Moving pharmacoepigenetics tools for depression toward clinical use
Open accessAbstract
Background Major depressive disorder (MDD) is a leading cause of disability worldwide, and over half of patients do not achieve symptom remission following an initial antidepressant course. Despite evidence implicating a strong genetic basis for the pathophysiology of MDD, there are no adequately validated biomarkers of treatment response routinely used in clinical practice. Pharmacoepigenetics is an emerging field that has the potential to combine both genetic and environmental information into treatment selection and further the goal of precision psychiatry. However, this field is in its infancy compared to the more established pharmacogenetics approaches.Methods We prepared a narrative review using literature searches of studies in English pertaining to pharmacoepigenetics and treatment of depressive disorders conducted in PubMed, Google Scholar, PsychINFO, and Ovid Medicine from inception through January 2019. We reviewed studies of DNA methylation and histone modifications in both humans and animal models of depression.Results Emerging evidence from human and animal work suggests a key role for epigenetic marks, including DNA methylation and histone modifications, in the prediction of antidepressant response. The challenges of heterogeneity of patient characteristics and loci studied as well as lack of replication that have impacted the field of pharmacogenetics also pose challenges to the development of pharmacoepigenetic tools. Additionally, given the tissue specific nature of epigenetic marks as well as their susceptibility to change in response to environmental factors and aging, pharmacoepigenetic tools face additional challenges to their development.Limitations This is a narrative and not systematic review of the literature on the pharmacoepigenetics of antidepressant response. We highlight key studies pertaining to pharmacoepigenetics and treatment of depressive disorders in humans and depressive-like behaviors in animal models, regardless of sample size or methodology. While we discuss DNA methylation and histone modifications, we do not cover microRNAs, which have been reviewed elsewhere recently.Conclusions Utilization of genome-wide approaches and reproducible epigenetic assays, careful selection of the tissue assessed, and integration of genetic and clinical information into pharmacoepigenetic tools will improve the likelihood of developing clinically useful tests.
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The goal of precision medicine (individually tailored treatments) is not being achieved for neurobehavioural conditions such as psychiatric disorders.
“The goal of precision medicine (individually tailored treatments) is not being achieved for neurobehavioural conditions such as psychiatric disorders.”
From Precision clinical trials: a framework for getting to precision medicine for neurobehavioural disorders (2021) · cites this paper as [28]
There is a lack of clinically validated biomarkers in mood, anxiety, psychotic, substance use and eating disorders to guide treatment.
“Evidence of this is the lack of clinically validated biomarkers in mood,28 anxiety,29 psychotic,30 substance use31 and eating disorders32 to guide treatment.”
From Precision clinical trials: a framework for getting to precision medicine for neurobehavioural disorders (2021) · cites this paper as [28]
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- Authors
- Hack, L. M., Fries, G. R., Eyre, H. A., Bousman, C. A., Singh, A. B., Quevedo, J., John, V. P., Baune, B. T., & Dunlop, B. W.
- Affiliations
- Emory University (US)
- The University of Texas Health Science Center at Houston (US)
- Texas Medical Center (US)
- University of Calgary (CA)
- Deakin University (AU)
- The University of Melbourne (AU)
- Corresponding author
- Hack, Laura M.
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 249
- Pages
- 336-346
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC6763314
- OpenAlex
- W2914765414
- Cited by
- 33
- References
- 107
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 5 · 2022: 8 · 2021: 7 · 2020: 4 · 2019: 1 · 2018: 1
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Affective Disorders (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Institutes of Health (R25MH101079)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- pharmacoepigenetics, major depressive disorder, antidepressant response, DNA methylation, histone modifications, epigenetic biomarkers, precision psychiatry, animal models of depression, clinical translation
- MeSH terms
- Animals, Antidepressive Agents, Depression, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Pharmacogenetics, DNA Methylation, MicroRNAs, Precision Medicine, Epigenomics
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