Baseline platelet serotonin in a multi-site treatment study of depression in veterans administration patients: Distribution and effects of demographic variables and serotonin reuptake inhibitors.
Baseline platelet serotonin in a multi-site treatment study of depression in veterans administration patients: Distribution and effects of demographic variables and serotonin reuptake inhibitors.
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退伍军人抑郁症多中心治疗研究中的基线血小板血清素：人口统计学变量和血清素再摄取抑制剂的分布和影响。
DOI：
10.1016/j.jad.2023.02.017
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发表时间：
2023
影响因子：
6.6
通讯作者：
Oslin,DavidW
中科院分区：
文献类型：
--
作者：
Anderson,GeorgeM;Ramsey,ChristineM;Lynch,KevinG;Gelernter,Joel;Oslin,DavidW
本研究的目的是：(1)检查寻求抑郁症治疗的患者的基线血小板5-羟色胺（5-羟色胺，5-HT）值的总体分布，并根据明显存在或不存在药物暴露来定义亚组；(2)评估5-羟色胺再摄取抑制剂（SRIs）对血小板5-羟色胺转运体的生物效应；(3)检验人口统计学变量（包括人群（血统）、性别、年龄和采样季节）与血小板5-HT浓度的关系。方法对1433名退伍军人管理局（VA）患者进行横断面研究，测量血小板5-HT水平，这些患者参加了一项实用的抑郁症多位点药物基因组学治疗研究。使用VA健康记录和自我报告对患者进行医学和人口统计学特征分析。结果血小板5-羟色胺水平呈明显的双峰分布，基线时暴露于SRIs的患者的血小板5-羟色胺水平较低。各种选择性5-羟色胺再摄取抑制剂（SSRIs）和5-羟色胺/去甲肾上腺素再摄取抑制剂（SNRIs）的中位转运体阻断生物效应相似。在明显未暴露于SRI的患者亚组中，观察到人口和性别的显著影响，非洲裔美国人（AA）的组平均血小板5-HT水平比欧美人（EAs）高25% （p< 0.001）。女性组的平均值比男性组高14% （p< 0.001）。观察到年龄的影响（r= - 0.11, p < 0.001），没有观察到季节或采样月份的影响。结论有必要进行进一步的研究，以了解人群和性别差异的基础和临床意义。5-羟色胺再摄取抑制剂在5-羟色胺转运体上的生物效应的明显相似性，以及在比较SSRIs和SNRIs时，对5-羟色胺再摄取抑制剂的起始、剂量调整和切换进行了讨论。
BackgroundThe objectives of the study were: (1) to examine the overall distribution of baseline platelet serotonin (5-hydroxytryptamine, 5-HT) values in patients seeking treatment for depression and to define subgroups based on the apparent presence or absence of drug exposure; (2) to assess the bioeffect of 5-HT reuptake inhibitors (SRIs) at the platelet 5-HT transporter; and (3) to examine the relationships of demographic variables including population (ancestry), sex, age, and season of sampling to platelet 5-HT concentration.MethodsPlatelet 5-HT levels were measured in a cross-sectional study of 1433 Veterans Administration (VA) patients participating in a pragmatic multi-site pharmacogenomic treatment study of depression. Patients were characterized medically and demographically using VA health records and self-report.ResultsA clearly bimodal distribution was observed for platelet 5-HT levels with the lower mode associated with patients exposed to SRIs at baseline. Median transporter blockade bioeffects were similar across the various selective 5-HT reuptake inhibitors (SSRIs) and 5-HT/norepinephrine reuptake inhibitors (SNRIs). In a subset of patients apparently not exposed to an SRI, significant effects of population and sex were observed with group mean platelet 5-HT levels being 25 % greater (p< 0.001) in African-American (AA) individuals compared to European-Americans (EAs). The female group mean was 14 % (p< 0.001) greater than male group mean. An effect of age was observed (r= −0.11, p < 0.001) and no effect of season or month of sampling was seen.ConclusionsFurther research is warranted to understand the bases and clinical implications of the population and sex differences. The apparent similarity in bioeffect at the 5-HT transporter across SSRIs and when comparing SSRIs and SNRIs informs discussions about initiating, dose adjustment and switching of 5-HT reuptake inhibitors.
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