A pharmacogenetic study of 300 patients being treated with isotretinoin found an association between different forms of the gene encoding the retinoic acid receptor and susceptibility to depression, headaches, nosebleeds, and muscle pain (myalgia).
RESULTS: Three-locus haplotype (Rs2715554 C/T – Rs4890109 G/T – Rs9303285 T/C) analysis showed that frequencies of CTG and TTG haplotypes are significantly associated with occurrence of arthralgia, myalgia, nose bleeds and headache in patients treated with isotretinoin. In addition, TCG haplotype was associated with nose bleeds and headache, whereas TTT haplotype was associated with arthralgia and myalgia. Furthermore, levels of AST were increased, and AST% change was more, after 1 month of treatment in patients with the TC genotype of rs2715554 polymorphism. Finally, allele T of rs9303285 was found to be protective against developing depression in the patients treated with isotretinoin.
CONCLUSIONS: Our findings suggest an association between polymorphisms of RARA gene and some of some common adverse effects of oral isotretinoin.
We could conceivably pursue a similar study on a larger scale using whole-genome analysis in the near future.