Association of a synonymous GAT3 polymorphism with antiepileptic drug pharmacoresistance

J Hum Genet. 2011 Sep;56(9):640-6. doi: 10.1038/jhg.2011.73. Epub 2011 Jul 21.

Abstract

It would be likely that the genetic variants of the GTA3 gene encoding GAT-3, an astrocytic GABA transporter, may alter gamma-aminobutyric acid (GABA) neurotransmission in the synaptic cleft in the epileptic brain and cause antiepileptic drugs (AEDs) pharmacoresistance. A candidate gene association analysis with fine mapping was performed to dissect the genetic contributions of GAT3 to AEDs pharmacoresistance. Two independent case sample sets were recruited (Samples 1 and 2), and each set was divided into two groups (drug-resistant and drug-responsive) according to the treatment outcomes with AEDs. Sample1 (n=400) was used for the initial exploratory stage of the study and sample 2 (n=435) was used for confirmation of the genetic association in the replication stage of the study. A GAT3 polymorphism (GAT3 c.1572 C>T, rs2272400) was nominally associated with AEDs pharmacoresistance (P(CC) vs P(CT/TT)=0.012, P(allelic)=0.01). The odds ratio (OR) for AED pharmacoresistance was 1.6 (95% confidence interval (CI), 1.11-2.24; P=0.01) in the additive models of inheritance. The statistical significance remained after we adjusted for a confounding factor, the etiology of epilepsy, at 0.012 (adjusted OR: 1.73, 95% CI: 1.13-2.67) and used Bonferroni's correction for multiple comparisons at 0.048. Importantly, the positive association of c.1572 T was reproduced in the replication stage (P(allelic)=0.037, joint P-value of the replication=0.001). The results suggest that GAT3 c.1572T may be one of the contributing factors with a modest effect on AEDs pharmacoresistance in the epileptic brain, shed light on a better understanding of the underlying mechanisms and serve as an impetus for new avenues of treatment for AEDs pharmacoresistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / pharmacology*
  • Anticonvulsants / therapeutic use
  • Brain / drug effects
  • Brain / metabolism
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Drug Resistance / genetics*
  • Epilepsy / drug therapy
  • Epilepsy / etiology
  • Epilepsy / genetics*
  • Female
  • GABA Plasma Membrane Transport Proteins / genetics*
  • Genetic Predisposition to Disease*
  • Genotype
  • Haplotypes
  • Humans
  • Infant
  • Male
  • Polymorphism, Single Nucleotide / genetics*
  • Republic of Korea
  • Young Adult
  • gamma-Aminobutyric Acid / metabolism

Substances

  • Anticonvulsants
  • GABA Plasma Membrane Transport Proteins
  • SLC6A11 protein, human
  • gamma-Aminobutyric Acid