Whole-exome sequencing identifies a polymorphism in the BMP5 gene associated with SSRI treatment response in major depression.
Although antidepressants are widely used in the pharmacotherapy of major depressive disorder (MDD), their efficacy is still insufficient as approximately one-third of the patients do not fully recover even after several treatment trials. Inter-individual genetic differences are thought to contribute to the variability in antidepressant response; however, current findings from pharmacogenetic studies are uncertain or not clearly replicated. Here we report the first application of full exome sequencing for the analysis of pharmacogenomics on antidepressant treatment. After 12 weeks of treatment with the selective serotonin re-uptake inhibitor escitalopram, we selected five clear responders and five clear non-responders for exome sequencing. By comparing the allele counts of previously known single nucleotide polymorphisms and novel polymorphisms we selected 38 markers for further genotyping in two independent patient samples treated with escitalopram (n=116 and n=394). The A allele, carried by approximately 30% of the patients with MDD, of rs41271330 in the bone morphogenetic protein (BMP5) gene showed strong association with worse treatment response in both sample sets (p=0.001), indicating that this is an promising pharmacogenetic marker for prediction of antidepressant therapeutic outcome.
1Institute of Molecular and Cell Biology, University of Tartu, Estonia.
Anu
A
Tammiste
Tao
T
Jiang
Krista
K
Fischer
Reedik
R
Mägi
Kaarel
K
Krjutškov
Kristi
K
Pettai
Tõnu
T
Esko
Yingrui
Y
Li
Katherine E
KE
Tansey
Liam S
LS
Carroll
Rudolf
R
Uher
Peter
P
McGuffin
Urmo
U
Võsa
Natalia
N
Tšernikova
Alois
A
Saria
Pauline C
PC
Ng
Triin
T
Eller
Veiko
V
Vasar
David J
DJ
Nutt
Eduard
E
Maron
Jun
J
Wang
Andres
A
Metspalu
D000328:Adult; D000483:Alleles; D055417:Bone Morphogenetic Protein 5 / Q000235:genetics*; D015283:Citalopram / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000235:genetics*; D059472:Exome / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D017422:Sequence Analysis, DNA; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D055417:Bone Morphogenetic Protein 5; D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors; C525814:BMP5 protein, human
BMP5; Major depression; SSRI; antidepressant; exome sequencing; pharmacogenomics