Abstract

Experimental studies have demonstrated that not only dopaminergic signaling but also glutamatergic/NMDA receptor signaling play indispensable roles in the development of methamphetamine psychosis. Our recent genetic studies provided evidence that genetic variants of glutamate-related genes such as DTNBP1, GLYT1, and G72, which are involved in glutamate release and regulation of co-agonists for NMDA receptors, conferred susceptibility to methamphetamine psychosis. Serine racemase converts l-serine to d-serine, which is an endogenous co-agonist for NMDA receptors. Three single nucleotide polymorphisms (SNPs) in the promoter region of the serine racemase gene (SRR), rs224770, rs3760229, and rs408067, were proven to affect the transcription activity of SRR. Therefore, we examined these SNPs in 225 patients with methamphetamine psychosis and 291 age- and sex-matched controls. There was no significant association between methamphetamine psychosis and any SNP examined or between the disorder and haplotypes comprising the three SNPs. However, rs408067 was significantly associated with the prognosis for methamphetamine psychosis and multi-substance abuse status. The patients with C-positive genotypes (CC or CG) of rs408067 showed better prognosis of psychosis after therapy and less abuse of multiple substances than the patients with GG genotypes. Because the C allele of rs408067 reduces the expression of SRR, a lower d-serine level or reduced NMDA receptor activation may affect the prognosis of methamphetamine psychosis and multiple substance abuse. Our sample size is, however, not large enough to eliminate the possibility of a type I error, our findings must be confirmed by replicate studies with larger samples.

Highlights

  • Methamphetamine is widely abused around the world [1, 2]

  • The present study revealed that the serine racemase gene (SRR) gene did not affect susceptibility to methamphetamine use disorders, but it was associated with several clinical phenotypes of methamphetamine dependence and psychosis

  • Carriers of the C allele of rs408067 showed the less prolonged type of methamphetamine psychosis compared with non-carriers, indicating a better prognosis after therapy with antipsychotics and less multi-substance abuse of illegal drugs other than methamphetamine

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Summary

Introduction

In Japan, it has been the most popular illegal abused substance since World War II, and its use produces serious social problems [3, 4]. Many experimental studies using a behavioral sensitization model, an animal model of methamphetamine dependence and psychosis, have revealed that the dopamine system in the brain plays central and indispensable roles in the induction and expression of methamphetamine use disorders [5]. These findings seem reasonable because methamphetamine is an indirect dopamine agonist. Animal studies have revealed that glutamate and its

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