title: Pharmacogenetic studies of change in cortisol on ecstasy (MDMA) consumption.
abstract: In this study we investigate the association of cytochrome P450 enzyme CYP2D6, catechol-O-methyl transferase (COMT, Val158Met) and serotonin transporter promoter (5-HTTLPR) genotypes on change in cortisol concentration following 3, 4-methylenedioxy-methamphetamine (MDMA, 'ecstasy') consumption. Forty-eight subjects (30 males, mean age 23 years), self-nominating regular clubbers provided 'in the field' pre- and post-clubbing biological samples and associated information. Of the 39 subjects who provided a post-clubbing urine sample, 21 were positive for MDMA. Plasma cortisol concentrations increased in subjects (n = 48) tested for cortisol, with changes being significantly greater in the MDMA-positive group (736.9 ± 83.2 vs. 350.9 ± 34.5 mmol/l, p = 0.001). We found a positive association between the low activity COMT genotype (Met/Met) and MDMA-induced change in cortisol and also between this and change in cortisol in the whole sample (p = 0.039, Bonferroni corrected). For CYP2D6, there was an association between genotype and change in cortisol, confined to subjects with MDMA-positive urine post-clubbing (p = 0.003, Bonferroni corrected). There was no association with 5-HTTLPR genotype. These associations suggest that chronic use of MDMA may lead to HPA axis dysregulation and that the magnitude of this may be moderated by genetic polymorphism, and warrant further investigation in a larger sample of those who consume the drug on a regular basis.
authors.affiliation: King's College London, Institute of Psychiatry, Addiction Department, London, UK.
authors.forename: Kim
authors.initials: K
authors.lastname: Wolff
authors.forename: Evangelia M
authors.initials: EM
authors.lastname: Tsapakis
authors.forename: Carmine M
authors.initials: CM
authors.lastname: Pariante
authors.forename: Robert W
authors.initials: RW
authors.lastname: Kerwin
authors.forename: Mary L
authors.initials: ML
authors.lastname: Forsling
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Aitchison
mesh_terms: D000328:Adult; D019943:Amino Acid Substitution; D015415:Biomarkers / Q000097:blood; D001711:Biotransformation; D002394:Catechol O-Methyltransferase / Q000235:genetics* / Q000378:metabolism; D015331:Cohort Studies; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics* / Q000378:metabolism; D005260:Female; D056726:Genetic Association Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000503:physiopathology; D013287:Illicit Drugs / Q000493:pharmacokinetics / Q000633:toxicity* / Q000652:urine; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000493:pharmacokinetics / Q000633:toxicity* / Q000652:urine; D020258:Neurotoxicity Syndromes / Q000097:blood* / Q000235:genetics / Q000378:metabolism / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000503:physiopathology; D011110:Polymorphism, Genetic; D020641:Polymorphism, Single Nucleotide; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D013287:Illicit Drugs; C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins; D019389:Cytochrome P-450 CYP2D6; D002394:Catechol O-Methyltransferase; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D006854:Hydrocortisone