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DRD3<br />

81776<br />

Class IgE kU/L Interpretation<br />

0 Negative<br />

1 0.35-0.69 Equivocal<br />

2 0.70-3.49 Positive<br />

3 3.50-17.4 Positive<br />

4 17.5-49.9 Strongly positive<br />

5 50.0-99.9 Strongly positive<br />

6 > or =100 Strongly positive Reference values<br />

apply to all ages.<br />

Clinical References: Homburger HA: Allergic diseases. In Clinical Diagnosis and Management by<br />

Laboratory Methods. 21st edition. Edited by RA McPherson, MR Pincus. New York, WB Saunders<br />

Company, 2007, Chapter 53, Part VI, pp 961-971<br />

Dopamine Receptor D3 Genotype<br />

Clinical Information: The neurotransmitter dopamine acts via dopamine receptors in the central<br />

nervous system. Dopamine receptor subtypes D1 through 5 (DRD1-5) are of interest in schizophrenia<br />

research because many of the antipsychotic drugs interact with and block 1 or several of these receptors.<br />

There has been a strong association between DRD2 receptor blockade and antipsychotic drug dose for<br />

typical antipsychotics (eg, haloperidol, chlorpromazine). However, this association has not been<br />

maintained for the atypical antipsychotics (eg, clozapine, risperidone). The atypical antipsychotic<br />

medications have high binding affinity for the polymorphic DRD3 receptor. For DRD3, a single<br />

nucleotide change (DRD3 25A->G) results in an amino acid coding polymorphism, Ser9Gly, which is<br />

associated with variable response to treatment with atypical antipsychotic medications and predisposition<br />

to tardive dyskinesia, a side effect of certain antipsychotic drugs. Worldwide, the frequency of the A<br />

(DRD3 25A) and G (DRD3 25G) alleles is nearly equal. However, the allele frequencies are markedly<br />

different in different populations (see below) and this may impact the risk of tardive dyskinesia within a<br />

given population or cohort following treatment with antipsychotic drugs. Population Frequencies for<br />

DRD3 25A and DRD3 25G alleles: -Allele frequency - European: G =35%, A =65% - African American:<br />

G =70%, A =30% - Han Chinese Beijing: G =37%, A =63% - Japanese: G =24%, A =76% Other<br />

polymorphisms in the 5' promoter region of DRD3 have also been studied, but results are too preliminary<br />

to be used in the management or diagnoses of psychiatric illnesses. Tardive dyskinesia: The DRD3 25G<br />

polymorphism is associated with the presence and severity of typical neuroleptic-induced tardive<br />

dyskinesia in schizophrenic patients. Higher mean movement scores were found in patients homozygous<br />

for the DRD3 25G allele as compared to both heterozygous and DRD3 25A homozygous patients.(1,2)<br />

The risk for tardive dyskinesia increases with the number of DRD3 25G alleles. Individuals homozygous<br />

for the DRD3 25G allele have an odds ratio of 2.8 for developing tardive dyskinesia compared to<br />

individuals homozygous for the DRD3 25A allele.(2) Treatment responses: The DRD3 25G allele has<br />

been associated with treatment response to clozapine(3) and olanzapine. Among a group of Chinese<br />

patients with schizophrenia treated with risperidone, patients homozygous for the DRD3 25A allele had a<br />

better response, as measured by improved scores on the Positive and Negative Symptom Scale (PANSS),<br />

a questionnaire used to evaluate symptoms associated with schizophrenia, compared to patients<br />

homozygous for the DRD3 25G allele.(4) These improved responses included decreased social and<br />

emotional withdrawal, improved abstract thinking, and increased spontaneity and flow f conversation. A<br />

better response was observed in the heterozygous state (DRD3 25AG) compared to the homozygous<br />

groups (DRD3 25GG, P=0.05; DRD3 25AA P=0.06) in another study of patients receiving a variety of<br />

typical and atypical antipsychotics.(5)<br />

Useful For: Influencing choice of antipsychotics prior to treatment, especially to ascertain if atypical<br />

antipsychotics may be used with low risk of tardive dyskinesia Identifying those patients receiving<br />

antipsychotics who are at increased risk of developing tardive dyskinesias. Individuals with the 25G allele<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 623

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