Dopamine D3-receptor gene variant and susceptibility to tardive dyskinesia in schizophrenic patients.
Schizophrenia is a serious psychiatric illness with a life-time risk of approximately one percent. Many of the patients, but not all, benefit from treatment with anti-psychotic drugs known to block dopamine D2-like receptors. The use of conventional neuroleptics is, however, hampered by the risk of extrapyramidal side-effects. Tardive dyskinesia (TD) is usually regarded as the most serious of these drug-induced movement disorders due to its high prevalence and potentially irreversible nature. In this study, we have investigated the genetic variation of the dopamine D3 receptor gene (DRD3) as a putative risk factor for TD in schizophrenic patients receiving long-term anti-psychotic drug therapy. We found a high frequency (22-24%) of homozygosity for the Ser9Gly variant (allele 2) of the DRD3 gene among subjects with TD in both a cross-sectional and a longitudinal evaluation, as compared with the relative under-representation (4-6%) of this genotype in patients with no or fluctuating TD. This result indicates that autosomal inheritance of two polymorphic Ser9Gly alleles (2-2 genotype), but not homozygosity for the wild-type allele (1-1 genotype), is a susceptibility factor for the development of TD, an observation which may improve the understanding of the pathophysiological mechanisms of TD and influence the design and choice of future anti-psychotic drugs. The correlation between a serious motor side-effect and a genetic marker could lead to selection bias in the sampling of schizophrenic patients for genetic studies, and may therefore explain the apparent association reported between susceptibility for schizophrenia per se and homozygosity for the DRD3 gene.
Steen
V M
VM
Center of Molecular Medicine, Haukeland University Hospital, Bergen, Norway.
Løvlie
R
R
MacEwan
T
T
McCreadie
R G
RG
D000328:Adult; D000368:Aged; D000483:Alleles; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000494:pharmacology; D003062:Codon / Q000235:genetics; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D018492:Dopamine Antagonists / Q000009:adverse effects / Q000494:pharmacology; D004409:Dyskinesia, Drug-Induced / Q000453:epidemiology / Q000209:etiology / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D011110:Polymorphism, Genetic; D015995:Prevalence; D017448:Receptors, Dopamine D2 / Q000187:drug effects / Q000235:genetics*; D050637:Receptors, Dopamine D3; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications / Q000235:genetics* / Q000503:physiopathology; D012606:Scotland / Q000453:epidemiology
D014150:Antipsychotic Agents; D003062:Codon; C493593:DRD3 protein, human; D018492:Dopamine Antagonists; D017448:Receptors, Dopamine D2; D050637:Receptors, Dopamine D3