据英国媒体9月26日报道，加拿大成瘾与精神健康中心(CAMH)通过最新的基因研究结果显示，戒烟药物是否能够帮助你成功戒烟，很可能取决于个人的基因。
这项最新的研究发表在9月的《生物精神病学》杂志上，研究人员发现这种促进戒烟药物安非他酮(bupropion)和尼古丁新陈代谢的酶，在所有的种族和戒烟的影响因素中具有高度的可变性。而这一发现是向个人基于其独特的基因组成适应戒烟治疗迈向了新的一步。
加拿大成瘾与精神健康中心遗传药理学组长雷切尔·汀代尔说：“这项研究确定了一种很普遍的遗传变异(目前世界各地25%至50%的人)，这似乎会影响戒烟治疗的结果。”汀代尔和同事对cyp2b6基因类型的吸烟者进行了试验，cyp2b6基因是非常可变的，它们的酶促进安非他酮，尼古丁和血清素新陈代谢。受试者随后被提供安慰剂或安非他酮治疗10周，随访6个月。
该研究项目由加拿大卫生研究所和国家卫生研究所支持，研究者发现，45%有特殊基因的人对安非他酮治疗从中受益，并且戒掉烟瘾维持得时间较长，而安慰剂在这些人身上并不奏效。相比之下，55%具有不同的变异基因(野生型变异体)的人，安慰剂有助于他们戒掉烟瘾，而安非他酮对他们一点用处都没有。值得注意的是，这个小组的成员能够在没有任何积极药物(安慰剂)的辅助下完全地戒掉烟瘾。
究竟是哪些人属于可以成功戒烟的这一组呢？先前的研究显示，45%的白人和50%的非洲人具有cyp2b6基因的变体形式。汀代尔博士说：“目前的项研究只对具有欧洲血统的人进行试验。”
研究者已对非裔美国吸烟者开始了类似的研究。他们推测，cyp2b6基因的变体形式会影响安非他酮的疗效，和这些采取与欧洲人同样的方式来戒烟的非裔美国人的戒烟效果。(新浪健康)
原始出处:
Biological Psychiatry
Genetic Variation Affects Smoking Cessation Treatment
19 September 2007
A new study being published in the September 15th issue of Biological Psychiatry reports that genetic variation in a particular enzyme affects the success rates of treatment with bupropion, an anti-smoking drug.
Philadelphia, PA, September 20, 2007 – Mark Twain boasted that it was easy to quit smoking because he did it every day. We now may have the beginnings of understanding why some people find it so difficult to stop smoking even when they are in treatment for this problem. According to statistics provided by the Centers for Disease Control and Prevention (CDC), tobacco use is the leading preventable cause of death in the United States, and it is the second major cause of death in the world according to the World Health Organization (WHO). An estimated 20.9% of all US adults smoke, and even with a strong desire to quit, most find it exceptionally difficult. A new study being published in the September 15th issue of Biological Psychiatry reports that genetic variation in a particular enzyme affects the success rates of treatment with bupropion, an anti-smoking drug.
Lee and colleagues performed CYP2B6 genotyping on smoking individuals, a gene that is known to be highly variable and whose enzyme metabolizes both bupropion and nicotine. Participants were then provided with either placebo or bupropion treatment for ten weeks. The authors discovered that individuals with the CYP2B6*6 allele of the gene benefited from bupropion treatment and maintained abstinence longer while doing poorly on placebo, with a 32.5% abstinent rate vs. 14.3%, respectively. In contrast, those in the CYP2B6*1 group did well on both bupropion and placebo, with similar abstinence rates at the end of treatment and after a six month follow-up.
Rachel Tyndale, M.Sc., Ph.D., one of the authors on this study, comments, "This first study, while requiring replication, identifies a very common genetic variant that appears to affect smoking cessation treatment outcome." This variant is present in 25-50% of people, thus affecting a large portion of the population.
John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, adds his thoughts about this exciting new data: "We look forward to the era of personalized medicine, when doctors are able to use genetic information about their patients to guide treatment. We are not ready to use this information in clinical practice, but this study provides us with a good example of the type of information that might, some day, guide the treatment for smoking."
