ABCB1 genotyping in the treatment of depression. (December 2016)

• Record Type: Journal Article
• Authors: Brückl, Tanja Maria; Uhr, Manfred
• Is Part Of: Pharmacogenomics. Volume 17:Number 18(2016)
• Page Start: 2039
• Page End: 2069
• Publication Date: 2016-12
• Subjects: ABCB1 genotyping -- antidepressant response -- antidepressant side effects -- antidepressants -- blood–brain barrier -- gene -- major depression -- multidrug resistance -- P-gp -- pharmacogenetic test -- pharmacokinetic gene; Pharmacogenomics -- Periodicals; 615.1
• DOI: 10.2217/pgs.16.18
• Languages: English
• ISSNs: 1462-2416

Abstract

P-glycoprotein (P-gp), the gene product of ABCB1, is a drug transporter at the blood–brain barrier and could be a limiting factor for entrance of antidepressants into the brain, the target site of antidepressant action. Animal studies showed that brain concentrations of many antidepressants depend on P-gp. In humans, ABCB1 genotyping in the treatment of depression rests on the assumption that genetic variations in ABCB1 explain individual differences in antidepressant response via their effects on P-gp expression at the blood–brain barrier. High P-gp expression is hypothesized to lead to lower and often insufficient brain concentrations of P-gp substrate antidepressants. In this review, we summarize 32 studies investigating the question of whether ABCB1 polymorphisms predict clinical efficacy and/or tolerability of antidepressants in humans and evaluate the clinical application status of ABCB1 genotyping in depression treatment.