bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTHbekhterev-33Research ArticleНАУЧНО-ИССЛЕДОВАТЕЛЬСКИЕ РАБОТЫRESEARCH PAPERSФармакогенетика антипсихотик-индуцированных метаболических нарушений: актуальное состояние проблемыPharmacogenetics of antipsychotic-induced metabolic disturbances: state-of-the-artНасыроваРегина ФаритовнаNasyrovaR. F.reginaf@bekhterev.ruСиваковаНаталья АлександровнаSivakovaN. A.sivakova-natali@rambler.ruИващенкоДмитрий ВладимировичIvashchenkoD. V.dvi1991@yandex.ruСосинДмитрий НиколаевичSosinD. N.sosin.dmitriy@gmail.comЕршовЕвгений ЕвгеньевичErshovE. E.e.e.ershov@mail.ruСосинаКристина АнатольевнаSosinaK. A.kristinasosina89@gmail.comАхметоваЛилия ШамильевнаAkhmetovaL. Sh.akhmetova.lil@yandex.ruВоликоваОльга ВладимировнаVolikovaO. V.ar-feiniel@mail.ruБейбалаеваТангюль ЗагировнаBeybalayevaT. Z.tanguel123@gmail.comНезнановНиколай ГригорьевичNeznanovN. G.spbinstb@bekhterev.ruСанкт-Петербургский научно-исследовательский психоневрологический институт им. В.М. БехтереваRussian FederationСПб ГБУЗ «Психиатрическая больница №1 им. П.П. Кащенко»Russian FederationКазанский государственный медицинский университетRussian FederationАлтайский государственный медицинский университетRussian Federation201619072018036780Copyright © Насырова Р.Ф., Сивакова Н.А., Иващенко Д.В., Сосин Д.Н., Ершов Е.Е., Сосина К.А., Ахметова Л.Ш., Воликова О.В., Бейбалаева Т.З., Незнанов Н.Г., 20182018Насырова Р.Ф., Сивакова Н.А., Иващенко Д.В., Сосин Д.Н., Ершов Е.Е., Сосина К.А., Ахметова Л.Ш., Воликова О.В., Бейбалаева Т.З., Незнанов Н.Г.Nasyrova R.F., Sivakova N.A., Ivashchenko D.V., Sosin D.N., Ershov E.E., Sosina K.A., Akhmetova L.S., Volikova O.V., Beybalayeva T.Z., Neznanov N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/33

Антипсихотики являются основными лекарственными препаратами при лечении шизофрении и других психических расстройств. По литературным данным до 60% больных шизофренией имеют антипсихотик-индуцированные метаболические нарушения. Основной задачей фармакогенетических исследований является поиск предикторов ответа на терапию, а так же определение вероятности развития нежелательных явлений. Проанализированы основные результаты в области фармакогенетики метаболических нарушений. В последнее время был достигнут значительный прогресс в области фармакогенетики антипсихотик-индуцированных метаболических нарушений, которые подтвердили результаты предыдущих изучений и выявили новые гены-кандидаты. Неоднозначные результаты в фармакогенетических исследованиях, вероятно, являются отражением сложности патогенеза, влиянием множества эпигенетических факторов на механизмы развития, что требует усложнения дизайна исследований, направленных на выявление генов-кандидатов, участвующих в реализации метаболических нарушений при приеме нейролептиков. Включение фармакогенетического подхода в клинические рекомендации необходимо, но в настоящее время затруднено, что связано преимущественно с недостаточным уровнем доказательности изученных генетических маркеров и их этнической гетерогенностью. Применение фармакогенетического тестирования совершенствует рациональную терапию и способствует обеспечению максимально эффективного и безопасного лечения.

Antipsychotics are the main pharmaceutical agents in treatment of schizophrenia and other mental disorders. According to literature data up to 60% of patients with schizophrenia have antipsychotic-induced metabolic disturbances. The main objective of pharmacogenetic studies is search for predictors of the response to therapy and definition of likelihood of development of undesirable phenomena. The main findings in the field of pharmacogenetics of metabolic disturbances were analysed. Recently, significant progress in the field of pharmacogenetic research was made which confirmed results of the previous studies and revealed new candidate genes. Ambiguous results in pharmacogenetic studies may be a reflection of complexity of pathogenesis of antipsychotic-induced weight gain, an influence of a set of epigenetic factors on mechanisms of its development. All this complicates design of the studies directed at identification of the candidate genes participating in realization of metabolic disturbances during intake of neuroleptics. Improvement of pharmacogenetic studies will provide the best understanding of how these genes are associated with antipsychotic-induced metabolic disturbances. Inclusion of pharmacogenetic approach in clinical guidelines is necessary, but now it is complicated that is associated mainly with the insufficient level of validity of the genetic markers studied and their ethnic heterogeneity. Use of pharmacogenetic testing improves rational therapy and contributes to the most efficient and safe therapy.

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The authors declare that there are no conflicts of interest present.