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Method for integrated assessment of genetic predisposition to development of psychoactive substance abuse. RU patent 2505820.

IPC classes for russian patent Method for integrated assessment of genetic predisposition to development of psychoactive substance abuse. RU patent 2505820. (RU 2505820):

G01N33/68 - involving proteins, peptides or amino acids
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FIELD: medicine.

SUBSTANCE: polymerase chain reaction is used in biological objects to determine allele G in locus rs 1042173 of gene SLC6A4 of the serotonin neurotransmitter system, and an allele specified in a group of genes of the dopamine neurotransmitter system: G in locus rs4680 of gene COMT, G in locus rs 17851478 and/or C in locus rs 1611115 of gene DBH, C in locus rs6275 of gene DRD2. If observing at least one risk allele in the both systems, a genetic predisposition to the development of psychoactive substance abuse is stated.

EFFECT: more accurate assessment of the risk of psychoactive substance abuse ensured by selecting the optimal system of neurotransmitter markers.

6 ex

 

The invention relates to medicine, namely to the narcology, and can be used to identify among population groups with high biodiversity risk of addiction to psychoactive substances (SAS)to provide for a differentiated prevention with the inclusion of socio-psychological and educative programs for the entire population and special for individuals with a predisposition to addiction diseases.

Clinical practice shows that not all members of a family having the genetic predisposition to abuse (SAS), is developing alcoholism or drug addiction.

In this connection special value gets search «markers»predictors for the identification of persons with a biological predisposition to drug surfactants.

Direct causal relationship between a specific gene and addiction in General are absent.

Several studies have shown a positive Association between a single replacement nucleotide 118A→G (rs 1799971) gene mu-opioid receptor 1 (OPRM1) and opioid dependence, as well as to dependence on other substances in different populations (Bart, G. et al. 2004; Kapur, S. et al. 2007), while other studies have not found this regard, the SNP (Yuferov, V. et al. 2010).

Examination of the relationship alleles TaqI Al gene dopamine receptor type 2 (DRD2) alcohol use remains controversial, because of contradictory results.

(Neville MJ, Johnstone EC, Walton RT: Identification and characterization of ANKK1: a novel kinase gene closely linked to DRD2 on chromosome band 11q23.1. Hum Mutat 2004, 23:540-45.

Blum K, Noble EP, Sheridan PJ, A Montgomery, Ritchie T, Jagadeeswaran P, Nogami H, Briggs AH, Cohn JB: Allelic association of human dopamine D2 receptor gene in alcoholism. J Am Med Assoc 1990, 263:2055-60.

Lucht M, Barnow S, Schroeder W, Grabe HJ, Rosskopf D, Brummer C, John U, Freyberger HJ, Herrmann FH: Alcohol consumption is associated with an interaction between DRD2 exon 8 A/A genotype and selfdirectedness in males. Neuropsychobiology 2007, 56:24-31.)

Research Prasad et al. indicate little occurrence frequency of genotype Taq A1 A1. However, the statistical analysis showed a significant (credible) communication genotype Taq A1 A1 with alcohol dependence (Fisher's p<0.05).

Thus, the combination of types of inheritance predisposition and nature of the diseases depending make methodically incorrect search only or main «gene dependence».

There is a method of complex determination of genetic predisposition to the development of psychoactive substance dependence, including the study of the complex of genes coding for the main elements of the dopaminergic system ( O.A. Genetics of substance abuse: a molecular-genetic profile of the dopamine neyromediatornoy system with alcoholism and opium addiction. // Narcology, 2011. №9. P.25-42).

However, the study only complex genes encoding the main elements of the dopaminergic system, does not give a sufficiently full picture of the genetic predisposition, resulting due to the lack of accuracy of its determination.

Known (VERDE Z. et al. ′Smoking genes′: a genetic association studies. PLoS One. 2011; 6(10)) way to determine the possibility of use of the definition in biological objects patient by the method of polymerase chain reaction polymorphic variants of genes of the two systems: dopaminergic (DRD2-ANKK1 2137G>A) and opioid (OPRM1 118A>G) for assessing the genetic predisposition to nicotine addiction.

However, the contribution of each gene was made separately, not in the complex. Found a statistically significant difference in the groups of smokers and non-smokers only DRD2 gene-ANKK1 2137G>A OPRM1 118A>G of this difference is not installed. Thus, in this source refers to the possibility of the use of the dopamine gene (DRD2-ANKK1) system for assessing the predisposition to nicotine addiction. The indicator OR (i.e. the ratio of the frequencies of alleles of risk in smokers to the same frequency in non-Smoking) in the case of DRD2-ANKK1 value of 3.6.

There is a method (Abstract; D. CHEN et al. Association between polymorphisms of DRD2 and DRD4 and opioid dependence: evidence from the current studies. Am J Med Genet In Neuropsychiatr Genet. 2011 Sep; 156B(6):661-670), which explored the relationships presence of polymorphic genes of the dopamine system and predisposition to dependence on opiates. Values OR were determined in each gene separately (no comprehensive assessment of the influence of genes), and the maximum OR amounted to 2.06 for DRD2 gene.

There is a method adopted for the prototype, which reveals the way to identify a predisposition to addiction to psychoactive substances, including the identification of biological objects of the patient by the method of polymerase chain reaction alleles risk in polymorphic genes dopamine, serotonin, and acid systems exchange, and in detecting polymorphic genes in each of neurotransmitter systems, in combination with the results of psycho-diagnostic testing, judge insufficiency exchange of this system (patent RU 2402974 C2, IPC publ. 10.11.2010 example 6, formula 1).

However, a complete picture of the genetic predisposition to dependence on substances this method is not independent, and the accuracy of its definition is insufficient.

The present invention solves the problem of increasing the accuracy of the objective, early ways to determine genetic predisposition to the development of dependence, as well as proactive clinical prediction.

The problem is solved by way of complex determination of genetic predisposition to the development of psychoactive substance dependence, including determination in biological objects patient by the method of polymerase chain reaction allele G locus rs1042173 SLC6A4 serotonin system exchange and at least one allele, selected from a group of genes of the dopamine system exchange, namely G locus rs4680 gene COMT, G locus rs17851478 and/or in the locus rs1611115 gene DBH, With the locus rs6275 DRD2 gene and identifying at least one allele of the risk of the system determine genetic predisposition to the development of substance dependence.

The new approach will allow to estimate more accurately the level of genetic risk of dependence and more fully describe disease.

Our analysis of literary sources showed that every single polymorphic locus declared genes was allegedly potentially important marker of risk of development of dependence. Therefore we propose to use the data of polymorphic variants of genes of various neurotransmitter systems in the brain, such as: dopamine and serotonin, which is a new approach in predisposition to the development of dependence, and, thus, according to the totality of the signs of compliance grounds of «novelty» and «inventive step».

The technical result of the proposed invention is to increase the accuracy of evaluation of genetic risk of dependence from 73% in the prototype to 81% and, therefore, increasing the opportunities for the most fully characterize disease.

For genotyping of patients, i.e. to identify the G allele in the locus rs1042173 SLC6A4 serotonin system exchange and alleles of genes ' groups of the dopamine system exchange, namely G locus rs4680 gene COMT, G locus rs17851478 and/or in the locus rs1611115 gene DBH, With the locus rs6275 DRD2 gene, using a polymerase chain reaction (PCR) (Polymeropoulos N, Xiao H, Rath D. Merrill C. Tetranucleotide repeat polymorphism at the human tyro-sine hydroxylase gene (TH). Nucleic Acid Res. 1991.19:3753), which DNA fragments that contain polymorphic loci to a sufficient concentration to their separation by electrophoresis.

The research material are samples of DNA of biological objects control individuals and patients with drug addiction and alcoholism. Allocation of genomic DNA is carried out by phenol extraction with some modifications (Strauss WM. Preparation of genomic DNA from mammalian tissue. In "Current Protocols in Molucular Biology (Ausubel FM et al., Eds.) Boston. MA / pp.2.2.1-2.2.3, 1990).

Identify the G allele in the locus rs1042173 SLC6A4 serotonin system exchange and alleles of genes ' groups of the dopamine system exchange, namely G locus rs4680 gene AGR, G locus rs17851478 and/or in the locus rs1611115 gene DBH, With the locus rs6275 DRD2 gene is carried out with the subsequent cutting of the PCR fragments processed by endonucle ases restriction ApoI, FatI, BstENI, FauI and NcoI respectively using electrophoretic separation products (3-4% agarose gel stained bromide . Electrophoresis spend in the buffer TAE 20 minutes at 120 Century Visualization of the obtained results is performed in ultraviolet light (UV).

Determining the accuracy of the method

Were surveyed 1,000 people: 800 patients INTERSECTORIAL narcology, 450 of them drug addicts, 350 patients with alcoholism and 200 healthy people without signs of dependence. Were tested samples of biological objects surveyed using PCR for risk alleles G locus rs1042173 SLC6A4, G rs4680 in the locus of the gene AGR, G locus rs17851478 and/or in the locus rs1611115 gene DBH, With the locus rs6275 DRD2 gene, characterizing the state of the systems of the body that play a key role in the development of dependence.

In patients with simultaneous detection of allele G locus rs1042173 SLC6A4 serotonin system exchange and at least one allele groups of genes of the dopamine system exchange, namely G locus rs4680 gene AGR, G locus rs17851478 and/or in the locus rs1611115 gene DBH; The locus rs6275 DRD2 gene percentage of overlap of the laboratory research with clinical diagnosis was 82%. For healthy people, the percentage of overlap was 91%.

We conducted a study of 200 patients risk alleles in the polymorphic genes complex specified in the prototype neurotransmitter systems: dopamine, serotonin, and acid polymorphic genes SerT, NPY, HTR2C, GAD2, DRD4, , IAIA, DRD2, DBH, DAT the percentage of overlap with clinical diagnosis in patients diseases dependence amounted to 73%.

Example 1

Patient A. addressed in the INTERSECTORIAL narcology advice on the availability of the occurrence of dependence in connection with the fact that his father is sick with alcoholism, and sister abused drugs. The results of medical-genetic study of PCR testified to the presence of the patient's G allele in the locus rs 1042173 SLC6A4 serotonin system exchange and 1 allele groups of genes of the dopamine system exchange, namely G rs4680 gene AGR, which allowed to make a conclusion about the genetic predisposition to dependence. Patient A. recommendations on formation of a healthy way of life.

Example 2

The patient Century asked the INTERSECTORIAL narcology advice on the availability of occurrence of dependence in connection with the fact that her mother is sick with alcoholism and sister abused drugs. The results of medical-genetic study of PCR testified to the presence of the patient G allele in the locus rs1042173 SLC6A4 serotonin system exchange and allele groups of genes of the dopamine system exchange, namely G locus rs17851478 gene DBH, which allowed to deduce the existence of genetic susceptibility to abuse of surfactants.

Example 3

Patient And. addressed in the INTERSECTORIAL narcology advice on the availability of the occurrence of dependence in connection with the fact that his father is sick with alcoholism, and brother abused drugs. The results of medical-genetic study of PCR testified to the presence of the patient's G allele in the locus rs 1042173 SLC6A4 serotonin system exchange and 2 alleles of the genes ' groups of the dopamine system exchange, namely G rs4680 gene AGR, G rs17851478 gene DBH, which allowed to make a conclusion about the genetic predisposition to dependence. Patient I. recommendations on formation of a healthy way of life.

Example 4

Patient C. admitted to the hospital INTERSECTORIAL narcology in a condition of narcotic intoxication. History: the systematic use of heroin for 6 years. Concomitant diseases: chronic hepatitis C. the Results of medical-genetic study of PCR testified to the presence of the patient's G allele in the locus rs1042173 SLC6A4 serotonin system exchange and 3 alleles of the genes ' groups of the dopamine system exchange, namely G locus rs17851478 and locus rs1611115 gene DBH, With the locus rs6275 DRD2 gene, which allowed making conclusion about the coincidence of clinical and laboratory forecast.

Example 5

Patient P. addressed the INTERSECTORIAL narcology advice on the availability of occurrence of dependence in connection with the fact that her mother is sick with alcoholism and cousin is abusing drugs. The results of medical-genetic study of PCR testified to the presence of the patient G allele in the locus rs1042173 SLC6A4 serotonin system exchange and 2 alleles of the genes ' groups of the dopamine system exchange, namely G rs4680 gene AGR and G locus rs17851478 gene DBH, which allowed to deduce the existence of genetic susceptibility to abuse of surfactants.

Example 6

The patient K. addressed the INTERSECTORIAL narcology advice on the availability of occurrence of dependence in connection with the fact that her uncle was sick with drug addiction. The results of medical-genetic study of PCR testified to the presence of the patient 2 alleles only groups of genes of the dopamine system exchange, namely G locus rs17851478 gene DBH and The locus rs6275 DRD2 gene dopamine system, which allowed making conclusion about the absence of genetic susceptibility to abuse of surfactants.

As seen from the above examples, the accuracy of the proposed method is characterized by the percentage of matches with clinical diagnosis in patients dependence diseases, increased compared with the prototype from 73% to 81%.

Way a more comprehensive definition of genetic predisposition to the development of psychoactive substance dependence, including the identification of biological objects of the patient by the method of polymerase chain reaction allele G locus rs1042173 SLC6A4 serotonin system exchange and at least one allele, selected from a group of genes of the dopamine system exchange, namely G locus rs4680 gene AGR, G locus rs17851478 and/or in the locus rs1611115 gene DBH, With the locus rs6275 DRD2 gene and identifying at least one allele of the risk of the system determine the a genetic predisposition to the development of substance dependence.

 

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