title: Pharmacogenetic predictors of nausea and vomiting of pregnancy severity and response to antiemetic therapy: a pilot study.
abstract: BACKGROUND
  Nausea and vomiting of pregnancy (NVP) is a common condition. The objective of this study was to evaluate the association between response to antiemetics in the treatment of NVP and genetic polymorphisms in the serotonin receptor subunit genes HTR3A and HTR3B.
  
  
  METHODS
  Pregnant women ≥18 years of age with NVP starting antiemetic therapy with promethazine, prochlorperazine, metoclopramide, or ondansetron at ≤ 16 weeks gestational age were eligible. The study recruited 29 women with complete data and sampling who returned for their one week follow-up and were genotyped for HTR3A and HTR3B polymorphisms. Severity of NVP was captured (using Pregnancy Unique Quantification of Emesis (PUQE) and Quality of Life (QOL) tools) upon enrollment and after one week of antiemetic therapy. These measures were correlated with pharmacogenetic variability.
  
  
  RESULTS
  Subjects with genotype associated with high serotonin affinity of the 5-HT3B receptor (rs1176744, CC) required more antiemetic medications (p < 0.001) than other subjects. Those with genotypes associated with increased expression of the 5-HT3A receptor subunit (rs1062613, CT or TT) had worse final PUQE scores (p = 0.01) than other subjects while rs3782025 variants carriers had significantly better initial (p = 0.02) and final (p = 0.02) PUQE scores than other subjects.
  
  
  CONCLUSIONS
  HTR3B and HTR3A gene variants may contribute to variability in response to antiemetic therapy for NVP.
authors.forename: Amalia S
authors.initials: AS
authors.lastname: Lehmann
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Renbarger
authors.forename: Catherine L
authors.initials: CL
authors.lastname: McCormick
authors.forename: Ariel R
authors.initials: AR
authors.lastname: Topletz
authors.forename: Carrie
authors.initials: C
authors.lastname: Rouse
authors.forename: David M
authors.initials: DM
authors.lastname: Haas
mesh_terms: D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008787:Metoclopramide / Q000627:therapeutic use; D048968:Morning Sickness / Q000188:drug therapy / Q000235:genetics*; D017294:Ondansetron / Q000627:therapeutic use; D010865:Pilot Projects; D020641:Polymorphism, Single Nucleotide; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011346:Prochlorperazine / Q000627:therapeutic use; D011398:Promethazine / Q000627:therapeutic use; D044406:Receptors, Serotonin, 5-HT3 / Q000235:genetics*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000932:Antiemetics; C509409:HTR3A protein, human; C509410:HTR3B protein, human; D044406:Receptors, Serotonin, 5-HT3; D017294:Ondansetron; D011398:Promethazine; D008787:Metoclopramide; D011346:Prochlorperazine