title: Response to Transdermal Selegiline Smoking Cessation Therapy and Markers in the 15q24 Chromosomal Region.
abstract: BACKGROUND
  Current treatments for smoking cessation have limited efficacy. A potential pharmaceutical treatment for smoking cessation is selegiline, a selective and irreversible monoamine oxidase B inhibitor. A few clinical trials have been carried out using selegiline but the results have been mixed. We sought to determine if genetic markers in cholinergic loci in the 15q24 chromosomal region predict response to smoking cessation therapy with selegiline.
  
  
  METHODS
  We performed an 8-week double-blind, placebo-controlled clinical trial of the selegiline transdermal system in heavy smokers, with follow-up at weeks 25 and 52. Eight single nucleotide polymorphisms (SNPs) in the 15q24 region, which contains the genes for the nicotinic acetylcholine receptor subunits CHRNA5, CHRNA3, and CHRNB4, were investigated for association with treatment response.
  
  
  RESULTS
  The CHRNB4 promoter SNP rs3813567 was associated with both point prevalence abstinence and post-quit craving. Carriers of the minor C allele treated with selegiline showed lower rates of abstinence and higher levels of craving than selegiline-treated non-carriers, indicating that the rs3813567 C allele adversely affects abstinence in selegiline-treated smokers. This effect was not present among placebo-treated smokers. Selegiline-treated smokers with the CHRNA5 rs680244 GG genotype had lower post-quit craving, and unlike placebo-treated GG-carrying smokers, did not experience a post-quit increase in depressive symptoms.
  
  
  CONCLUSIONS
  Variants in genes encoding cholinergic receptors affect abstinence, craving and mood in selegiline-treated smokers. Selegiline primarily affects dopamine levels in the brain, but cholinergic input affects nicotine-induced dopaminergic activity. These markers may have value in identifying those likely to respond to selegiline for smoking cessation.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA;
authors.forename: Jane E
authors.initials: JE
authors.lastname: Sarginson
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA;
authors.forename: Joel D
authors.initials: JD
authors.lastname: Killen
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA;
authors.forename: Laura C
authors.initials: LC
authors.lastname: Lazzeroni
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA; Center for Health Research, Kaiser Permanente Center for Health Research Northwest, Portland, OR.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Fortmann
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA;
authors.forename: Heather S
authors.initials: HS
authors.lastname: Ryan
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA;
authors.forename: Niloufar
authors.initials: N
authors.lastname: Ameli
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA;
authors.forename: Alan F
authors.initials: AF
authors.lastname: Schatzberg
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA; gmurphy@stanford.edu.
authors.forename: Greer M
authors.initials: GM
authors.lastname: Murphy
mesh_terms: D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000483:Alleles; D002884:Chromosomes, Human, Pair 15 / Q000235:genetics*; D066249:Craving / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D005819:Genetic Markers; D006801:Humans; D008297:Male; D008875:Middle Aged; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use*; D020641:Polymorphism, Single Nucleotide; D011978:Receptors, Nicotinic / Q000235:genetics; D012642:Selegiline / Q000627:therapeutic use*; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000235:genetics* / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D005819:Genetic Markers; D008996:Monoamine Oxidase Inhibitors; D011978:Receptors, Nicotinic; D012642:Selegiline