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Cinciripini PM, Wetter DW, Wang J, Yu R, Kypriotakis G, Kumar T, Robinson JD, Cui Y, Green CE, Bergen AW, Kosten TR, Scherer SE, Shete S. Deep sequencing of candidate genes identified 14 variants associated with smoking abstinence in an ethnically diverse sample. Sci Rep 2024; 14:6385. [PMID: 38493193 PMCID: PMC10944542 DOI: 10.1038/s41598-024-56750-7] [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: 07/18/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Despite the large public health toll of smoking, genetic studies of smoking cessation have been limited with few discoveries of risk or protective loci. We investigated common and rare variant associations with success in quitting smoking using a cohort from 8 randomized controlled trials involving 2231 participants and a total of 10,020 common and 24,147 rare variants. We identified 14 novel markers including 6 mapping to genes previously related to psychiatric and substance use disorders, 4 of which were protective (CYP2B6 (rs1175607105), HTR3B (rs1413172952; rs1204720503), rs80210037 on chr15), and 2 of which were associated with reduced cessation (PARP15 (rs2173763), SCL18A2 (rs363222)). The others mapped to areas associated with cancer including FOXP1 (rs1288980) and ZEB1 (rs7349). Network analysis identified significant canonical pathways for the serotonin receptor signaling pathway, nicotine and bupropion metabolism, and several related to tumor suppression. Two novel markers (rs6749438; rs6718083) on chr2 are flanked by genes associated with regulation of bodyweight. The identification of novel loci in this study can provide new targets of pharmacotherapy and inform efforts to develop personalized treatments based on genetic profiles.
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Affiliation(s)
- Paul M Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - David W Wetter
- Department of Department of Population Health Sciences, University of Utah and Huntsman Cancer Institute, Salt Lake City, Utah, 84112, USA
| | - Jian Wang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Robert Yu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - George Kypriotakis
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Tapsi Kumar
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Jason D Robinson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Yong Cui
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Charles E Green
- Department of Pediatrics, The University of Texas Medical School at Houston, Houston, TX, 77030, USA
| | | | - Thomas R Kosten
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Steven E Scherer
- Department of Molecular and Human Genetics, Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Sanjay Shete
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
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Almahasneh F, Gerges RH, Abu-El-Rub E, Khasawneh RR. Nicotine Abuse and Neurodegeneration: Novel Pharmacogenetic Targets to Aid Quitting and Reduce the Risk of Dementia. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:2-8. [PMID: 36803746 DOI: 10.2174/1871527322666230220121655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/23/2022] [Accepted: 01/11/2023] [Indexed: 02/22/2023]
Abstract
Nicotine dependence has deleterious neurological impacts. Previous studies found an association between cigarette smoking and accelerating age-related thinning of the brain's cortex and subsequent cognitive decline. Smoking is considered the third most common risk factor for dementia, which prompted the inclusion of smoking cessation in dementia prevention strategies. Traditional pharmacologic options for smoking cessation include nicotine transdermal patches, bupropion and varenicline. However, based on smokers' genetic makeup, pharmacogenetics can be used to develop novel therapies to replace these traditional approaches. Genetic variability of cytochrome P450 2A6 has a major impact on smokers' behavior and their response to quitting therapies. Gene polymorphism in nicotinic acetylcholine receptor subunits also has a great influence on the ability to quit smoking. In addition, polymorphism of certain nicotinic acetylcholine receptors was found to affect the risk of dementia and the impact of tobacco smoking on the development of Alzheimer's disease. Nicotine dependence involves the activation of pleasure response through the stimulation of dopamine release. Central dopamine receptors, catechol-o-methyltransferase and the dopamine transporter protein, regulate synaptic dopamine levels. The genes of these molecules are potential targets for novel smoking cessation drugs. Pharmacogenetic studies of smoking cessation also investigated other molecules, such as ANKK1 and dopamine-beta-hydroxylase (DBH). In this perspective article, we aim to highlight the promising role of pharmacogenetics in the development of effective drugs for smoking cessation, which can increase the success rate of smoking quitting plans and ultimately reduce the incidence of neurodegeneration and dementia.
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Affiliation(s)
- Fatimah Almahasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Romany H Gerges
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
- Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ejlal Abu-El-Rub
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Ramada R Khasawneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
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Hall W, Gartner C, Morphett K. How has the brain disease model of addiction contributed to tobacco control? Drug Alcohol Depend 2023; 253:111033. [PMID: 38006672 DOI: 10.1016/j.drugalcdep.2023.111033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/09/2023] [Accepted: 11/13/2023] [Indexed: 11/27/2023]
Abstract
Our paper evaluates the extent to which the brain disease model of addiction (BDMA) has contributed to reducing the prevalence of tobacco smoking and tobacco-related harm over the past 20 years. We discuss the ways in which genetic and neuroscience research on nicotine addiction have contributed to our understanding of tobacco smoking. We then examine the extent to which the BDMA has produced more effective treatments to assist smoking cessation. We also assess the degree to which the BDMA has contributed to the tobacco control policies that have produced substantial reductions in tobacco-related morbidity and mortality in the two decades since the model was first proposed by Alan Leshner. We also assess whether the BDMA has reduced the stigmatisation of people who smoke tobacco.
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Affiliation(s)
- Wayne Hall
- The National Centre for Youth Substance Use Research, the University of Queensland, Australia.
| | - Coral Gartner
- The School of Public Health, The University of Queensland, Australia
| | - Kylie Morphett
- The School of Public Health, The University of Queensland, Australia
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Kumaraguru M, L L, Priyadharsini VJ, I MA, S R. Identification of Pathogenic Missense Mutations in the CHRNA5 Gene: A Computational Approach. Cureus 2023; 15:e47519. [PMID: 38021533 PMCID: PMC10663970 DOI: 10.7759/cureus.47519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
Aim The CHRNA5/A3/B4 gene locus is closely related to nicotine dependence and other smoking-related disorders. Coupling genetic and clinical studies of nicotine dependence and smoking behaviors may open new avenues for medication development. The aim of this study is to investigate the functional missense mutations in the CHRNA5 gene. Methodology The Ensembl database was used to gather data on missense mutations of the human CHRNA5 gene. Computational tools viz. SIFT (Sorting Intolerant From Tolerant), PolyPhen (Polymorphism Phenotyping), PROVEAN (Protein Variation Effect Analyzer), I-Mutant, and MutPred were used to uncover the pathogenic mutations in the gene under investigation. Results Among 161 missense variants reported inthe CHRNA5 gene, 94 variants were found to be highly pathogenic. Moreover, 20 were pathogenic and 4 were not pathogenic. Conclusion The computational analysis disclosed harmful mutations in the CHRNA5 gene which could be potentially associated with smoking-related traits.
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Affiliation(s)
- Mahalakshmi Kumaraguru
- Public Health Dentistry, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Leelavathi L
- Public Health Dentistry, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Vijayashree J Priyadharsini
- Clinical Genetics, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Meignana Arumugham I
- Public Health Dentistry, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Rajeshkumar S
- Pharmacology, Saveetha Dental College & Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Chen LS, Baker TB, Ramsey A, Amos CI, Bierut LJ. Genomic medicine to reduce tobacco and related disorders: Translation to precision prevention and treatment. ADDICTION NEUROSCIENCE 2023; 7:100083. [PMID: 37602286 PMCID: PMC10434839 DOI: 10.1016/j.addicn.2023.100083] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Genomic medicine can enhance prevention and treatment. First, we propose that advances in genomics have the potential to enhance assessment of disease risk, improve prognostic predictions, and guide treatment development and application. Clinical implementation of polygenic risk scores (PRSs) has emerged as an area of active research. The pathway from genomic discovery to implementation is an iterative process. Second, we provide examples on how genomic medicine has the potential to solve problems in prevention and treatment using two examples: Lung cancer screening and evidence-based tobacco treatment are both under-utilized and great opportunities for genomic interventions. Third, we discuss the translational process for developing genomic interventions from evidence to implementation by presenting a model to evaluate genomic evidence for clinical implementation, mechanisms of genomic interventions, and patient desire for genomic interventions. Fourth, we present potential challenges in genomic interventions including a great need for evidence in all diverse populations, little evidence on treatment algorithms, challenges in accommodating a dynamic evidence base, and implementation challenges in real world clinical settings. Finally, we conclude that research to identify genomic markers that are associated with smoking cessation success and the efficacy of smoking cessation treatments is needed to empower people of all diverse ancestry. Importantly, genomic data can be used to help identify patients with elevated risk for nicotine addiction, difficulty quitting smoking, favorable response to specific pharmacotherapy, and tobacco-related health problems.
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Affiliation(s)
- Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO, United States
| | - Timothy B. Baker
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Alex Ramsey
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO, United States
| | - Christopher I. Amos
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
- Department of Medicine, Baylor College of Medicine, Institute for Clinical and Translational Research, Houston, TX, United States
| | - Laura J. Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO, United States
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Abstract
Diseases associated with nicotine dependence in the form of habitual tobacco use are a major cause of premature death in the United States. The majority of tobacco smokers will relapse within the first month of attempted abstinence. Smoking cessation agents increase the likelihood that smokers can achieve long-term abstinence. Nevertheless, currently available smoking cessation agents have limited utility and fail to prevent relapse in the majority of smokers. Pharmacotherapy is therefore an effective strategy to aid smoking cessation efforts but considerable risk of relapse persists even when the most efficacious medications currently available are used. The past decade has seen major breakthroughs in our understanding of the molecular, cellular, and systems-level actions of nicotine in the brain that contribute to the development and maintenance of habitual tobacco use. In parallel, large-scale human genetics studies have revealed allelic variants that influence vulnerability to tobacco use disorder. These advances have revealed targets for the development of novel smoking cessation agents. Here, we summarize current efforts to develop smoking cessation therapeutics and highlight opportunities for future efforts.
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Affiliation(s)
- Dana Lengel
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Paul J. Kenny
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Drug Discovery Institute (DDI), Icahn School of Medicine at Mount Sinai, New York, NY 10029, 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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Jones SK, Alberg AJ, Wallace K, Froeliger B, Carpenter MJ, Wolf BJ. CHRNA5-A3-B4 and DRD2 Genes and Smoking Cessation Throughout Adulthood: A Longitudinal Study of Women. Nicotine Tob Res 2023; 25:1164-1173. [PMID: 36794842 PMCID: PMC10413434 DOI: 10.1093/ntr/ntad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/22/2022] [Accepted: 02/14/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Smoking cessation is more than 50% heritable. Genetic studies of smoking cessation have been limited by short-term follow-up or cross-sectional design. AIMS AND METHODS This study tests single nucleotide polymorphism (SNP) associations with cessation during long-term follow-up throughout adulthood in women. The secondary aim tests whether genetic associations differ by smoking intensity. Associations between 10 SNPs in CHRNA5, CHRNA3, CHRNB2, CHRNB4, DRD2, and COMT and the probability of smoking cessation over time were evaluated in two longitudinal cohort studies of female nurses, the Nurses' Health Study (NHS) (n = 10 017) and NHS-2 (n = 2793). Participant follow-up ranged from 2 to 38 years with data collected every 2 years. RESULTS Women with the minor allele of either CHRNA5 SNP rs16969968 or CHRNA3 SNP rs1051730 had lower odds of cessation throughout adulthood [OR = 0.93, p-value = .003]. Women had increased odds of cessation if they had the minor allele of CHRNA3 SNP rs578776 [OR = 1.17, p-value = .002]. The minor allele of DRD2 SNP rs1800497 was associated with lower odds of cessation in moderate-to-heavy smokers [OR = 0.92, p-value = .0183] but increased odds in light smokers [OR = 1.24, p-value = .096]. CONCLUSIONS Some SNP associations with short-term smoking abstinence observed in prior studies were shown in the present study to persist throughout adulthood over decades of follow-up. Other SNP associations with short-term abstinence did not persist long-term. The secondary aim findings suggest genetic associations may differ by smoking intensity. IMPLICATIONS The results of the present study expand on previous studies of SNP associations in relation to short-term smoking cessation to demonstrate some of these SNPs were associated with smoking cessation throughout decades of follow-up, whereas other SNP associations with short-term abstinence did not persist long-term. The rate of relapse to smoking remains high for several years after quitting smoking, and many smokers experience multiple quit attempts and relapse episodes throughout adulthood. Understanding genetic associations with long-term cessation has potential importance for precision medicine approaches to long-term cessation management.
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Affiliation(s)
- Stephanie K Jones
- Department of Public Health, Baylor University, Waco, TX, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Anthony J Alberg
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Kristin Wallace
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Brett Froeliger
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Matthew J Carpenter
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Bethany J Wolf
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
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Jones SK, Alberg AJ, Wallace K, Froeliger B, Carpenter MJ, Wolf B. Genetic Associations with Smoking Relapse and Proportion of Follow-up in Smoking Relapse throughout Adulthood in Pre- and Postmenopausal Women. Cancer Prev Res (Phila) 2023; 16:269-279. [PMID: 37070666 PMCID: PMC10159950 DOI: 10.1158/1940-6207.capr-22-0421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/10/2023] [Accepted: 03/08/2023] [Indexed: 04/19/2023]
Abstract
PREVENTION RELEVANCE This study is the first to quantify genetic associations with smoking relapse among female smokers throughout adulthood. These findings could inform precision medicine approaches to improve long-term smoking relapse prevention to reduce smoking attributable cancer morbidity and mortality.
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Affiliation(s)
| | - Anthony J. Alberg
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia SC 29208
| | - Kristin Wallace
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC 29425
- Hollings Cancer Center, 86 Jonathan Lucas Street, Medical University of South Carolina, Charleston SC 29425
| | - Brett Froeliger
- Department of Psychological Sciences, University of Missouri, Columbia MO 65211
| | - Matthew J. Carpenter
- Hollings Cancer Center, 86 Jonathan Lucas Street, Medical University of South Carolina, Charleston SC 29425
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston SC 29425
| | - Bethany Wolf
- Department of Public Health Sciences, Medical University of South Carolina, Charleston SC 29425
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10
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Jones SK, Wolf BJ, Froeliger B, Wallace K, Carpenter MJ, Alberg AJ. A systematic review of genetic variation within nicotinic acetylcholine receptor genes and cigarette smoking cessation. Drug Alcohol Depend 2022; 239:109596. [PMID: 35981468 PMCID: PMC10876157 DOI: 10.1016/j.drugalcdep.2022.109596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Nicotine produces its effects by binding to nicotinic acetylcholine receptors (nAChRs). Variants of genes encoding properties of nAChRs are candidates for affecting likelihood of smoking cessation. METHODS A systematic review was conducted summarizing evidence of associations between single nucleotide polymorphisms (SNPs) of nAChR genes and smoking cessation. From 24 articles meeting inclusion criteria, summary odds ratios (ORs) for associations between nine SNPs and smoking cessation were calculated from 26 studies (N = 233-29,072) stratified by gene, ancestry, study design, and pharmacotherapy; SNPs in linkage disequilibrium were pooled. Results for a tenth SNP from two GWAS were summarized. RESULTS People of European ancestry with minor alleles of CHRNA5 rs16969968 and CHRNA3 rs1051730 had longer time to cessation [HR = 0.90, 95 % CI 0.88 - 0.92 (n = 2 studies)] and lower odds of cessation [OR = 0.88, 95 % CI 0.80 - 0.97 (n = 5 cohort studies), OR = 0.64, 95 % CI 0.45 - 0.90 (n = 4 placebo arms)]. Risk of persistent smoking associated with these alleles was attenuated in smokers receiving nicotine replacement therapy (NRT). Recipients of bupropion alone or with NRT with these alleles had higher, though not statistically significant, odds of cessation. Results for CHRNA5 rs588765 and rs680244 were similar to rs16969968/rs1051730 findings. Evidence was limited for other SNPs. CONCLUSION Evidence consistently indicates the minor alleles of four SNPs within CHRNA3 or CHRNA5 are risk alleles for cessation failure. Analysis by pharmacotherapy revealed bupropion may be the most efficacious intervention for people with these alleles.
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Affiliation(s)
- Stephanie K Jones
- Department of Public Health, Baylor University, Waco, TX 76798, USA; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Bethany J Wolf
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Brett Froeliger
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Kristin Wallace
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA; Hollings Cancer Center, Medical University of South Carolina, 86 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Matthew J Carpenter
- Hollings Cancer Center, Medical University of South Carolina, 86 Jonathan Lucas Street, Charleston, SC 29425, USA; Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Anthony J Alberg
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
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Jordi SBU, Lang BM, Auschra B, von Känel R, Biedermann L, Greuter T, Schreiner P, Rogler G, Krupka N, Sulz MC, Misselwitz B, Begré S. Depressive Symptoms Predict Clinical Recurrence of Inflammatory Bowel Disease. Inflamm Bowel Dis 2022; 28:560-571. [PMID: 34096587 DOI: 10.1093/ibd/izab136] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) patients are at high risk for depression, and depression has been shown to affect disease course. We examined interrelations between depression, genetic risk factors for depression, and IBD flares. METHOD In 1973 patients (1137 Crohn's disease, 836 ulcerative colitis) of the Swiss IBD Cohort Study (SIBDCS), depressive status (hospital anxiety and depression subscale for depression, HADS-D ≥11) was assessed on a yearly basis. We investigated the impact of depression on IBD-relevant clinical outcomes in Cox proportional hazards models. We used active disease (CDAI ≥150 or MTWAI ≥10) and 2 published composite flare definitions-FNCE (physician-reported flare, nonresponse to therapy, new complication, or extraintestinal manifestation) and AFFSST (active disease, physician-reported flare, fistula, stenosis, and new systemic therapy)-as clinical end points. Additionally, 62 preselected single nucleotide polymorphisms (SNPs) were screened for cross-sectional associations with depression, and if present, their predictive value for future depression and clinical deterioration was assessed. RESULTS Depression was a strong risk factor for disease-related end points, including active disease (adjusted hazard ratio [aHR], 3.55; P < 0.001), AFFSST (aHR, 1.62; P < 0.001), and FNCE (aHR, 1.35; P = 0.019). The SNP rs2522833 was significantly associated with depression at enrollment (q = 0.059). The TC allele of rs588765 was negatively associated with the presence of depression at enrollment (q = 0.050) and after enrollment (aHR, 0.67; P = 0.035) and with fewer active disease states (aHR, 0.72; P = 0.045) during follow-up. CONCLUSION In IBD, depressive symptoms and inflammatory activity are intimately related. Depressive symptoms were a strong predictor of clinical deterioration, and genetic markers may play a role in this relationship.
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Affiliation(s)
- Sebastian Bruno Ulrich Jordi
- Clinic for Visceral Surgery and Medicine, Inselspital Bern and Bern University, Bern, Switzerland.,Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Brian Matthew Lang
- Clinic for Transplantation Immunology and Nephrology (Swiss Transplant Cohort Study), University Hospital of Basel, Basel, Switzerland
| | - Bianca Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Luc Biedermann
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Thomas Greuter
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Philipp Schreiner
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Gerhard Rogler
- Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Niklas Krupka
- Clinic for Visceral Surgery and Medicine, Inselspital Bern and Bern University, Bern, Switzerland
| | - Michael Christian Sulz
- Department of Gastroenterology and Hepatology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Benjamin Misselwitz
- Clinic for Visceral Surgery and Medicine, Inselspital Bern and Bern University, Bern, Switzerland.,Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Stefan Begré
- Neurology, Department of Biomedical Research, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Stress Diseases and Stressmanagement (ISFOM), Zurich, Switzerland
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Muderrisoglu A, Babaoglu E, Korkmaz ET, Kalkisim S, Karabulut E, Emri S, Babaoglu MO. Comparative Assessment of Outcomes in Drug Treatment for Smoking Cessation and Role of Genetic Polymorphisms of Human Nicotinic Acetylcholine Receptor Subunits. Front Genet 2022; 13:812715. [PMID: 35222535 PMCID: PMC8866864 DOI: 10.3389/fgene.2022.812715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the effects of genetic polymorphisms of human nicotinic acetylcholine receptor subunits α3, α4 and α5, which are encoded by CHRNA3, CHRNA4 CHRNA5 genes, respectively, on nicotine addiction and outcomes of pharmacological treatments for smoking cessation.Methods: A total of 143 smokers and 130 non-smokers were included. Genotyping for CHRNA3 rs578776, CHRNA4 rs1044396-rs1044397, CNRNA5 rs16969968 polymorphisms was performed by PCR, flowed by RFLP. Clinical outcomes and success rates of pharmacological treatments for smoking cessation with nicotine replacement therapy (NRT), bupropion or varenicline were determined at the 12th week of the treatment.Results: Overall, 52 out of 143 (36.4%) smokers who received pharmacotherapy were able to quit smoking. Success rates for smoking cessation were similar for female (30.3%) and male (41.6%) subjects (p = 0.16). The success rate for smoking cessation treatment with varenicline (58.5%) was significantly higher as compared to other treatments with NRT (20.0%), bupropion (32.3%) or bupropion + NRT (40.0%) (chi-square test, p = 0.001). Smoker vs. non-smoker status and the clinical outcomes of drugs used for smoking cessation were found similar in subjects carrying wild-type and variant alleles of human nicotinic acetylcholine receptor α subunits.Conclusion: In this study, smoking cessation treatment with varenicline was significantly more effective than treatments with nicotine replacement or bupropion in a cohort of Turkish subjects. Smoker/non-smoker status and the clinical outcomes of treatment with pharmacological agents were similar in subjects with wild-type or variant alleles for human nicotinic acetylcholine receptor subunits α3 (CHRNA3), α4 (CHRNA4) and α5 (CHRNA5).
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Affiliation(s)
- Ahmet Muderrisoglu
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- *Correspondence: Ahmet Muderrisoglu, , orcid.org/0000-0003-2954-360X
| | - Elif Babaoglu
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elif Tugce Korkmaz
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Said Kalkisim
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Salih Emri
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Melih O. Babaoglu
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Perez-Paramo YX, Lazarus P. Pharmacogenetics factors influencing smoking cessation success; the importance of nicotine metabolism. Expert Opin Drug Metab Toxicol 2021; 17:333-349. [PMID: 33322962 PMCID: PMC8049967 DOI: 10.1080/17425255.2021.1863948] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/10/2020] [Indexed: 01/12/2023]
Abstract
Introduction: Smoking remains a worldwide epidemic, and despite an increase in public acceptance of the harms of tobacco use, it remains the leading cause of preventable death. It is estimated that up to 70% of all smokers express a desire to quit, but only 3-5% of them are successful.Areas covered: The goal of this review was to evaluate the current status of smoking cessation treatments and the feasibility of implementing personalized-medicine approaches to these pharmacotherapies. We evaluated the genetics associated with higher levels of nicotine addiction and follow with an analysis of the genetic variants that affect the nicotine metabolic ratio (NMR) and the FDA approved treatments for smoking cessation. We also highlighted the gaps in the process of translating current laboratory understanding into clinical practice, and the benefits of personalized treatment approaches for a successful smoking cessation strategy.Expert opinion: Evidence supports the use of tailored therapies to ensure that the most efficient treatments are utilized in an individual's smoking cessation efforts. An understanding of the genetic effects on the efficacy of individualized smoking cessation pharmacotherapies is key to smoking cessation, ideally utilizing a polygenetic risk score that considers all genetic variation.
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Affiliation(s)
- Yadira X. Perez-Paramo
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington, USA
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington, USA
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14
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Bucklin M. A 5-Factor Framework for Assessing Tobacco Use Disorder. Tob Use Insights 2021; 14:1179173X21998355. [PMID: 33716514 PMCID: PMC7922618 DOI: 10.1177/1179173x21998355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 02/04/2021] [Indexed: 11/30/2022] Open
Abstract
Cigarette use is the leading cause of preventable death in the United
States. Despite the well documented dangers of smoking, nearly 20% of
adults report regular use of tobacco. A majority desire to discontinue
but the long-term cessation success rate remains near 4%. One
challenge to reducing the prevalence of tobacco use is an incomplete
understanding of the individual correlates that reinforce continued
use. Evidence from research on nicotine and tobacco suggests that
Tobacco Use Disorder is a complex, and multifactorial condition.
Personality traits, comorbidities, habits and lifestyle, genetics,
socioeconomic status, and mental and physical health all contribute to
the risk for dependence and to the likelihood of quitting. This
perspective review provides an overview of some common factors that
contribute to liability risk for Tobacco Use Disorder and a framework
for assessing individual tobacco users. The framework includes 5 areas
that research suggests contribute to continued tobacco use: nicotine
addiction, psychological influences, behavioral dependencies,
neurobiological factors, and social reinforcement. Nicotine addiction
includes drug-seeking behavior and the role of withdrawal avoidance.
Psychological and emotional states contribute to a perceived reliance
on tobacco. Behavioral dependence is reinforced by associative and
non-associative learning mechanisms. Neurobiological factors include
genetic variables, variations in neurotransmitters and receptors,
pharmacogenetics, and interaction between psychiatric illnesses and
nicotine use and dependence. Finally, social reinforcement of smoking
behavior is explained by a network phenomenon and consistent visual
cues to smoke. A comprehensive assessment of individual tobacco users
will help better determine appropriate treatment options to achieve
improved efficacy and outcomes.
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Muderrisoglu A, Babaoglu E, Korkmaz ET, Ongun MC, Karabulut E, Iskit AB, Emri S, Babaoglu MO. Effects of Genetic Polymorphisms of Drug Transporter ABCB1 (MDR1) and Cytochrome P450 Enzymes CYP2A6, CYP2B6 on Nicotine Addiction and Smoking Cessation. Front Genet 2020; 11:571997. [PMID: 33329709 PMCID: PMC7734344 DOI: 10.3389/fgene.2020.571997] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/12/2020] [Indexed: 01/08/2023] Open
Abstract
Objectives To determine the effects of genetic polymorphisms of ABCB1 (MDR1), CYP2A6, CYP2B6 on smoking status, and clinical outcomes of smoking cessation therapies in a Turkish population. Methods 130 smokers and 130 non-smokers were recruited. Individuals who never smoked were described as non-smokers. 130 smokers were treated with nicotine replacement therapy (NRT) (n = 40), bupropion (n = 47), bupropion + NRT (n = 15), and varenicline (n = 28). Smokers were checked by phone after 12 weeks of treatment whether they were able to quit smoking or not. Genotyping and phenotyping were performed. Results Cessation rates were as follows; 20.0% for NRT, 29.8% for bupropion, 40.0% for bupropion + NRT, 57.1% for varenicline (p = 0.013). The frequency of ABCB1 1236TT-2677TT-3435TT haplotype was significantly higher in non-smokers as compared to smokers (21.5% vs. 10.8, respectively; p = 0.018). Neither smoking status nor smoking cessation rates were associated with genetic variants of CYP2A6 (p = 0.652, p = 0.328, respectively), or variants of CYP2B6 (p = 0.514, p = 0.779, respectively). Conclusion Genetic variants of the drug transporter ABCB1 and the 1236TT-2677TT-3435TT haplotype was significantly associated with non-smoking status. Neither ABCB1 nor CYP2A6, CYP2B6 genetic variants were associated with smoking cessation rates at the 12th week of drug treatment.
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Affiliation(s)
- Ahmet Muderrisoglu
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elif Babaoglu
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Elif Tugce Korkmaz
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mert C Ongun
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alper B Iskit
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Salih Emri
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Melih O Babaoglu
- Department of Pharmacology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Culverhouse RC, Chen LS, Saccone NL, Ma Y, Piper ME, Baker TB, Bierut LJ. Variants in the CHRNA5-CHRNA3-CHRNB4 Region of Chromosome 15 Predict Gastrointestinal Adverse Events in the Transdisciplinary Tobacco Use Research Center Smoking Cessation Trial. Nicotine Tob Res 2020; 22:248-255. [PMID: 30882151 DOI: 10.1093/ntr/ntz044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 03/16/2019] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Reducing adverse events from pharmacologic treatment is an important goal of precision medicine and identifying genetic predictors of adverse events is a step toward this goal. In 2012, King et al. reported associations between genetic variants and adverse events in a placebo-controlled smoking cessation trial of varenicline and bupropion. Strong associations were found between gastrointestinal adverse events and 11 variants in the CHRNA5-CHRNA3-CHRNB4 region of chromosome 15, a region repeatedly associated with smoking-related phenotypes. Our goal was to replicate, in an independent sample, the impact of variants in the CHRNA5-CHRNA3-CHRNB4 region on gastrointestinal adverse events and to extend the analyses to adherence and smoking cessation. METHODS The University of Wisconsin Transdisciplinary Tobacco Use Research Center (TTURC) conducted a multiarmed, placebo-controlled smoking cessation trial of bupropion and nicotine replacement therapy that included 985 genotyped European-ancestry participants. We evaluated relationships between our key variables using logistic regression. RESULTS Gastrointestinal adverse events were experienced by 31.6% TTURC participants. Each of the CHRNA5-CHRNA3-CHRNB4 associations from the King et al. study was found in TTURC, with the same direction of effect. Neither these variants nor the gastrointestinal adverse events themselves were associated with adherence to medication or successful smoking cessation. CONCLUSIONS Variants in the CHRNA5-CHRNA3-CHRNB4 region of chromosome 15 are associated with gastrointestinal adverse events in smoking cessation. Additional independent variants in this region strengthen the association. The consistency between the results of these two independent studies supports the conclusion that these findings reflect biological response to the use of smoking cessation medication. IMPLICATIONS The fact that our findings from the TTURC smoking cessation trial support the independent findings of King et al. suggest that associations of variants in the CHRNA5-CHRNA3-CHRNB4 region of chromosome 15 with gastrointestinal adverse events while taking medications for smoking cessation reflect biology. However, although adherence to medication was a strong predictor of successful smoking cessation in TTURC, neither adverse events nor the genetic variants associated with them predicted either adherence or successful cessation in this study. Thus, although we should strive to minimize adverse events during treatment, we should not expect that to increase successful smoking cessation substantially.
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Affiliation(s)
- Robert C Culverhouse
- John T. Milliken Department of Medicine, Washington University School of Medicine, St. Louis, MO.,Division of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Nancy L Saccone
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Yinjiao Ma
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Megan E Piper
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Timothy B Baker
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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Chen LS, Baker TB, Miller JP, Bray M, Smock N, Chen J, Stoneking F, Culverhouse RC, Saccone NL, Amos CI, Carney RM, Jorenby DE, Bierut LJ. Genetic Variant in CHRNA5 and Response to Varenicline and Combination Nicotine Replacement in a Randomized Placebo-Controlled Trial. Clin Pharmacol Ther 2020; 108:1315-1325. [PMID: 32602170 DOI: 10.1002/cpt.1971] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/14/2020] [Indexed: 12/11/2022]
Abstract
It is unclear if genetic variants affect smoking cessation treatment response. This study tested whether variants in the cholinergic receptor nicotinic alpha 5 subunit (CHRNA5) predict response to smoking cessation medication by directly comparing the two most effective smoking cessation pharmacotherapies. In this genotype-stratified randomized, double-blind, placebo-controlled clinical trial (May 2015-August 2019 in St Louis, Missouri), smokers were randomized by genotype in blocks of six (1:1:1 ratio) to three conditions: 12 weeks of placebo (n = 273), combination nicotine patch and lozenge (combination nicotine replacement therapy, cNRT, n = 275), or varenicline (n = 274). All participants received counseling and were followed for 12 months. The primary end point was biochemically verified 7-day point prevalence abstinence at the end of treatment (EOT, week 12). Trial registration and eligibility criteria are on clinicaltrials.gov (https://clinicaltrials.gov/) (NCT02351167). We conducted the genetic analyses separately for 516 European ancestry (EA) smokers and 306 non-EA smokers (including 270 African American smokers). In African American smokers, there was a genotype-by-treatment interaction for EOT abstinence (χ2 = 10.7, degrees of freedom = 2. P = 0.0049): specifically, cNRT was more effective in smokers with rs16969968 GG genotype than was placebo, while varenicline was more effective in smokers of GA/AA genotypes. In EA ancestry smokers, there was no significant genotype-by-treatment interaction. In the whole sample, although both were effective at EOT, only varenicline, and not cNRT, was significantly effective relative to placebo at 6-month follow-up. Importantly, this study suggests that genetic information can further enhance smoking cessation treatment effectiveness.
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Affiliation(s)
- Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA.,Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital, Washington University School of Medicine, St Louis, Missouri, USA
| | - Timothy B Baker
- Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - J Philip Miller
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA
| | - Michael Bray
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA
| | - Nina Smock
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA
| | - Jingling Chen
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA
| | - Faith Stoneking
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA
| | - Robert C Culverhouse
- John T. Milliken Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA.,Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Nancy L Saccone
- Department of Genetics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Christopher I Amos
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA.,Department of Medicine, Baylor College of Medicine, Institute for Clinical and Translational Research, Houston, Texas, USA
| | - Robert M Carney
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA
| | - Douglas E Jorenby
- Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri, USA.,Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital, Washington University School of Medicine, St Louis, Missouri, USA
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Abstract
Human behavior can be controlled by physical or psychological dependencies associated with addiction. One of the most insidious addictions in our society is the use of tobacco products which contain nicotine. This addiction can be associated with specific receptors in the brain that respond to the natural neurotransmitter acetylcholine. These nicotinic acetylcholine receptors (nAChR) are ligand-gated ion channels formed by the assembly of one or multiple types of nAChR receptor subunits. In this paper, we review the structure and diversity of nAChR subunits and our understanding for how different nAChR subtypes play specific roles in the phenomenon of nicotine addiction. We focus on receptors containing β2 and/or α6 subunits and the special significance of α5-containing receptors. These subtypes all have roles in regulating dopamine-mediated neurotransmission in the mesolimbic reward pathways of the brain. We also discuss the unique roles of homomeric α7 nAChR in behavioral responses to nicotine and how our knowledge of nAChR functional diversity may help guide pharmacotherapeutic approaches for treating nicotine addiction. While nicotine addiction is a truly global problem, the use of areca nut (betel) products is also a serious addiction associated with public health issues across most of South Asia, impacting as many as 600 million people. We discuss how cholinergic receptors of the brain are also involved with areca addiction and the unique challenges for dealing with addiction to this substance.
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19
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Chronic Obstructive Pulmonary Disease Risk and Smoking Cessation Changes Induced by CHRNA5-A3 and CHRNB3-A6 Variation in a Chinese Male Population. Balkan J Med Genet 2019; 22:51-58. [PMID: 31942417 PMCID: PMC6956637 DOI: 10.2478/bjmg-2019-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Most studies in the field of CHRNA5-A3 and CHRNB3-A6 have only focused on lung cancer risk; however, the associations with chronic obstructive pulmonary disease (COPD) risk and smoking cessation is less understood, particularly in the Chinese male population. In this study, samples from 823 male patients with COPD (non smokers: 416; still smoking: 407) and 435 smoking male healthy control subjects were performed with DNA extraction and single nucleotide polymorphism (SNP) genotyping. We studied three SNPS in two genes, namely rs667282 and rs3743073 in CHRNA5-A3 and rs4950 in CHRNB3-A6, and their distributions in the three groups are not statistically different (p >0.05). We grouped COPD patients according to whether they had successfully quit smoking, the CT genotype of rs667282 demonstrated association with an increased rate of successful smoking cessation compared with the TT genotype [adjusted odds ratio (OR) = 0.54, 95% confidence interval (95% CI) = 0.37-0.7, p <0.001); rs4950 AG genotypes were distinctly associated with increased rates of successful smoking cessation (adjusted OR = 0.55, 95% CI = 0.40-0.76, p <0.001). The effect is significant under the assumption of an over dominant mode of inheritance (adjusted OR = 0.58, 95% CI = 0.43 to 0.79, p <0.001). No significant difference in rs3743073 was found (p >0.05). Our findings confirmed the hypothesis that CHRNA5-A3 and CHRNB3-A6 variation are not associated with the risk of COPD. We found CHRNA5-A3 and CHRNB3-A6 were significantly associated with successful smoking cessation in smoking COPD patients.
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20
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Chuang YH, Paul KC, Sinsheimer JS, Bronstein JM, Bordelon YM, Ritz B. Genetic variants in nicotinic receptors and smoking cessation in Parkinson's disease. Parkinsonism Relat Disord 2019; 62:57-61. [PMID: 30777653 DOI: 10.1016/j.parkreldis.2019.01.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Negative associations between smoking and Parkinson's disease (PD) are well documented. While common biases may not explain this association, some studies have suggested reverse causality and ease of quitting might be an early sign of PD, possibly related to a reduced nicotinic response. We investigated nicotinic receptor (nAChR) genetics to add to our understanding of possible biologic mechanisms underlying the smoking-PD relationship. METHODS We relied on 612 patients and 691 controls enrolled in the PEG (Parkinson's Environment and Gene) study for whom we obtained information on smoking and quitting ease through interviews. Genotyping in the nAChR genes, i.e. CHRNA5-A3-B4 and CHRNB3-A6 gene regions that have been linked to smoking or quitting behaviors, were based on blood and saliva DNA samples. We assessed associations with logistic regression assuming logit-additive allelic effects and used product terms for genetic allele status and smoking or quitting assessing interactions. RESULTS As expected, we observed negative associations between smoking and PD that were strongest for current followed by former smokers. In former smokers, high quitting difficulty was negatively associated with PD risk (extremely hard vs. easy: OR = 0.62 [0.39-0.99], p = 0.05), meaning those who developed PD were able to quit smoking with less difficulty than controls. The CHRNA3 rs578776-A allele predicted quitting difficulty in smoking controls (OR = 0.53 [0.32-0.91], p = 0.02), but not in smoking PD patients (OR = 1.09 [0.61-1.95], p = 0.77). CONCLUSION Our study further corroborates previous findings that ease of quitting may be an early sign of PD onset related to a loss of nicotinic response in prodromal stages.
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Affiliation(s)
- Yu-Hsuan Chuang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
| | - Kimberly C Paul
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
| | - Janet S Sinsheimer
- Department of Human Genetics and Biomathematics, UCLA David Geffen School of Medicine, Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
| | - Jeff M Bronstein
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA.
| | - Yvette M Bordelon
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA.
| | - Beate Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA; Department of Environmental Health, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
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21
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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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22
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Tomaz PRX, Santos JR, Scholz J, Abe TO, Gaya PV, Negrão AB, Krieger JE, Pereira AC, Santos PCJL. Cholinergic receptor nicotinic alpha 5 subunit polymorphisms are associated with smoking cessation success in women. BMC MEDICAL GENETICS 2018; 19:55. [PMID: 29621993 PMCID: PMC5887212 DOI: 10.1186/s12881-018-0571-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/23/2018] [Indexed: 11/16/2022]
Abstract
Background The identification of variants in the nicotinic acetylcholine receptor (nAChR) subunit genes associated with smoking phenotypes are increasingly important for prevention and treatment of nicotine dependence. In the context of personalized medicine, the aims of this study were to evaluate whether cholinergic receptor nicotinic alpha 2 (CHRNA2), cholinergic receptor nicotinic alpha 3 (CHRNA3), cholinergic receptor nicotinic alpha 5 (CHRNA5) and cholinergic receptor nicotinic beta 3 (CHRNB3) polymorphisms were associated with nicotine dependence severity, and to investigate possible pharmacogenetics markers of smoking cessation treatment. Methods This study cohort enrolled 1049 smoking patients who received pharmacological treatment (varenicline, varenicline plus bupropion, bupropion plus/or nicotine replacement therapy). Smoking cessation success was considered for patients who completed 6 months of continuous abstinence. Fagerström test for nicotine dependence (FTND) and Issa situational smoking scores (Issa score) were analyzed for nicotine dependence. CHRNA2 (rs2472553), CHRNA3 (rs1051730), CHRNA5 (rs16969968 and rs2036527) and CHRNB3 (rs6474413) polymorphisms were genotyped by high resolution melting analysis. Results Females with GA and AA genotypes for CHRNA5 rs16969968 and rs2036527 polymorphisms had higher success rate in smoking cessation treatment: 44.0% and 56.3% (rs16969968), 41.5% and 56.5% (rs2036527), respectively, compared with carriers of the GG genotypes: 35.7% (rs16969968), 34.8% (rs2036527), (P = 0.03, n = 389; P = 0.01, n = 391). The GA or AA genotypes for the rs16969968 and rs2036527 were associated with higher odds ratio for success in women (OR = 1.63; 95% CI = 1.04 to 2.54; P = 0.03 and OR = 1.59, 95% CI = 1.02 to 2.48; P = 0.04; respectively). We did not find association of these polymorphisms with nicotine dependence related scores. Polymorphisms in the CHRNA2, CHRNA3 and CHRNB3 genes were not associated with the phenotypes studied. Conclusion CHRNA5 rs16969968 and rs2036527 were associated with higher success rate in the smoking cessation treatment in women. These findings might contribute to advances in personalized medicine. Electronic supplementary material The online version of this article (10.1186/s12881-018-0571-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paulo Roberto Xavier Tomaz
- Laboratory of Genetics and Molecular Cardiology, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Juliana Rocha Santos
- Laboratory of Genetics and Molecular Cardiology, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Jaqueline Scholz
- Smoking Cessation Program Department, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Tânia Ogawa Abe
- Smoking Cessation Program Department, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Patrícia Viviane Gaya
- Smoking Cessation Program Department, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - André Brooking Negrão
- Laboratory of Genetics and Molecular Cardiology, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - José Eduardo Krieger
- Laboratory of Genetics and Molecular Cardiology, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Alexandre Costa Pereira
- Laboratory of Genetics and Molecular Cardiology, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Paulo Caleb Júnior Lima Santos
- Laboratory of Genetics and Molecular Cardiology, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. .,Department of Pharmacology, Universidade Federal de Sao Paulo - UNIFESP, Sao Paulo, SP, Brazil.
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Chen LS, Horton A, Bierut L. Pathways to precision medicine in smoking cessation treatments. Neurosci Lett 2018; 669:83-92. [PMID: 27208830 PMCID: PMC5115988 DOI: 10.1016/j.neulet.2016.05.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/12/2016] [Accepted: 05/17/2016] [Indexed: 02/06/2023]
Abstract
Cigarette smoking is highly addictive and modern genetic research has identified robust genetic influences on nicotine dependence. An important step in translating these genetic findings to clinical practice is identifying the genetic factors affecting smoking cessation in order to enhance current smoking cessation treatments. We reviewed the significant genetic variants that predict nicotine dependence, smoking cessation, and response to cessation pharmacotherapy. These data suggest that genetic risks can predict smoking cessation outcomes and moderate the effect of pharmacological treatments. Some pharmacogenetic findings have been replicated in meta-analyses or in multiple smoking cessation trials. The variation in efficacy between smokers with different genetic markers supports the notion that personalized smoking cessation intervention based upon genotype could maximize the efficiency of such treatment while minimizing side effects, thus influencing the number needed to treat (NNT) and the number needed to harm. In summary, as precision medicine is revolutionizing healthcare, smoking cessation may be one of the first areas where genetic variants may identify individuals at increased risk. Current evidence strongly suggests that genetic variants predict cessation failure and that cessation pharmacotherapy effectiveness is modulated by biomarkers such as nicotinic cholinergic receptor α5 subunit (CHRNA5) genotypes or nicotine metabolism ratio (NMR). These findings strengthen the case for the development and rigorous testing of treatments that target patients with different biological risk profiles.
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Affiliation(s)
- Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, United States.
| | - Amy Horton
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, United States
| | - Laura Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, United States
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24
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Saccone NL, Baurley JW, Bergen AW, David SP, Elliott HR, Foreman MG, Kaprio J, Piasecki TM, Relton CL, Zawertailo L, Bierut LJ, Tyndale RF, Chen LS. The Value of Biosamples in Smoking Cessation Trials: A Review of Genetic, Metabolomic, and Epigenetic Findings. Nicotine Tob Res 2018; 20:403-413. [PMID: 28472521 PMCID: PMC5896536 DOI: 10.1093/ntr/ntx096] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/01/2017] [Indexed: 02/03/2023]
Abstract
Introduction Human genetic research has succeeded in definitively identifying multiple genetic variants associated with risk for nicotine dependence and heavy smoking. To build on these advances, and to aid in reducing the prevalence of smoking and its consequent health harms, the next frontier is to identify genetic predictors of successful smoking cessation and also of the efficacy of smoking cessation treatments ("pharmacogenomics"). More broadly, additional biomarkers that can be quantified from biosamples also promise to aid "Precision Medicine" and the personalization of treatment, both pharmacological and behavioral. Aims and Methods To motivate ongoing and future efforts, here we review several compelling genetic and biomarker findings related to smoking cessation and treatment. Results These Key results involve genetic variants in the nicotinic receptor subunit gene CHRNA5, variants in the nicotine metabolism gene CYP2A6, and the nicotine metabolite ratio. We also summarize reports of epigenetic changes related to smoking behavior. Conclusions The results to date demonstrate the value and utility of data generated from biosamples in clinical treatment trial settings. This article cross-references a companion paper in this issue that provides practical guidance on how to incorporate biosample collection into a planned clinical trial and discusses avenues for harmonizing data and fostering consortium-based, collaborative research on the pharmacogenomics of smoking cessation. Implications Evidence is emerging that certain genotypes and biomarkers are associated with smoking cessation success and efficacy of smoking cessation treatments. We review key findings that open potential avenues for personalizing smoking cessation treatment according to an individual's genetic or metabolic profile. These results provide important incentive for smoking cessation researchers to collect biosamples and perform genotyping in research studies and clinical trials.
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Affiliation(s)
- Nancy L Saccone
- Department of Genetics and Division of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | | | | | - Sean P David
- Department of Medicine, Stanford University, Stanford, CA
| | - Hannah R Elliott
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Marilyn G Foreman
- Pulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA
| | - Jaakko Kaprio
- Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Thomas M Piasecki
- Department of Psychological Sciences, University of Missouri, Columbia, MO
| | - Caroline L Relton
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Laurie Zawertailo
- Nicotine Dependence Service, Centre for Addiction and Mental Health, and Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Laura J Bierut
- Siteman Cancer Center, Institute of Public Health, and Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and Departments of Pharmacology & Toxicology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Li-Shiun Chen
- Siteman Cancer Center, Institute of Public Health, and Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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25
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Chen LS, Zawertailo L, Piasecki TM, Kaprio J, Foreman M, Elliott HR, David SP, Bergen AW, Baurley JW, Tyndale RF, Baker TB, Bierut LJ, Saccone NL. Leveraging Genomic Data in Smoking Cessation Trials in the Era of Precision Medicine: Why and How. Nicotine Tob Res 2018; 20:414-424. [PMID: 28498934 PMCID: PMC5896450 DOI: 10.1093/ntr/ntx097] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/09/2017] [Indexed: 01/11/2023]
Abstract
Implications This article outlines a framework for the consistent integration of biological data/samples into smoking cessation pharmacotherapy trials, aligned with the objectives of the recently unveiled Precision Medicine Initiative. Our goal is to encourage and provide support for treatment researchers to consider biosample collection and genotyping their existing samples as well as integrating genetic analyses into their study design in order to realize precision medicine in treatment of nicotine dependence.
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Affiliation(s)
- Li-Shiun Chen
- Siteman Cancer Center, Institute of Public Health, and Department of Psychiatry, Washington University School of Medicine, St. Louis, MI
| | - Laurie Zawertailo
- Nicotine Dependence Service, Centre for Addiction and Mental Health, and Dept. of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Thomas M Piasecki
- Department of Psychological Sciences, University of Missouri, Columbia, MI
| | - Jaakko Kaprio
- Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Marilyn Foreman
- Pulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA
| | - Hannah R Elliott
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Sean P David
- Department of Medicine, Stanford University, Stanford, CA
| | | | | | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and Departments of Pharmacology & Toxicology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Timothy B Baker
- Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Laura J Bierut
- Siteman Cancer Center, Institute of Public Health, and Department of Psychiatry, Washington University School of Medicine, St. Louis, MI
| | - Nancy L Saccone
- Department of Genetics, Washington University School of Medicine, St. Louis, MI
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26
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Ramsey AT, Chen LS, Hartz SM, Saccone NL, Fisher SL, Proctor EK, Bierut LJ. Toward the implementation of genomic applications for smoking cessation and smoking-related diseases. Transl Behav Med 2018; 8:7-17. [PMID: 29385591 PMCID: PMC6065540 DOI: 10.1093/tbm/ibx060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The incorporation of genomic information into routine care settings is a burgeoning area for investigation in behavioral medicine. The past decade has witnessed rapid advancements in knowledge of genetic biomarkers associated with smoking behaviors and tobacco-related morbidity and mortality, providing the basis for promising genomic applications in clinical and community settings. We assessed the current state of readiness for implementing genomic applications involving variation in the α5 nicotinic cholinergic receptor subunit gene CHRNA5 and smoking outcomes (behaviors and related diseases) using a process that could be translatable to a wide range of genomic applications in behavioral medicine. We reviewed the scientific literature involving CHRNA5 genetic variation and smoking cessation, and then summarized and synthesized a chain of evidence according to analytic validity, clinical validity, clinical utility, and ethical, legal, and social implications (ACCE), a well-established set of criteria used to evaluate genomic applications. Our review identified at least three specific genomic applications for which implementation may be considered, including the use of CHRNA5 genetic test results for informing disease risk, optimizing smoking cessation treatment, and motivating smoking behavior change. For these genomic applications, we rated analytic validity as convincing, clinical validity as adequate, and clinical utility and ethical, legal, and social implications as inadequate. For clinical genomic applications involving CHRNA5 variation and smoking outcomes, research efforts now need to focus on establishing clinical utility. This approach is compatible with pre-implementation research, which is also needed to accelerate translation, improve innovation design, and understand and refine system processes involved in implementation. This study informs the readiness to incorporate smoking-related genomic applications in real-world settings and facilitates cross-disciplinary collaboration to accelerate the integration of evidence-based genomics in behavioral medicine.
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Affiliation(s)
- Alex T Ramsey
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sarah M Hartz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Nancy L Saccone
- Department of Genetics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sherri L Fisher
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Enola K Proctor
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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27
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Bierut LJ, Tyndale RF. Preparing the Way: Exploiting Genomic Medicine to Stop Smoking. Trends Mol Med 2018; 24:187-196. [PMID: 29307500 DOI: 10.1016/j.molmed.2017.12.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/07/2017] [Accepted: 12/10/2017] [Indexed: 12/15/2022]
Abstract
Clinical medicine of the future is poised to use an individual's genomic data to predict disease risk and guide clinical care. The treatment of cigarette smoking and tobacco use disorder represents a prime area for genomics implementation. The genes CHRNA5 and CYP2A6 are strong genomic contributors that alter the risk of heaviness of smoking, tobacco use disorder, and smoking-related diseases in humans. These biomarkers have proven analytical and clinical validity, and evidence for their clinical utility continues to grow. We propose that these biomarkers harbor the potential of enabling the identification of elevated disease risk in smokers, personalizing smoking cessation treatments, and motivating behavioral changes. We must prepare for the integration of genomic applications into clinical care of patients who smoke.
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Affiliation(s)
- Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH) and Departments of Psychiatry, Pharmacology and Toxicology, University of Toronto, Toronto, M5S 1A8, Ontario, Canada
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28
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Weafer J, Gray JC, Hernandez K, Palmer AA, MacKillop J, de Wit H. Hierarchical investigation of genetic influences on response inhibition in healthy young adults. Exp Clin Psychopharmacol 2017; 25:512-520. [PMID: 29251981 PMCID: PMC5737791 DOI: 10.1037/pha0000156] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Poor inhibitory control is a known risk factor for substance use disorders, making it a priority to identify the determinants of these deficits. The aim of the current study was to identify genetic associations with inhibitory control using the stop signal task in a large sample (n = 934) of healthy young adults of European ancestry. We genotyped the subjects genome-wide and then used a hierarchical approach in which we tested seven a priori single nucleotide polymorphisms (SNPs) previously associated with stop signal task performance, approximately 9,000 SNPs designated as high-value addiction (HVA) markers by the SmokeScreen array, and approximately five million genotyped and imputed SNPs, followed by a gene-based association analysis using the resultant p values. A priori SNP analyses revealed nominally significant associations between response inhibition and one locus in HTR2A (rs6313; p = .04, dominance model, uncorrected) in the same direction as prior findings. A nominally significant association was also found in one locus in ANKK1 (rs1800497; p = .03, uncorrected), although in the opposite direction of previous reports. After accounting for multiple comparisons, the HVA, genome-wide, and gene-based analyses yielded no significant findings. This study implicates variation in serotonergic and dopaminergic genes while underscoring the difficulty of detecting the influence of individual SNPs, even when biological information is used to prioritize testing. Although such small effect sizes suggest limited utility of individual SNPs in predicting risk for addiction or other impulse control disorders, they may nonetheless shed light on complex biological processes underlying poor inhibitory control. (PsycINFO Database Record
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Affiliation(s)
- Jessica Weafer
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago
| | - Joshua C. Gray
- Department of Psychology, University of Georgia,Department of Psychiatry and Human Behavior, Brown University
| | | | - Abraham A. Palmer
- Department of Psychiatry, University of California, San Diego,Institute for Genomic Medicine, University of California, San Diego
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University,Homewood Research Institute, Homewood Health Centre
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago,Corresponding author: Harriet de Wit, Department of Psychiatry and Behavioral Neuroscience, MC 3077, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, Phone: 773-702-1537, Fax: 773-834-7698,
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Pharmacogenetic study of seven polymorphisms in three nicotinic acetylcholine receptor subunits in smoking-cessation therapies. Sci Rep 2017; 7:16730. [PMID: 29196725 PMCID: PMC5711795 DOI: 10.1038/s41598-017-16946-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/19/2017] [Indexed: 11/23/2022] Open
Abstract
Smoking-cessation therapy reduces the risk of smoking-related diseases, but is successful only in a fraction of smokers. There is growing evidence that genetic variations in nicotinic acetylcholine receptor (nAChR) subunits influence the risk of nicotine dependence and the ability to quit smoking. To investigate the role of polymorphisms in nAChR genes on smoking quantity and the outcome of smoking-cessation therapies, we carried out an association study on 337 smokers who underwent pharmacotherapy with varenicline, bupropion, nicotine replacement therapy (NRT) alone, or NRT plus bupropion. Smoking habit and abstention were assessed from the number of cigarettes smoked per day (CPD) and the exhaled CO (eCO), at baseline and up to 12 months. We genotyped seven polymorphisms in genes encoding the nAChR subunits CHRNA4, CHRNA5, and CHRNB2. At baseline, both CPD and eCO were associated with polymorphisms in the CHRNA5 locus (rs503464, rs55853698, rs55781567 and rs16969968; P < 0.01). rs503464, a variant in the 5′-UTR of CHRNA5, was also associated with short-, mid- and long-term responses to therapy (P = 0.011, P = 0.0043, P = 0.020, respectively), although after correction for multiple testing only the association at the mid-term assessment remained significant (FDR = 0.03). These data support the role of individual genetic makeup in the ability to quit smoking.
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30
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Kranzler HR, Smith RV, Schnoll R, Moustafa A, Greenstreet-Akman E. Precision medicine and pharmacogenetics: what does oncology have that addiction medicine does not? Addiction 2017; 112:2086-2094. [PMID: 28431457 PMCID: PMC5650957 DOI: 10.1111/add.13818] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/08/2017] [Accepted: 03/08/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Precision, personalized or stratified medicine, which promises to deliver the right treatment to the right patient, is a topic of international interest in both the lay press and the scientific literature. A key aspect of precision medicine is the identification of biomarkers that predict the response to medications (i.e. pharmacogenetics). We examined why, despite the great strides that have been made in biomarker identification in many areas of medicine, only in oncology has there been substantial progress in their clinical implementation. We also considered why progress in this effort has lagged in addiction medicine. METHODS We compared the development of pharmacogenetic biomarkers in oncology, cardiovascular medicine (where developments are also promising) and addictive disorders. RESULTS The first major reason for the success of oncologic pharmacogenetics is ready access to tumor tissue, which allows in-vitro testing and insights into cancer biology. The second major reason is funding, with cancer research receiving, by far, the largest allocation by the National Institutes of Health (NIH) during the past two decades. The second largest allocation of research funding has gone to cardiovascular disease research. Addictions research received a much smaller NIH funding allocation, despite the major impact that tobacco use, alcohol consumption and illicit drug use have on the public health and healthcare costs. CONCLUSIONS Greater support for research on the personalized treatment of addictive disorders can be expected to yield disproportionately large benefits to the public health and substantial reductions in healthcare costs.
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Affiliation(s)
- Henry R. Kranzler
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA 19104
| | - Rachel V. Smith
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA 19104
| | - Robert Schnoll
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Afaf Moustafa
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Emma Greenstreet-Akman
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
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Ritz BR, Chatterjee N, Garcia-Closas M, Gauderman WJ, Pierce BL, Kraft P, Tanner CM, Mechanic LE, McAllister K. Lessons Learned From Past Gene-Environment Interaction Successes. Am J Epidemiol 2017; 186:778-786. [PMID: 28978190 PMCID: PMC5860326 DOI: 10.1093/aje/kwx230] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 04/01/2017] [Accepted: 04/04/2017] [Indexed: 12/20/2022] Open
Abstract
Genetic and environmental factors are both known to contribute to susceptibility to complex diseases. Therefore, the study of gene-environment interaction (G×E) has been a focus of research for several years. In this article, select examples of G×E from the literature are described to highlight different approaches and underlying principles related to the success of these studies. These examples can be broadly categorized as studies of single metabolism genes, genes in complex metabolism pathways, ranges of exposure levels, functional approaches and model systems, and pharmacogenomics. Some studies illustrated the success of studying exposure metabolism for which candidate genes can be identified. Moreover, some G×E successes depended on the availability of high-quality exposure assessment and longitudinal measures, study populations with a wide range of exposure levels, and the inclusion of ethnically and geographically diverse populations. In several examples, large population sizes were required to detect G×Es. Other examples illustrated the impact of accurately defining scale of the interactions (i.e., additive or multiplicative). Last, model systems and functional approaches provided insights into G×E in several examples. Future studies may benefit from these lessons learned.
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Affiliation(s)
- Beate R. Ritz
- Correspondence to Dr. Beate R. Ritz, Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, 650 Charles Young Drive South, Los Angeles, CA 90095 (e-mail: )
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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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Heckman BW, Cummings KM, Kasza KA, Borland R, Burris JL, Fong GT, McNeill A, Carpenter MJ. Effectiveness of Switching Smoking-Cessation Medications Following Relapse. Am J Prev Med 2017; 53:e63-e70. [PMID: 28336353 PMCID: PMC5522631 DOI: 10.1016/j.amepre.2017.01.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 12/16/2016] [Accepted: 01/23/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Nicotine dependence is a chronic disorder often characterized by multiple failed quit attempts (QAs). Yet, little is known about the sequence of methods used across multiple QAs or how this may impact future ability to abstain from smoking. This prospective cohort study examines the effectiveness of switching smoking-cessation medications (SCMs) across multiple QAs. METHODS Adult smokers (aged ≥18 years) participating in International Tobacco Control surveys in the United Kingdom, U.S., Canada, and Australia (N=795) who: (1) completed two consecutive surveys between 2006 and 2011; (2) initiated a QA at least 1 month before each survey; and (3) provided data for the primary predictor (SCM use during most recent QA), outcome (1-month point prevalence abstinence), and relevant covariates. Analyses were conducted in 2016. RESULTS Five SCM user classifications were identified: (1) non-users (43.5%); (2) early users (SCM used for initial, but not subsequent QA; 11.4%); (3) later users (SCM used for subsequent, but not initial QA; 18.4%); (4) repeaters (same SCM used for both QAs; 10.7%); and (5) switchers (different SCM used for each QA; 14.2%). Abstinence rates were lower for non-users (15.9%, OR=0.48, p=0.002), early users (16.6%, OR=0.27, p=0.03), and repeaters (12.4%, OR=0.36, p=0.004) relative to switchers (28.5%). CONCLUSIONS Findings suggest smokers will be more successful if they use a SCM in QAs and vary the SCM they use across time. That smokers can increase their odds of quitting by switching SCMs is an important message that could be communicated to smokers.
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Affiliation(s)
- Bryan W Heckman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina; Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina; Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York
| | - Ron Borland
- Nigel Gray Fellowship Group, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Jessica L Burris
- Department of Psychology, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Ann McNeill
- UK Centre for Tobacco and Alcohol Studies, King's College London, Strand, London, United Kingdom
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina; Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
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Newnham JP, Kemp MW, White SW, Arrese CA, Hart RJ, Keelan JA. Applying Precision Public Health to Prevent Preterm Birth. Front Public Health 2017; 5:66. [PMID: 28421178 PMCID: PMC5379772 DOI: 10.3389/fpubh.2017.00066] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/17/2017] [Indexed: 12/12/2022] Open
Abstract
Preterm birth (PTB) is one of the major health-care challenges of our time. Being born too early is associated with major risks to the child with potential for serious consequences in terms of life-long disability and health-care costs. Discovering how to prevent PTB needs to be one of our greatest priorities. Recent advances have provided hope that a percentage of cases known to be related to risk factors may be amenable to prevention; but the majority of cases remain of unknown cause, and there is little chance of prevention. Applying the principle of precision public health may offer opportunities previously unavailable. Presented in this article are ideas that may improve our abilities in the fields of studying the effects of migration and of populations in transition, public health programs, tobacco control, routine measurement of length of the cervix in mid-pregnancy by ultrasound imaging, prevention of non-medically indicated late PTB, identification of pregnant women for whom treatment of vaginal infection may be of benefit, and screening by genetics and other “omics.” Opening new research in these fields, and viewing these clinical problems through a prism of precision public health, may produce benefits that will affect the lives of large numbers of people.
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Affiliation(s)
- John P Newnham
- School of Women's and Infants' Health, The University of Western Australia, Crawley, WA, Australia.,Department of Maternal Fetal Medicine, King Edward Memorial Hospital, Subiaco, WA, Australia
| | - Matthew W Kemp
- School of Women's and Infants' Health, The University of Western Australia, Crawley, WA, Australia
| | - Scott W White
- School of Women's and Infants' Health, The University of Western Australia, Crawley, WA, Australia.,Department of Maternal Fetal Medicine, King Edward Memorial Hospital, Subiaco, WA, Australia
| | - Catherine A Arrese
- School of Women's and Infants' Health, The University of Western Australia, Crawley, WA, Australia
| | - Roger J Hart
- School of Women's and Infants' Health, The University of Western Australia, Crawley, WA, Australia
| | - Jeffrey A Keelan
- School of Women's and Infants' Health, The University of Western Australia, Crawley, WA, Australia
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Wang Q, Li S, Li H, Yang X, Jiang F, Zhang N, Han M, Jia C. Relative contribution of genetic, individual, and self-efficacy factors to smoking cessation in a Chinese rural population. Am J Addict 2017; 26:161-166. [PMID: 28191914 DOI: 10.1111/ajad.12507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 12/19/2016] [Accepted: 01/28/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Nicotine dependence is influenced by genetic, individual, and psychological factors. We aimed to examine whether nicotinic acetylcholine receptor genes (CHRN) were associated with smoking cessation (SC) using genetic risk score and compare the relative contribution of genetic, individual and self-efficacy factors to SC. METHODS Eight hundred and nineteen male smokers (mean age: 59.62) were recruited from 17 villages of three counties in Shandong province, China. Thirty-two single nucleotide polymorphisms (SNPs) in seven CHRN genes were genotyped. Logistic regression was used to explore the relationship between genetic risk score and SC. Dominance analysis was performed to compare the relative contribution of genetic, individual, and self-efficacy factors on SC. RESULTS CHRNA3 genetic risk score was associated with SC. Dominance analysis showed that individual factor was the most important predictor for SC, followed by genetic and self-efficacy factors. CONCLUSIONS CHRNA3 was associated with successful SC. Individual factor had more contribution than genetic factor to SC. SCIENTIFIC SIGNIFICANCE Our findings provide support to the role of CHRN genes in the etiology of smoking cessation using genetic risk score. Individual factor should be particularly valued in smoking control intervention. (Am J Addict 2017;26:161-166).
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Suyun Li
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Huijie Li
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Xiaorong Yang
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Fan Jiang
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Nan Zhang
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Mingkui Han
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Chongqi Jia
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
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Chenoweth MJ, Tyndale RF. Pharmacogenetic Optimization of Smoking Cessation Treatment. Trends Pharmacol Sci 2017; 38:55-66. [PMID: 27712845 PMCID: PMC5195866 DOI: 10.1016/j.tips.2016.09.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/08/2016] [Accepted: 09/12/2016] [Indexed: 12/12/2022]
Abstract
Worldwide, approximately one billion people smoke cigarettes. Cigarette smoking persists in part because long-term smoking cessation rates are modest on existing treatments. Smoking cessation outcomes are influenced by genetic factors, including genetic variation in enzymes that metabolize nicotine and smoking cessation medications, as well as in receptor targets for nicotine and treatment medications. For example, smokers with genetically slow nicotine metabolism have higher cessation success on behavioural counseling and nicotine patches compared with smokers with genetically fast nicotine metabolism. In this review, we highlight new progress in our understanding of how genetic variation in the pharmacological targets of nicotine and smoking cessation medications could be used to tailor smoking cessation therapy, increase quit rates, and reduce tobacco-related harm.
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Affiliation(s)
- Meghan J Chenoweth
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ONT, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ONT, Canada
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ONT, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ONT, Canada; Department of Psychiatry, University of Toronto, Toronto, ONT, Canada.
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Genetic Risk Can Be Decreased: Quitting Smoking Decreases and Delays Lung Cancer for Smokers With High and Low CHRNA5 Risk Genotypes - A Meta-Analysis. EBioMedicine 2016; 11:219-226. [PMID: 27543155 PMCID: PMC5049934 DOI: 10.1016/j.ebiom.2016.08.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/05/2016] [Accepted: 08/06/2016] [Indexed: 12/02/2022] Open
Abstract
Background Recent meta-analyses show that individuals with high risk variants in CHRNA5 on chromosome 15q25 are likely to develop lung cancer earlier than those with low-risk genotypes. The same high-risk genetic variants also predict nicotine dependence and delayed smoking cessation. It is unclear whether smoking cessation confers the same benefits in terms of lung cancer risk reduction for those who possess CHRNA5 risk variants versus those who do not. Methods Meta-analyses examined the association between smoking cessation and lung cancer risk in 15 studies of individuals with European ancestry who possessed varying rs16969968 genotypes (N = 12,690 ever smokers, including 6988 cases of lung cancer and 5702 controls) in the International Lung Cancer Consortium. Results Smoking cessation (former vs. current smokers) was associated with a lower likelihood of lung cancer (OR = 0.48, 95%CI = 0.30–0.75, p = 0.0015). Among lung cancer patients, smoking cessation was associated with a 7-year delay in median age of lung cancer diagnosis (HR = 0.68, 95%CI = 0.61–0.77, p = 4.9 ∗ 10–10). The CHRNA5 rs16969968 risk genotype (AA) was associated with increased risk and earlier diagnosis for lung cancer, but the beneficial effects of smoking cessation were very similar in those with and without the risk genotype. Conclusion We demonstrate that quitting smoking is highly beneficial in reducing lung cancer risks for smokers regardless of their CHRNA5 rs16969968 genetic risk status. Smokers with high-risk CHRNA5 genotypes, on average, can largely eliminate their elevated genetic risk for lung cancer by quitting smoking- cutting their risk of lung cancer in half and delaying its onset by 7 years for those who develop it. These results: 1) underscore the potential value of smoking cessation for all smokers, 2) suggest that CHRNA5 rs16969968 genotype affects lung cancer diagnosis through its effects on smoking, and 3) have potential value for framing preventive interventions for those who smoke. CHRNA5 rs16969968 confers risk for earlier lung cancer diagnosis, but quitting produces benefit regardless of genotype. Smokers can cut their risk of lung cancer in half and delay its onset by 7 years among those diagnosed. Precision prevention allows clinicians to provide personalized health benefits of smoking cessation.
This is a report on whether smoking cessation confers the same benefits in terms of lung cancer risk reduction for those who possess CHRNA5 risk variants versus those who do not. We determined that quitting smoking is highly beneficial in reducing lung cancer risk levels for smokers regardless of their CHRNA5 rs16969968 genetic risk status. Although CHRNA5 rs16969968 increases risk for earlier lung cancer by 4 years, quitting produces essentially the same benefit for smokers with either high or low genetic risks. Smokers can cut their risk of lung cancer in half and delay its onset by 7 years among those diagnosed. These results are important for smokers to prevent cancer. On average, smokers at all genetic risk levels can largely eliminate their elevated risk for lung cancer by quitting smoking.
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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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Wang Q, Li S, Pan L, Li H, Yang X, Jiang F, Zhang N, Han M, Jia C. Association between variants in nicotinic acetylcholine receptor genes and smoking cessation in a Chinese rural population. Am J Addict 2016; 25:297-300. [PMID: 27197960 DOI: 10.1111/ajad.12383] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/28/2016] [Accepted: 05/06/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Genetic studies have revealed a significant association between variants in nicotinic acetylcholine receptor (CHRN) genes and smoking cessation, but the results are inconsistent. In this study, we aimed to examine the relationship between single nucleotide polymorphisms (SNPs) in seven CHRN genes and smoking cessation in a Chinese rural population. METHODS Participants were recruited from 17 villages of 3 counties in Shandong, China. DNA was extracted from the blood samples. Thirty-two SNPs in seven CHRN genes were genotyped. Logistic regression was used to explore the relationship between single SNP and smoking cessation. Pearson's χ(2) test was performed to test the association between haplotype and smoking cessation. RESULTS Rs578776 (in CHRNA3), rs660652 (in CHRNA3), and rs588765 (in CHRNA5) were significantly related to smoking cessation. Two haplotypes were associated with smoking cessation. CONCLUSIONS This study confirmed the association between CHRN genes and smoking cessation in the Chinese rural population. SCIENTIFIC SIGNIFICANCE Our findings provide confirmatory support to the role of CHRN genes to the etiology of smoking cessation in the Chinese rural population. (Am J Addict 2016;25:297-300).
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Suyun Li
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Lulu Pan
- Hebei Center for Disease Control and Prevention, Hebei, P. R. China
| | - Huijie Li
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Xiaorong Yang
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Fan Jiang
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Nan Zhang
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Mingkui Han
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
| | - Chongqi Jia
- Department of Epidemiology, Shandong University, Jinan, Shandong, P. R. China
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Baurley JW, Edlund CK, Pardamean CI, Conti DV, Bergen AW. Smokescreen: a targeted genotyping array for addiction research. BMC Genomics 2016; 17:145. [PMID: 26921259 PMCID: PMC4769529 DOI: 10.1186/s12864-016-2495-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 02/17/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Addictive disorders are a class of chronic, relapsing mental disorders that are responsible for increased risk of mental and medical disorders and represent the largest, potentially modifiable cause of death. Tobacco dependence is associated with increased risk of disease and premature death. While tobacco control efforts and therapeutic interventions have made good progress in reducing smoking prevalence, challenges remain in optimizing their effectiveness based on patient characteristics, including genetic variation. In order to maximize collaborative efforts to advance addiction research, we have developed a genotyping array called Smokescreen. This custom array builds upon previous work in the analyses of human genetic variation, the genetics of addiction, drug metabolism, and response to therapy, with an emphasis on smoking and nicotine addiction. RESULTS The Smokescreen genotyping array includes 646,247 markers in 23 categories. The array design covers genome-wide common variation (65.67, 82.37, and 90.72% in African (YRI), East Asian (ASN), and European (EUR) respectively); most of the variation with a minor allele frequency ≥ 0.01 in 1014 addiction genes (85.16, 89.51, and 90.49% for YRI, ASN, and EUR respectively); and nearly all variation from the 1000 Genomes Project Phase 1, NHLBI GO Exome Sequencing Project and HapMap databases in the regions related to smoking behavior and nicotine metabolism: CHRNA5-CHRNA3-CHRNB4 and CYP2A6-CYP2B6. Of the 636 pilot DNA samples derived from blood or cell line biospecimens that were genotyped on the array, 622 (97.80%) passed quality control. In passing samples, 90.08% of markers passed quality control. The genotype reproducibility in 25 replicate pairs was 99.94%. For 137 samples that overlapped with HapMap2 release 24, the genotype concordance was 99.76%. In a genome-wide association analysis of the nicotine metabolite ratio in 315 individuals participating in nicotine metabolism laboratory studies, we identified genome-wide significant variants in the CYP2A6 region (min p = 9.10E-15). CONCLUSIONS We developed a comprehensive genotyping array for addiction research and demonstrated its analytic validity and utility through pilot genotyping of HapMap and study samples. This array allows researchers to perform genome-wide, candidate gene, and pathway-based association analyses of addiction, tobacco-use, treatment response, comorbidities, and associated diseases in a standardized, high-throughput platform.
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Affiliation(s)
- James W Baurley
- BioRealm LLC, 6101 W. Centinela Ave., Suite 270, Culver City, CA, 90230-6359, USA.
| | - Christopher K Edlund
- BioRealm LLC, 6101 W. Centinela Ave., Suite 270, Culver City, CA, 90230-6359, USA.
| | - Carissa I Pardamean
- BioRealm LLC, 6101 W. Centinela Ave., Suite 270, Culver City, CA, 90230-6359, USA.
| | - David V Conti
- BioRealm LLC, 6101 W. Centinela Ave., Suite 270, Culver City, CA, 90230-6359, USA.
| | - Andrew W Bergen
- BioRealm LLC, 6101 W. Centinela Ave., Suite 270, Culver City, CA, 90230-6359, USA.
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Chan J, Oshiro T, Thomas S, Higa A, Black S, Todorovic A, Elbarbry F, Harrelson JP. Inactivation of CYP2A6 by the Dietary Phenylpropanoid trans-Cinnamic Aldehyde (Cinnamaldehyde) and Estimation of Interactions with Nicotine and Letrozole. ACTA ACUST UNITED AC 2016; 44:534-43. [PMID: 26851241 DOI: 10.1124/dmd.115.067942] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 02/04/2016] [Indexed: 12/19/2022]
Abstract
Human exposure to trans-cinnamic aldehyde [t-CA; cinnamaldehyde; cinnamal; (E)-3-phenylprop-2-enal] is common through diet and through the use of cinnamon powder for diabetes and to provide flavor and scent in commercial products. We evaluated the likelihood of t-CA to influence metabolism by inhibition of P450 enzymes. IC50 values from recombinant enzymes indicated that an interaction is most probable for CYP2A6 (IC50 = 6.1 µM). t-CA was 10.5-fold more selective for human CYP2A6 than for CYP2E1; IC50 values for P450s 1A2, 2B6, 2C9, 2C19, 2D6, and 3A4 were 15.8-fold higher or more. t-CA is a type I ligand for CYP2A6 (KS = 14.9 µM). Inhibition of CYP2A6 by t-CA was metabolism-dependent; inhibition required NADPH and increased with time. Glutathione lessened the extent of inhibition modestly and statistically significantly. The carbon monoxide binding spectrum was dramatically diminished after exposure to NADPH and t-CA, suggesting degradation of the heme or CYP2A6 apoprotein. Using a static model and mechanism-based inhibition parameters (K(I) = 18.0 µM; k(inact) = 0.056 minute(-1)), changes in the area under the concentration-time curve (AUC) for nicotine and letrozole were predicted in the presence of t-CA (0.1 and 1 µM). The AUC fold-change ranged from 1.1 to 3.6. In summary, t-CA is a potential source of pharmacokinetic variability for CYP2A6 substrates due to metabolism-dependent inhibition, especially in scenarios when exposure to t-CA is elevated due to high dietary exposure, or when cinnamon is used as a treatment of specific disease states (e.g., diabetes).
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Affiliation(s)
- Jeannine Chan
- Chemistry Department, Pacific University Oregon, Forest Grove, Oregon (J.C., T.O., A.H., S.B.); and School of Pharmacy, Pacific University Oregon, Hillsboro, Oregon (S.T., A.H., S.B., A.T., F.E., J.P.H.)
| | - Tyler Oshiro
- Chemistry Department, Pacific University Oregon, Forest Grove, Oregon (J.C., T.O., A.H., S.B.); and School of Pharmacy, Pacific University Oregon, Hillsboro, Oregon (S.T., A.H., S.B., A.T., F.E., J.P.H.)
| | - Sarah Thomas
- Chemistry Department, Pacific University Oregon, Forest Grove, Oregon (J.C., T.O., A.H., S.B.); and School of Pharmacy, Pacific University Oregon, Hillsboro, Oregon (S.T., A.H., S.B., A.T., F.E., J.P.H.)
| | - Allyson Higa
- Chemistry Department, Pacific University Oregon, Forest Grove, Oregon (J.C., T.O., A.H., S.B.); and School of Pharmacy, Pacific University Oregon, Hillsboro, Oregon (S.T., A.H., S.B., A.T., F.E., J.P.H.)
| | - Stephen Black
- Chemistry Department, Pacific University Oregon, Forest Grove, Oregon (J.C., T.O., A.H., S.B.); and School of Pharmacy, Pacific University Oregon, Hillsboro, Oregon (S.T., A.H., S.B., A.T., F.E., J.P.H.)
| | - Aleksandar Todorovic
- Chemistry Department, Pacific University Oregon, Forest Grove, Oregon (J.C., T.O., A.H., S.B.); and School of Pharmacy, Pacific University Oregon, Hillsboro, Oregon (S.T., A.H., S.B., A.T., F.E., J.P.H.)
| | - Fawzy Elbarbry
- Chemistry Department, Pacific University Oregon, Forest Grove, Oregon (J.C., T.O., A.H., S.B.); and School of Pharmacy, Pacific University Oregon, Hillsboro, Oregon (S.T., A.H., S.B., A.T., F.E., J.P.H.)
| | - John P Harrelson
- Chemistry Department, Pacific University Oregon, Forest Grove, Oregon (J.C., T.O., A.H., S.B.); and School of Pharmacy, Pacific University Oregon, Hillsboro, Oregon (S.T., A.H., S.B., A.T., F.E., J.P.H.)
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Melroy-Greif WE, Stitzel JA, Ehringer MA. Nicotinic acetylcholine receptors: upregulation, age-related effects and associations with drug use. GENES, BRAIN, AND BEHAVIOR 2016; 15:89-107. [PMID: 26351737 PMCID: PMC4780670 DOI: 10.1111/gbb.12251] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 12/16/2022]
Abstract
Nicotinic acetylcholine receptors are ligand-gated ion channels that exogenously bind nicotine. Nicotine produces rewarding effects by interacting with these receptors in the brain's reward system. Unlike other receptors, chronic stimulation by an agonist induces an upregulation of receptor number that is not due to increased gene expression in adults; while upregulation also occurs during development and adolescence there have been some opposing findings regarding a change in corresponding gene expression. These receptors have also been well studied with regard to human genetic associations and, based on evidence suggesting shared genetic liabilities between substance use disorders, numerous studies have pointed to a role for this system in comorbid drug use. This review will focus on upregulation of these receptors in adulthood, adolescence and development, as well as the findings from human genetic association studies which point to different roles for these receptors in risk for initiation and continuation of drug use.
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Affiliation(s)
- Whitney E. Melroy-Greif
- Department of Molecular and Cellular Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
| | - Jerry A. Stitzel
- Institute for Behavioral Genetics, University of Colorado Boulder, CO, USA
- Department of Integrative Physiology, University of Colorado Boulder, CO, USA
| | - Marissa A. Ehringer
- Institute for Behavioral Genetics, University of Colorado Boulder, CO, USA
- Department of Integrative Physiology, University of Colorado Boulder, CO, USA
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Chen LS, Baker TB, Bierut LJ. The value of control conditions for evaluating pharmacogenetic effects. Pharmacogenomics 2015; 16:2005-6. [PMID: 26607722 DOI: 10.2217/pgs.15.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Timothy B Baker
- Tobacco Research and Intervention, University of Wisconsin, School of Medicine, Madison, WI, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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A CHRNA5 Smoking Risk Variant Decreases the Aversive Effects of Nicotine in Humans. Neuropsychopharmacology 2015; 40:2813-21. [PMID: 25948103 PMCID: PMC4864657 DOI: 10.1038/npp.2015.131] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 03/16/2015] [Accepted: 04/16/2015] [Indexed: 02/07/2023]
Abstract
Genome-wide association studies have implicated the CHRNA5-CHRNA3-CHRNB4 gene cluster in risk for heavy smoking and several smoking-related disorders. The heavy smoking risk allele might reduce the aversive effects of nicotine, but this hypothesis has not been tested in humans. We evaluated the effects of a candidate causal variant in CHRNA5, rs16969968, on the acute response to nicotine in European American (EA) and African American (AA) smokers (n=192; 50% AA; 73% male). Following overnight abstinence from nicotine, participants completed a protocol that included an intravenous (IV) dose of saline and two escalating IV doses of nicotine. The outcomes evaluated were the aversive, pleasurable, and stimulatory ratings of nicotine's effects, cardiovascular reactivity to nicotine, withdrawal severity, and cognitive performance before and after the nicotine administration session. The heavy smoking risk allele (rs16969968*A; frequency=28% (EA) and 6% (AA)) was associated with lower ratings of aversive effects (P<5 × 10(-8)) with marked specificity. This effect was evident in EA and AA subjects analyzed as separate groups and was most robust at the highest nicotine dose. Rs16969968*A was also associated with greater improvement on a measure of cognitive control (Stroop Task) following nicotine administration. These findings support differential aversive response to nicotine as one likely mechanism for the association of CHRNA5-CHRNA3-CHRNB4 with heavy smoking.
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Chen LS, Baker TB, Jorenby D, Piper M, Saccone N, Johnson E, Breslau N, Hatsukami D, Carney RM, Bierut LJ. Genetic variation (CHRNA5), medication (combination nicotine replacement therapy vs. varenicline), and smoking cessation. Drug Alcohol Depend 2015; 154:278-82. [PMID: 26142345 PMCID: PMC4537319 DOI: 10.1016/j.drugalcdep.2015.06.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 06/08/2015] [Accepted: 06/09/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Recent evidence suggests that the efficacy of smoking cessation pharmacotherapy can vary across patients based on their genotypes. This study tests whether the coding variant rs16969968 in the CHRNA5 nicotinic receptor gene predicts the effects of combination nicotine replacement therapy (cNRT) and varenicline on treatment outcomes. METHOD In two randomized smoking cessation trials comparing cNRT vs. placebo, and varenicline vs. placebo, we used logistic regression to model associations between CHRNA5 rs16969968 and abstinence at end of treatment. RESULTS For abstinence at end of treatment, there was an interaction between cNRT and rs16969968 (X(2)=8.15, df=2, omnibus-p=0.017 for the interaction); individuals with the high-risk AA genotype were more likely to benefit from cNRT. In contrast, varenicline increased abstinence, but its effect did not vary with CHRNA5. However, the genetic effects differed between the placebo control groups across two trials (wald=3.94, df=1, p=0.047), this non-replication can alter the interpretation of pharmacogenetic findings. CONCLUSIONS Results from two complementary smoking cessation trials demonstrate inconsistent genetic results in the placebo arms. This evidence highlights the need to compare the most effective pharmacotherapies with the same placebo control to establish pharmacogenetic evidence to aid decisions on medication choice for patients trying to quit smoking.
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Affiliation(s)
- Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, United States; The Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, 63110, United States.
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, University of Wisconsin, School of Medicine and Public Health, Madison, WI, 53711, United States
| | - Douglas Jorenby
- Center for Tobacco Research and Intervention, University of Wisconsin, School of Medicine and Public Health, Madison, WI, 53711, United States
| | - Megan Piper
- Center for Tobacco Research and Intervention, University of Wisconsin, School of Medicine and Public Health, Madison, WI, 53711, United States
| | - Nancy Saccone
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, 63110, United States
| | - Eric Johnson
- Division of Health, Social and Economic Research, Research Triangle Institute International, Research Triangle Park, NC, 27709, United States
| | - Naomi Breslau
- Department of Epidemiology, Michigan State University, East Lansing, MI, 48824, United States
| | - Dorothy Hatsukami
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, 55455, United States
| | - Robert M Carney
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, United States
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, United States; The Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, 63110, United States
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Polak K, Haug NA, Drachenberg HE, Svikis DS. Gender Considerations in Addiction: Implications for Treatment. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2015; 2:326-338. [PMID: 26413454 PMCID: PMC4578628 DOI: 10.1007/s40501-015-0054-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Kathryn Polak
- Virginia Commonwealth University 806 W. Franklin St., P.O. Box 842018, Richmond, VA 23284 804-477-5091,
| | - Nancy A. Haug
- PGSP-Stanford Psy.D. Consortium, Palo Alto University, The Gronowski Center, 5150 El Camino Real, C-24, Los Altos, CA 94022, 650-961-9300, ext. 3616,
| | | | - Dace S. Svikis
- Professor, Department of Psychology, Deputy Director, Institute for Women’s Health, Virginia Commonwealth University, 806 W. Franklin St., P.O. Box 842018, Richmond, VA 23284
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Bacoside A: Role in Cigarette Smoking Induced Changes in Brain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:286137. [PMID: 26413118 PMCID: PMC4564636 DOI: 10.1155/2015/286137] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 01/11/2015] [Accepted: 02/26/2015] [Indexed: 12/29/2022]
Abstract
Cigarette smoking (CS) is a major health hazard that exerts diverse physiologic and biochemical effects mediated by the components present and generated during smoking. Recent experimental studies have shown predisposition to several biological consequences from both active and passive cigarette smoke exposure. In particular, passive smoking is linked to a number of adverse health effects which are equally harmful as active smoking. A pragmatic approach should be considered for designing a pharmacological intervention to combat the adverse effects of passive smoking. This review describes the results from a controlled experimental condition, testing the effect of bacoside A (BA) on the causal role of passive/secondhand smoke exposure that caused pathological and neurological changes in rat brain. Chronic exposure to cigarette smoke induced significant changes in rat brain histologically and at the neurotransmitter level, lipid peroxidation states, mitochondrial functions, membrane alterations, and apoptotic damage in rat brain. Bacoside A is a neuroactive agent isolated from Bacopa monnieri. As a neuroactive agent, BA was effective in combating these changes. Future research should examine the effects of BA at molecular level and assess its functional effects on neurobiological and behavioral processes associated with passive smoke.
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Bergen AW, Michel M, Nishita D, Krasnow R, Javitz HS, Conneely KN, Lessov-Schlaggar CN, Hops H, Zhu AZX, Baurley JW, McClure JB, Hall SM, Baker TB, Conti DV, Benowitz NL, Lerman C, Tyndale RF, Swan GE. Drug Metabolizing Enzyme and Transporter Gene Variation, Nicotine Metabolism, Prospective Abstinence, and Cigarette Consumption. PLoS One 2015; 10:e0126113. [PMID: 26132489 PMCID: PMC4488893 DOI: 10.1371/journal.pone.0126113] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 03/29/2015] [Indexed: 11/28/2022] Open
Abstract
The Nicotine Metabolite Ratio (NMR, ratio of trans-3’-hydroxycotinine and cotinine), has previously been associated with CYP2A6 activity, response to smoking cessation treatments, and cigarette consumption. We searched for drug metabolizing enzyme and transporter (DMET) gene variation associated with the NMR and prospective abstinence in 2,946 participants of laboratory studies of nicotine metabolism and of clinical trials of smoking cessation therapies. Stage I was a meta-analysis of the association of 507 common single nucleotide polymorphisms (SNPs) at 173 DMET genes with the NMR in 449 participants of two laboratory studies. Nominally significant associations were identified in ten genes after adjustment for intragenic SNPs; CYP2A6 and two CYP2A6 SNPs attained experiment-wide significance adjusted for correlated SNPs (CYP2A6 PACT=4.1E-7, rs4803381 PACT=4.5E-5, rs1137115, PACT=1.2E-3). Stage II was mega-regression analyses of 10 DMET SNPs with pretreatment NMR and prospective abstinence in up to 2,497 participants from eight trials. rs4803381 and rs1137115 SNPs were associated with pretreatment NMR at genome-wide significance. In post-hoc analyses of CYP2A6 SNPs, we observed nominally significant association with: abstinence in one pharmacotherapy arm; cigarette consumption among all trial participants; and lung cancer in four case:control studies. CYP2A6 minor alleles were associated with reduced NMR, CPD, and lung cancer risk. We confirmed the major role that CYP2A6 plays in nicotine metabolism, and made novel findings with respect to genome-wide significance and associations with CPD, abstinence and lung cancer risk. Additional multivariate analyses with patient variables and genetic modeling will improve prediction of nicotine metabolism, disease risk and smoking cessation treatment prognosis.
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Affiliation(s)
- Andrew W. Bergen
- Center for Health Sciences, SRI International, Menlo Park, California, United States of America
- * E-mail:
| | - Martha Michel
- Academic Research Systems, University of California San Francisco, San Francisco, California, United States of America
| | - Denise Nishita
- Center for Health Sciences, SRI International, Menlo Park, California, United States of America
| | - Ruth Krasnow
- Center for Health Sciences, SRI International, Menlo Park, California, United States of America
| | - Harold S. Javitz
- Center for Health Sciences, SRI International, Menlo Park, California, United States of America
| | - Karen N. Conneely
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | | | - Hyman Hops
- Oregon Research Institute, Eugene, Oregon, United States of America
| | - Andy Z. X. Zhu
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | | | - Jennifer B. McClure
- Group Health Research Institute, Seattle, Washington, United States of America
| | - Sharon M. Hall
- Department of Psychiatry, University of California San Francisco, San Francisco, California, United States of America
| | - Timothy B. Baker
- Center for Tobacco Research and Intervention, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America
| | - David V. Conti
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Neal L. Benowitz
- Departments of Medicine and of Bioengineering & Therapeutic Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Caryn Lerman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Rachel F. Tyndale
- Cambell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and Departments of Psychiatry, and of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Gary E. Swan
- Oregon Research Institute, Eugene, Oregon, United States of America
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, United States of America
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Genetic influences on smoking and clinical disease. Understanding behavioral and biological pathways with mediation analysis. Ann Am Thorac Soc 2015; 11:1082-3. [PMID: 25237988 DOI: 10.1513/annalsats.201407-315ed] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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50
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Tyndale RF, Zhu AZX, George TP, Cinciripini P, Hawk LW, Schnoll RA, Swan GE, Benowitz NL, Heitjan DF, Lerman C. Lack of Associations of CHRNA5-A3-B4 Genetic Variants with Smoking Cessation Treatment Outcomes in Caucasian Smokers despite Associations with Baseline Smoking. PLoS One 2015; 10:e0128109. [PMID: 26010901 PMCID: PMC4444267 DOI: 10.1371/journal.pone.0128109] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 04/22/2015] [Indexed: 01/21/2023] Open
Abstract
CHRNA5-A3-B4 variants, rs16969968, rs588765 and rs578776, are consistently associated with tobacco consumption among smokers, but the association with smoking cessation is less consistent. Among the studies that reported significant associations with cessation, the effects were observed in smokers treated with placebo treatment in some studies and conversely in those receiving active pharmacological therapy (bupropion and nicotine replacement therapies) in others. Thus, it remains unclear whether CHRNA5-A3-B4 is a useful marker for optimizing smoking cessation. Using data from 654 Caucasian smokers treated with placebo, nicotine patch or varenicline, we investigated whether CHRNA5-A3-B4 variants were associated with smoking cessation outcomes, and whether there were significant genotype-by-treatment or haplotype-by-treatment interactions. We observed no significant associations between CHRNA5-A3-B4 variants and smoking cessation, despite replicating previous associations with baseline tobacco consumption. At end of treatment the effect size on smoking cessation in the placebo, patch and varenicline groups for rs16969968 [GG vs. GA+AA] was OR = 0.66 (P = 0.23), OR = 1.01 (P = 0.99), and OR = 1.30 (P = 0.36) respectively, of rs588765 [CC vs. CT+TT] was OR = 0.96 (P = 0.90), OR = 0.84 (P = 0.58), and OR = 0.74 (P = 0.29) respectively, and for rs578776 [GG vs. GA+AA] on smoking cessation was OR = 1.02 (P = 0.95), OR = 0.75 (P = 0.35), and OR = 1.20 (P = 0.51) respectively. Furthermore, we observed no associations with cessation using the CHRNA5-A3-B4 haplotype (constructed using rs16969968 and rs588765), nor did we observe any significant genotype-by-treatment interactions, with or without adjusting for the rate of nicotine metabolism (all P>0.05). We also observed no significant genetic associations with 6 month or 12 month smoking abstinence. In conclusion, we found no association between CHRNA5-A3-B4 variants and smoking cessation rates in this clinical trial; however, as expected, significant associations with baseline tobacco consumption were replicated. Our data suggest that CHRNA5-A3-B4 gene variants do not exhibit a robust association with smoking cessation and are unlikely to be useful for clinically optimizing smoking cessation pharmacotherapy for Caucasian smokers.
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Affiliation(s)
- Rachel F. Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Division of Brain & Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
| | - Andy Z. X. Zhu
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Tony P. George
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
- Division of Brain & Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Paul Cinciripini
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Larry W. Hawk
- Department of Psychology, University at Buffalo, State University of New York (SUNY), Buffalo, New York, United States of America
- Center for Children and Families, University at Buffalo, State University of New York (SUNY), Buffalo, New York, United States of America
| | - Robert A. Schnoll
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Gary E. Swan
- Department of Medicine, Stanford University, Palo Alto, California, United States of America
| | - Neal L. Benowitz
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
- Department of Bioengineering & Therapeutic Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Daniel F. Heitjan
- Department of Biostatistics & Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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