title: Variants of Dopamine Beta Hydroxylase Gene Moderate Atomoxetine Response in Children with Attention-Deficit/Hyperactivity Disorder.
abstract: OBJECTIVE
  Atomoxetine is the most widely used nonstimulant for the treatment of attention-deficit/hyperactivity disorder (ADHD). It selectively acts on the norepinephrine (NE) system. Dopamine beta hydroxylase (DBH) regulates the synthesis of NE. This study aimed to investigate whether variants in the DBH gene have an effect on the differential response to atomoxetine.
  
  
  METHODS
  Children and adolescents with ADHD were enrolled in a prospective, open-label study of atomoxetine for 8-12 weeks. The dose was titrated to 1.2-1.4 mg/kg per day and maintained for at least 4 weeks. The primary efficacy measure was the investigator-rated ADHD Rating Scale-IV (ADHD-RS-IV). Three categorical evaluations of treatment effects (defined as response, robust response, and remission) were used. We used a candidate gene approach. Eight single nucleotide polymorphisms (SNPs) in DBH were selected and genotyped based on the functional annotation in literature. Their association with response or remission status was analyzed.
  
  
  RESULTS
  Four SNPs were found nominally associated with response status (rs1076150, p = 0.0484; rs2873804, p = 0.0348; rs1548364, p = 0.0383; and rs2519154, p = 0.0097), two were associated with robust response (rs1076150, p = 0.0349; and rs2519154, p = 0.0047), and one was associated with remission (rs2519154, p = 0.0479). The association between rs2519154 and robust response was significant after correction of multiple comparison (p = 0.0384). Two haplotypes of linkage disequilibrium (LD) block1 (constituted by rs1108580, rs2873804, rs1548364, and rs2519154) were nominally associated with response and robust response status (CTAC: p = 0.0301 for response, p = 0.0374 for robust response; TCGT: p = 0.0317 for response, p = 0.021 for robust response), whereas one haplotype (GC) of LD block2 (constituted by rs2073837 and rs129882) was associated with robust response and remission status (p = 0.0377 for robust response; p = 0.0321 for remission), although none achieved significant threshold after multiple comparison.
  
  
  CONCLUSIONS
  Variants in DBH genes were associated with atomoxetine response in the treatment of ADHD. Further replication in larger samples would be warranted.
authors.affiliation: 1 The Affiliated Hospital Hangzhou Normal University , Hangzhou, China .
authors.forename: Yantong
authors.initials: Y
authors.lastname: Fang
authors.affiliation: 2 Beijing University Sixth Hospital/Institute of Mental Health , Key Laboratory of Mental Health, Ministry of Health, Beijing, China .|3 National Clinical Research Center for Mental Disorders, Beijing University Sixth Hospital , Beijing, China .
authors.forename: Ning
authors.initials: N
authors.lastname: Ji
authors.affiliation: 2 Beijing University Sixth Hospital/Institute of Mental Health , Key Laboratory of Mental Health, Ministry of Health, Beijing, China .|3 National Clinical Research Center for Mental Disorders, Beijing University Sixth Hospital , Beijing, China .
authors.forename: Qingjiu
authors.initials: Q
authors.lastname: Cao
authors.affiliation: 2 Beijing University Sixth Hospital/Institute of Mental Health , Key Laboratory of Mental Health, Ministry of Health, Beijing, China .|3 National Clinical Research Center for Mental Disorders, Beijing University Sixth Hospital , Beijing, China .
authors.forename: Yi
authors.initials: Y
authors.lastname: Su
authors.affiliation: 2 Beijing University Sixth Hospital/Institute of Mental Health , Key Laboratory of Mental Health, Ministry of Health, Beijing, China .|3 National Clinical Research Center for Mental Disorders, Beijing University Sixth Hospital , Beijing, China .
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.affiliation: 2 Beijing University Sixth Hospital/Institute of Mental Health , Key Laboratory of Mental Health, Ministry of Health, Beijing, China .|3 National Clinical Research Center for Mental Disorders, Beijing University Sixth Hospital , Beijing, China .
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 2 Beijing University Sixth Hospital/Institute of Mental Health , Key Laboratory of Mental Health, Ministry of Health, Beijing, China .|3 National Clinical Research Center for Mental Disorders, Beijing University Sixth Hospital , Beijing, China .
authors.forename: Li
authors.initials: L
authors.lastname: Yang
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000069445:Atomoxetine Hydrochloride / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000235:genetics*; D002648:Child; D004299:Dopamine beta-Hydroxylase / Q000235:genetics*; D005260:Female; D005838:Genotype; D006239:Haplotypes; D006801:Humans; D015810:Linkage Disequilibrium / Q000235:genetics; D008297:Male; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000069445:Atomoxetine Hydrochloride; D004299:Dopamine beta-Hydroxylase