Pharmacoepigenetics in schizophrenia: Predicting drug response.

IF 3.4 4区医学 Q1 PSYCHIATRY

World Journal of Psychiatry Pub Date : 2025-07-19 DOI:10.5498/wjp.v15.i7.107597

Sariye Aybüke Yıldırım, Irmak Dal, Selin Özkan-Kotiloğlu, Bora Baskak, Dilek Kaya-Akyüzlü

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Abstract

Individual differences in treatment response in schizophrenia pose a significant challenge in the management of the disease, due to several biological as well as psychosocial factors, including genetic and epigenetic mechanisms. Pharmacoepigenetics investigates how epigenetic mechanisms affect the variability in effectiveness of treatments and adverse side effects. Antipsychotics such as clozapine (atypical) and haloperidol (typical) directly induce epigenetic changes by altering DNA methyltransferases and histone acetyltransferases, while indirectly affecting neuroinflammatory and stress response pathways. Personalized medicine using epigenetic markers (DNA methylation, non-coding RNAs including microRNAs and long non-coding RNAs) holds great promise for improving the drug response and reducing the side effects of antipsychotic treatment. These developments could revolutionize the treatment of schizophrenia by addressing the complexities involved in responding to treatment. However, ethical and technical barriers to implementing strategies based on epigenetic regulation in clinical practice are fundamental challenges that need to be carefully addressed in this field. This review examined the epigenetic mechanisms involved in the efficacy of antipsychotic drugs.

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精神分裂症的药物表观遗传学：预测药物反应。

由于包括遗传和表观遗传机制在内的一些生物学和社会心理因素，精神分裂症治疗反应的个体差异对该病的管理构成了重大挑战。药物表观遗传学研究表观遗传机制如何影响治疗效果和不良副作用的可变性。抗精神病药物如氯氮平（非典型）和氟哌啶醇（典型）通过改变DNA甲基转移酶和组蛋白乙酰转移酶直接诱导表观遗传变化，同时间接影响神经炎症和应激反应途径。使用表观遗传标记（DNA甲基化，非编码rna，包括microRNAs和长链非编码rna）的个性化医疗在改善药物反应和减少抗精神病药物治疗的副作用方面具有很大的希望。这些进展可以通过解决治疗反应的复杂性来彻底改变精神分裂症的治疗。然而，在临床实践中实施基于表观遗传调控的策略的伦理和技术障碍是该领域需要仔细解决的基本挑战。本文综述了抗精神病药物疗效的表观遗传机制。

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来源期刊

World Journal of Psychiatry PSYCHIATRY-

自引率

6.50%

发文量

110

期刊介绍： The World Journal of Psychiatry (WJP) is a high-quality, peer reviewed, open-access journal. The primary task of WJP is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of psychiatry. In order to promote productive academic communication, the peer review process for the WJP is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJP are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in psychiatry.