was associated significantly with MOR BP(ND) difference in right amygdala, caudate, anterior cingulate cortex, and thalamus. Future translational investigations can elucidate the role of MORs in nicotine addiction, which may lead to development of novel therapeutics.
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Affiliation(s)
- Riju Ray
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Department of Emergency Medicine and Radiology, Thomas Jefferson University, Philadelphia, PA 19107
| | - E. Paul Wileyto
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
| | - James W. Loughead
- Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
| | - Chaitanya Divgi
- Division of Nuclear Medicine, Department of Radiology, Columbia University, New York, NY 10032
| | - Julie A. Blendy
- Center for Neurobiology and Behavior, Department of Pharmacology, University of Pennsylvania, Philadelphia, PA 19104
| | - Jean Logan
- Medical Department, Brookhaven National Laboratory, Upton, NY 11973; and
| | - Jon-Kar Zubieta
- Molecular and Behavioral Neuroscience Institute, Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104
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David SP, Johnstone EC, Churchman M, Aveyard P, Murphy MFG, Munafò MR. Pharmacogenetics of smoking cessation in general practice: results from the patch II and patch in practice trials. Nicotine Tob Res 2011; 13:157-67. [PMID: 21330274 PMCID: PMC3107615 DOI: 10.1093/ntr/ntq246] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 12/14/2010] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Cigarette smoking remains the leading cause of preventable death worldwide. However, the efficacy of available first-line therapies remains low, particularly in primary care practice where most smokers seek and receive treatment. These observations reinforce the notion that 'one size fits all' smoking cessation therapies may not be optimal. Therefore, a translational research effort was launched by the Imperial Cancer Research Fund (later Cancer Research UK) General Practice Research Group, who led a decade-long research enterprise that examined the influence of pharmacological hypothesis-driven research into genetic influences on drug response for smoking cessation with transdermal nicotine replacement therapy in general practice. METHODS New and previously published smoking cessation genetic association results of 30 candidate gene polymorphisms genotyped for participants in two transdermal nicotine replacement clinical trials based in UK general practices, which employed an intention to analyze approach. RESULTS By this high bar, one of the polymorphisms (COMT rs4680) was robust to correction for multiple comparisons. Moreover, future research directions are outlined; and lessons learned as well as best-practice models for designing, analyzing, and translating results into clinical practice are proposed. CONCLUSIONS The results and lessons learned from this general practice-based pharmacogenetic research programme provide transportable insights at the transition to the second generation of pharmacogenetic and genomic investigations of smoking cessation and its translation to primary care.
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Affiliation(s)
- Sean P David
- Center for Education and Research in Family and Community Medicine, 1215 Welch Road, Modular G, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Marteau TM, Munafò MR, Aveyard P, Hill C, Whitwell S, Willis TA, Crockett RA, Hollands GJ, Johnstone EC, Wright AJ, Prevost AT, Armstrong D, Sutton S, Kinmonth AL. Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence. BMC Public Health 2010; 10:680. [PMID: 21062464 PMCID: PMC2996370 DOI: 10.1186/1471-2458-10-680] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 11/09/2010] [Indexed: 11/21/2022] Open
Abstract
Background The behavioural impact of pharmacogenomics is untested; informing smokers of genetic test results for responsiveness to smoking cessation medication may increase adherence to this medication. The objective of this trial is to estimate the impact upon adherence to nicotine replacement therapy (NRT) of informing smokers that their oral dose of NRT has been tailored to a DNA analysis. Hypotheses to be tested are as follows: I Adherence to NRT is greater among smokers informed that their oral dose of NRT is tailored to an analysis of DNA (genotype), compared to one tailored to nicotine dependence questionnaire score (phenotype). II Amongst smokers who fail to quit at six months, motivation to make another quit attempt is lower when informed that their oral dose of NRT was tailored to genotype rather than phenotype. Methods/Design An open label, parallel groups randomised trial in which 630 adult smokers (smoking 10 or more cigarettes daily) using National Health Service (NHS) stop smoking services in primary care are randomly allocated to one of two groups: i. NRT oral dose tailored by DNA analysis (OPRM1 gene) (genotype), or ii. NRT oral dose tailored by nicotine dependence questionnaire score (phenotype) The primary outcome is proportion of prescribed NRT consumed in the first 28 days following an initial quit attempt, with the secondary outcome being motivation to make another quit attempt, amongst smokers not abstinent at six months. Other outcomes include adherence to NRT in the first seven days and biochemically validated smoking abstinence at six months. The primary outcome will be collected on 630 smokers allowing sufficient power to detect a 7.5% difference in mean proportion of NRT consumed using a two-tailed test at the 5% level of significance between groups. The proportion of all NRT consumed in the first four weeks of quitting will be compared between arms using an independent samples t-test and by estimating the 95% confidence interval for observed between-arm difference in mean NRT consumption (Hypothesis I). Motivation to make another quit attempt will be compared between arms in those failing to quit by six months (Hypothesis II). Discussion This is the first clinical trial evaluating the behavioural impact on adherence of prescribing medication using genetic rather than phenotypic information. Specific issues regarding the choice of design for trials of interventions of this kind are discussed. Trial details Funder: Medical Research Council (MRC) Grant number: G0500274 ISRCTN: 14352545 Date trial stated: June 2007 Expected end date: December 2009 Expected reporting date: December 2010
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Affiliation(s)
- Theresa M Marteau
- Psychology Department at Guy's, Health Psychology Section, King's College London, 5th Floor Bermondsey Wing, Guy's Campus, London SE1 9RT, UK.
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Mackillop J, Obasi E, Amlung MT, McGeary JE, Knopik VS. The Role of Genetics in Nicotine Dependence: Mapping the Pathways from Genome to Syndrome. CURRENT CARDIOVASCULAR RISK REPORTS 2010; 4:446-453. [PMID: 21686075 DOI: 10.1007/s12170-010-0132-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Nicotine dependence continues to be a major public health problem worldwide and there is unequivocal evidence that genetics play a substantial role in its etiology. This review provides an overview of the evidence for genetic influences and recent advances in the field. Traditional quantitative genetics studies have revealed nicotine dependence is heritable and molecular genetics studies are providing increasing evidence that the genes responsible for nicotine's pharmacokinetics and pharmacodynamics are particularly important. Despite considerable progress, a number of significant complexities and challenges remain. These include determining the specificity of genetic influences and clarifying the role of interactive contributions. One promising strategy for addressing these issues is an intermediate phenotype approach that attempts to identify the intervening proximal mechanisms that confer differential genetic risk. Understanding these mechanisms may permit more precision in understanding genetic influences and may also identify novel targets for intervention or prevention.
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Affiliation(s)
- James Mackillop
- Department of Psychology, University of Georgia; Center for Alcohol and Addiction Studies, Brown University
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Mague SD, Blendy JA. OPRM1 SNP (A118G): involvement in disease development, treatment response, and animal models. Drug Alcohol Depend 2010; 108:172-82. [PMID: 20074870 PMCID: PMC2887703 DOI: 10.1016/j.drugalcdep.2009.12.016] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 12/17/2009] [Accepted: 12/17/2009] [Indexed: 12/21/2022]
Abstract
Endogenous opioids acting at mu-opioid receptors mediate many biological functions. Pharmacological intervention at these receptors has greatly aided in the treatment of acute and chronic pain, in addition to other uses. However, the development of tolerance and dependence has made it difficult to adequately prescribe these therapeutics. A common single nucleotide polymorphism (SNP), A118G, in the mu-opioid receptor gene can affect opioid function and, consequently, has been suggested to contribute to individual variability in pain management and drug addiction. Investigation into the role of A118G in human disease and treatment response has generated a large number of association studies across various disease states as well as physiological responses. However, characterizing the functional consequences of this SNP and establishing if it causes or contributes to disease phenotypes have been significant challenges. In this manuscript, we will review a number of association studies as well as investigations of the functional impact of this gene variant. In addition, we will describe a novel mouse model that was generated to recapitulate this SNP in mice. Evaluation of models that incorporate known human genetic variants into a tractable system, like the mouse, will facilitate the understanding of discrete contributions of SNPs to human disease.
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Affiliation(s)
| | - Julie A. Blendy
- Address correspondence to: Julie A. Blendy, Ph.D., Department of Pharmacology, University of Pennsylvania, TRL, 125 South 31st Street, Tel: (215) 898-0730, Fax: (215) 573-2041,
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Wang J, Li MD. Common and unique biological pathways associated with smoking initiation/progression, nicotine dependence, and smoking cessation. Neuropsychopharmacology 2010; 35:702-19. [PMID: 19890259 PMCID: PMC2814000 DOI: 10.1038/npp.2009.178] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Twin and family studies reveal a significant genetic contribution to the risk of smoking initiation and progression (SI/P), nicotine dependence (ND), and smoking cessation (SC). Further, numerous genes have been implicated in these smoking-related behaviors, especially for ND. However, no study has presented a comprehensive and systematic view of the genetic factors associated with these important smoking-related phenotypes. By reviewing the literature on these behaviors, we identified 16, 99, and 75 genes that have been associated with SI/P, ND, and SC, respectively. We then determined whether these genes were enriched in pathways important in the neuronal and brain functions underlying addiction. We identified 9, 21, and 13 pathways enriched in the genes associated with SI/P, ND, and SC, respectively. Among these pathways, four were common to all of the three phenotypes, that is, calcium signaling, cAMP-mediated signaling, dopamine receptor signaling, and G-protein-coupled receptor signaling. Further, we found that serotonin receptor signaling and tryptophan metabolism pathways were shared by SI/P and ND, tight junction signaling pathway was shared by SI/P and SC, and gap junction, neurotrophin/TRK signaling, synaptic long-term potentiation, and tyrosine metabolism were shared between ND and SC. Together, these findings show significant genetic overlap among these three related phenotypes. Although identification of susceptibility genes for smoking-related behaviors is still in an early stage, the approach used in this study has the potential to overcome the hurdles caused by factors such as genetic heterogeneity and small sample size, and thus should yield greater insights into the genetic mechanisms underlying these complex phenotypes.
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Affiliation(s)
- Ju Wang
- Section of Neurobiology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA
| | - Ming D Li
- Section of Neurobiology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA,Section of Neurobiology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, 1670 Discovery Drive, Suite 110, Charlottesville, VA 22911, USA. Tel: +434 243 0566; Fax: +434 973 7031; E-mail:
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Kortmann GL, Dobler CJ, Bizarro L, Bau CHD. Pharmacogenetics of smoking cessation therapy. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:17-28. [PMID: 19475569 DOI: 10.1002/ajmg.b.30978] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Nicotine dependence is a major health problem, with a large amount of smoking-related premature deaths and disabilities. The dependence mechanism of nicotine is especially complex and is under strong genetic influence. Smoking cessation is associated with substantial health benefits. Evidence from animal and human studies suggests that genetic polymorphisms influencing pharmacokinetics and pharmacodynamics of nicotine may have great potential for aiding smoking treatment. There are more than 30 association studies and one genome-wide association study (GWAS) between genetic polymorphisms and smoking cessation following nicotine replacement therapy (NRT) and/or bupropion therapy. However, only a few candidate genes or regions were analyzed more than twice and even these genes require additional investigations in different therapeutic schemes. There are a growing number of new pharmacologic options that have not been pharmacogenetically assessed according to published literature. In addition, molecular genetics studies are needed to assess the functional mechanisms of some putative association results. Taken together, the preliminary findings are promising but raise the need for new studies with adequate sample sizes and adjustment for several potential confounding factors frequently neglected, such as comorbidity and sociodemographic factors. The current state of the art in the field encourages an optimist view that personalized treatment approaches may become possible. However, the current scientific evidence still does not support the use of pharmacogenetic tests in routine smoking cessation therapy.
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Affiliation(s)
- Gustavo L Kortmann
- Departamento de Genética, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Hardin J, He Y, Javitz HS, Wessel J, Krasnow RE, Tildesley E, Hops H, Swan GE, Bergen AW. Nicotine withdrawal sensitivity, linkage to chr6q26, and association of OPRM1 SNPs in the SMOking in FAMilies (SMOFAM) sample. Cancer Epidemiol Biomarkers Prev 2009; 18:3399-406. [PMID: 19959688 PMCID: PMC3536862 DOI: 10.1158/1055-9965.epi-09-0960] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Nicotine withdrawal symptoms are related to smoking cessation. A Rasch model has been used to develop a unidimensional sensitivity score representing multiple correlated measures of nicotine withdrawal. A previous autosome-wide screen identified a nonparametric linkage (NPL) log-likelihood ratio (LOD) score of 2.7 on chromosome 6q26 for the sum of nine withdrawal symptoms. METHODS The objectives of these analyses were to (a) assess the influence of nicotine withdrawal sensitivity on relapse, (b) conduct autosome-wide NPL analysis of nicotine withdrawal sensitivity among 158 pedigrees with 432 individuals with microsatellite genotypes and nicotine withdrawal scores, and (c) explore family-based association of single nucleotide polymorphism (SNP) at the mu opioid receptor candidate gene (OPRM1) with nicotine withdrawal sensitivity in 172 nuclear pedigrees with 419 individuals with both SNP genotypes and nicotine withdrawal scores. RESULTS An increased risk for relapse was associated with nicotine withdrawal sensitivity score (odds ratio, 1.25; 95% confidence interval, 1.10-1.42). A maximal NPL LOD score of 3.15, suggestive of significant linkage, was identified at chr6q26 for nicotine withdrawal sensitivity. Evaluation of 18 OPRM1 SNPs via the family-based association test with the nicotine withdrawal sensitivity score identified eight tagging SNPs with global P values <0.05 and false discovery rate Q values <0.06. CONCLUSION An increased risk of relapse, suggestive linkage at chr6q26, and nominally significant association with multiple OPRM1 SNPs were found with Rasch-modeled nicotine withdrawal sensitivity scores in a multiplex smoking pedigree sample. Future studies should attempt to replicate these findings and investigate the relationship between nicotine withdrawal symptoms and variation at OPRM1.
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Schnoll RA, Patterson F. Sex heterogeneity in pharmacogenetic smoking cessation clinical trials. Drug Alcohol Depend 2009; 104 Suppl 1:S94-9. [PMID: 19135319 PMCID: PMC2810256 DOI: 10.1016/j.drugalcdep.2008.11.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 09/03/2008] [Accepted: 11/20/2008] [Indexed: 11/24/2022]
Abstract
Approximately one-quarter of smokers who use treatments for nicotine dependence are able to achieve cessation. However, there is evidence that women do not respond as well to nicotine replacement therapy (NRT) and, perhaps, to bupropion, compared to men. In this contribution to the Special Issue of Drug and Alcohol Dependence concerning Women and Smoking, we begin with a brief overview of data supporting the role of sex in influencing response to NRT and bupropion. Next, we summarize the results of pharmacogenetic smoking cessation clinical trials which assessed sex as a moderator as well. A relatively small number of pharmacogenetic studies of nicotine dependence treatments have been conducted and five studies reported sex effects in these trials. Of these trials, sex moderated the association of genetic variation in drug pharmacokinetics or pharmacodynamics and treatment response. We conclude this paper with a summary and a brief discussion of the major caveats of this literature and priorities for future research.
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Affiliation(s)
- Robert A. Schnoll
- Corresponding Author/Requests for Reprints: Robert A. Schnoll, Ph.D., Transdisciplinary Tobacco Use Research Center, 3535 Market Street, Suite 4100, University of Pennsylvania, Philadelphia PA, 19104; Phone: 215-746-7143; Fax: 215-746-7140;
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Mouse model of OPRM1 (A118G) polymorphism has sex-specific effects on drug-mediated behavior. Proc Natl Acad Sci U S A 2009; 106:10847-52. [PMID: 19528658 DOI: 10.1073/pnas.0901800106] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
A single nucleotide polymorphism (SNP) in the human mu-opioid receptor gene (OPRM1 A118G) has been widely studied for its association in a variety of drug addiction and pain sensitivity phenotypes; however, the extent of these adaptations and the mechanisms underlying these associations remain elusive. To clarify the functional mechanisms linking the OPRM1 A118G SNP to addiction and analgesia phenotypes, we derived a mouse model possessing the equivalent nucleotide/amino acid substitution in the Oprm1 gene. Mice harboring this SNP (A112G) demonstrated several phenotypic similarities to humans carrying the A118G SNP, including reduced mRNA expression and morphine-mediated antinociception. We found additional phenotypes associated with this SNP including significant reductions of receptor protein levels, morphine-mediated hyperactivity, and the development of locomotor sensitization in mice harboring the G112 allele. In addition, we found sex-specific reductions in the rewarding properties of morphine and the aversive components of naloxone-precipitated morphine withdrawal. Further cross-species analysis will allow us to investigate mechanisms and adaptations present in humans carrying this SNP.
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A micro opioid receptor gene polymorphism (A118G) and naltrexone treatment response in adherent Korean alcohol-dependent patients. Psychopharmacology (Berl) 2009; 201:611-8. [PMID: 18795264 DOI: 10.1007/s00213-008-1330-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 09/01/2008] [Indexed: 12/20/2022]
Abstract
RATIONALE Previous studies have demonstrated an association between genetic polymorphisms of the mu opioid receptor gene (OPRM1) and response to naltrexone treatment. The Asp40 variant genotype previously shown to be associated with naltrexone treatment response is known to be relatively common among Koreans. OBJECTIVES This study was conducted to prospectively investigate the relationship between genotype and response to open-label naltrexone treatment in Korean alcohol-dependent subjects. MATERIALS AND METHODS Sixty-three alcohol-dependent subjects were prescribed naltrexone for 12 weeks in combination with cognitive behavioral therapy. Thirty-two subjects were adherent, taking the medication at least 80% of the treatment days [16 Asn40 (A/A) patients and 16 Asp40 variant (A/G or G/G) patients]. RESULTS Subjects adherent to naltrexone treatment with one or two copies of the Asp40 allele took a significantly longer time than the Asn40 group to relapse (p=0.014). Although not significant, the Asn40 group treated with naltrexone had a 10.6 times greater relapse rate than the Asp40 variant group. There was no significant difference between the Asn40 group and the Asp40 variant group treated with naltrexone in rates of abstinence. CONCLUSIONS These results demonstrating a higher therapeutic effect of naltrexone in Korean alcohol-dependent individuals with the Asp40 variant genotype than the Asn40 genotype are consistent with previous study results in individuals of European descent. This is the first study to examine the pharmacogenetics treatment response to naltrexone in non-European subjects.
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Dopamine and opioid gene variants are associated with increased smoking reward and reinforcement owing to negative mood. Behav Pharmacol 2008; 19:641-9. [PMID: 18690118 DOI: 10.1097/fbp.0b013e32830c367c] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Negative mood increases smoking reinforcement and risk of relapse. We explored associations of gene variants in the dopamine, opioid, and serotonin pathways with smoking reward ('liking') and reinforcement (latency to first puff and total puffs) as a function of negative mood and expected versus actual nicotine content of the cigarette. Smokers of European ancestry (n=72) were randomized to one of four groups in a 2x2 balanced placebo design, corresponding with manipulation of actual (0.6 vs. 0.05 mg) and expected (told nicotine and told denicotinized) nicotine 'dose' in cigarettes during each of two sessions (negative vs. positive mood induction). Following mood induction and expectancy instructions, they sampled and rated the assigned cigarette, and then smoked additional cigarettes ad lib during continued mood induction. The increase in smoking amount owing to negative mood was associated with: dopamine D2 receptor (DRD2) C957T (CC>TT or CT), SLC6A3 (presence of 9 repeat>absence of 9), and among those given a nicotine cigarette, DRD4 (presence of 7 repeat>absence of 7) and DRD2/ANKK1 TaqIA (TT or CT>CC). SLC6A3, and DRD2/ANKK1 TaqIA were also associated with smoking reward and smoking latency. OPRM1 (AA>AG or GG) was associated with smoking reward, but SLC6A4 variable number tandem repeat was unrelated to any of these measures. These results warrant replication but provide the first evidence for genetic associations with the acute increase in smoking reward and reinforcement owing to negative mood.
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Abstract
This paper is the thirtieth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2007 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia; stress and social status; tolerance and dependence; learning and memory; eating and drinking; alcohol and drugs of abuse; sexual activity and hormones, pregnancy, development and endocrinology; mental illness and mood; seizures and neurologic disorders; electrical-related activity and neurophysiology; general activity and locomotion; gastrointestinal, renal and hepatic functions; cardiovascular responses; respiration and thermoregulation; and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, 65-30 Kissena Blvd.,Flushing, NY 11367, United States.
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Uhl GR, Liu QR, Drgon T, Johnson C, Walther D, Rose JE, David SP, Niaura R, Lerman C. Molecular genetics of successful smoking cessation: convergent genome-wide association study results. ACTA ACUST UNITED AC 2008; 65:683-93. [PMID: 18519826 DOI: 10.1001/archpsyc.65.6.683] [Citation(s) in RCA: 192] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Smoking remains a major public health problem. Twin studies indicate that the ability to quit smoking is substantially heritable, with genetics that overlap modestly with the genetics of vulnerability to dependence on addictive substances. OBJECTIVES To identify replicated genes that facilitate smokers' abilities to achieve and sustain abstinence from smoking (herein after referred to as quit-success genes) found in more than 2 genome-wide association (GWA) studies of successful vs unsuccessful abstainers, and, secondarily, to nominate genes for selective involvement in smoking cessation success with bupropion hydrochloride vs nicotine replacement therapy (NRT). DESIGN The GWA results in subjects from 3 centers, with secondary analyses of NRT vs bupropion responders. SETTING Outpatient smoking cessation trial participants from 3 centers. PARTICIPANTS European American smokers who successfully vs unsuccessfully abstain from smoking with biochemical confirmation in a smoking cessation trial using NRT, bupropion, or placebo (N = 550). MAIN OUTCOME MEASURES Quit-success genes, reproducibly identified by clustered nominally positive single-nucleotide polymorphisms (SNPs) in more than 2 independent samples with significant P values based on Monte Carlo simulation trials. The NRT-selective genes were nominated by clustered SNPs that display much larger t values for NRT vs placebo comparisons. The bupropion-selective genes were nominated by bupropion-selective results. RESULTS Variants in quit-success genes are likely to alter cell adhesion, enzymatic, transcriptional, structural, and DNA, RNA, and/or protein-handling functions. Quit-success genes are identified by clustered nominally positive SNPs from more than 2 samples and are unlikely to represent chance observations (Monte Carlo P< .0003). These genes display modest overlap with genes identified in GWA studies of dependence on addictive substances and memory. CONCLUSIONS These results support polygenic genetics for success in abstaining from smoking, overlap with genetics of substance dependence and memory, and nominate gene variants for selective influences on therapeutic responses to bupropion vs NRT. Molecular genetics should help match the types and/or intensity of antismoking treatments with the smokers most likely to benefit from them.
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Affiliation(s)
- George R Uhl
- Molecular Neurobiology Research Branch, National Institutes of Health-Intramural Research Program, National Institute on Drug Abuse, 333 Cassell Dr, Ste 3510, Baltimore, MD 21224, USA.
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Abstract
Tobacco use is associated with 5 million deaths per year worldwide and is regarded as one of the leading causes of premature death. Comprehensive programmes for tobacco control can substantially reduce the frequency of tobacco use. An important component of a comprehensive programme is the provision of treatment for tobacco addiction. Treatment involves targeting several aspects of addiction including the underlying neurobiology and behavioural processes. Furthermore, building an infrastructure in health systems that encourages and helps with cessation, as well as expansion of the accessibility of treatments, is necessary. Although pharmacological and behavioural treatments are effective in improving cessation success, the rate of relapse to smoking remains high, emphasising the strong addictive nature of nicotine. The future of treatment resides in improvement in patient matching to treatment, combination or novel drugs, and viewing nicotine addiction as a chronic disorder that might need long-term treatment.
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Affiliation(s)
- Dorothy K Hatsukami
- University of Minnesota, Comprehensive Cancer Center and Psychiatry, Minneapolis, Minnesota, USA.
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Abstract
AIMS Attempts to further our understanding of the determinants of cigarette smoking, tobacco addiction and related behaviours have included the dissection of genetic influences on these phenotypes. This review summarizes the current state of evidence from both twin and adoption studies and molecular genetic studies. We also review future research horizons and the direction which studies of this kind are likely to take in the near future. FINDINGS There is consistent evidence from twin and adoption studies that genetic factors play a role in the aetiology of cigarette smoking. Nevertheless, despite a large number of candidate gene studies, and a smaller number of linkage studies, few reported associations and chromosomal regions of interest have proved to replicate reliably. This is due most probably to the small effects of individual loci on complex behaviours such as smoking. CONCLUSIONS Future research is likely to include the study of gene x environment interactions (including gene x treatment interactions, which offer the prospect of genetically tailored smoking cessation treatment) and the use of more sophisticated smoking-related phenotypes, such as longitudinal smoking trajectories, and intermediate phenotypes which use technologies such as neuroimaging and other laboratory and biobehavioural measures.
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Affiliation(s)
- Marcus R Munafò
- Department of Experimental Psychology, University of Bristol, Bristol, UK.
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Munafo MR, Johnstone EC, Murphy MF, Aveyard P. "Intention to Analyze" in Pharmacogenomics Studies. Cancer Epidemiol Biomarkers Prev 2008. [DOI: 10.1158/1055-9965.epi-08-0099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Hall WD, Gartner CE, Carter A. The genetics of nicotine addiction liability: ethical and social policy implications. Addiction 2008; 103:350-9. [PMID: 18190673 DOI: 10.1111/j.1360-0443.2007.02070.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To assess the promise and risks of technological applications of genetic research on liability to develop nicotine dependence. METHODS We reviewed (i) the evidence on the genetics of nicotine dependence; (ii) the technical feasibility of using genetic information to reduce smoking uptake and increase cessation; and (iii) policy and ethical issues raised by the uses of genetic information on addiction liability. RESULTS (i) Despite evidence from twin studies that genes contribute to addiction susceptibility, research to date has not identified commonly occurring alleles that are strongly predictive of developing nicotine addiction. Nicotine addiction is likely to involve multiple alleles of small effect that interact with each other and with the environment. (ii) Population screening for susceptibility alleles is unlikely to be effective or cost-effective. Tailoring of smoking cessation treatments with genetic information is more plausible but results to date have been disappointing. Population health strategies such as increased taxation and reduced opportunities to smoke are more efficient in reducing cigarette smoking. Tobacco harm reduction policies applied to populations may also play a role in reducing tobacco-related harm. (iii) Future uses of genomic information on addiction risk will need to assess the risks of medicalising addiction (e.g. pessimism about capacity to quit) and community concerns about genetic privacy. CONCLUSIONS Nicotine genomics is a very new and underdeveloped field. On the evidence to date, its advocates would be wise to avoid extravagant claims about its preventive applications.
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Affiliation(s)
- Wayne D Hall
- School of Population Health, The University of Queensland, Queensland, Australia.
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Abstract
Accumulating data support the role of genetic factors in smoking initiation, progression to tobacco dependence, and smoking persistence. This review summarizes current research on the heritability of tobacco use phenotypes and genetic association studies of smoking-related behaviors. Although progress has been made in genetics research on smoking behavior, many studies have methodological limitations, including insufficient samples for detecting gene-gene and gene-environment interactions and use of less refined phenotypes. Pharmacogenetic investigations also are identifying variants in drug-metabolizing enzymes, receptors, and transporters that modify therapeutic response to smoking cessation medications; however, the field is relatively new, and most findings in this area have yet to be replicated. As this research advances, it will be important to study and address practical, economic, ethical, and social barriers to the translation of genetics research on tobacco use to clinical practice.
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Affiliation(s)
- Robert A Schnoll
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104, USA.
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Lessov-Schlaggar CN, Pergadia ML, Khroyan TV, Swan GE. Genetics of nicotine dependence and pharmacotherapy. Biochem Pharmacol 2007; 75:178-95. [PMID: 17888884 PMCID: PMC2238639 DOI: 10.1016/j.bcp.2007.08.018] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Revised: 08/13/2007] [Accepted: 08/15/2007] [Indexed: 12/22/2022]
Abstract
Nicotine dependence is substantially heritable. Several regions across the genome have been implicated in containing genes that confer liability to nicotine dependence and variation in individual genes has been associated with nicotine dependence. Smoking cessation measures are also heritable, and measured genetic variation is associated with nicotine dependence treatment efficacy. Despite significant strides in the understanding of the relative contribution of genetic and environmental factors to nicotine dependence and treatment, emergent challenges necessitate interdisciplinary coordinated effort for effective problem solving. These challenges include refinement of the nicotine dependence phenotype, better understanding of the dynamic interplay between genes and environment in nicotine dependence etiology, application and development of molecular and statistical methodology that can adequately address vast amounts of data, and continuous translational cross-talk.
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