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Guerra et al. J Transl Genet Genom 2022;6:304-21      https://dx.doi.org/10.20517/jtgg.2022.08                                                                                       Page 308



                          Table 1. Pharmacogenetics of dopaminergic agonists in the treatment of neurogenic dysphagia

                          Drug                  Properties                                                                                Pharmacogenetics
                                                Name: Levodopa                                                                            Pathogenic genes: ANKK1, BDNF, LRRK2, PARK2
                                                IUPAC Name: l-Tyrosine-3-hydroxy                                                          Mechanistic genes: CCK, CCKAR, CCKBR, DRD1, DRD2, DRD3, DRD4, DRD5, GRIN2A,
                                                Molecular Formula: C H NO                                                                 GRIN2B, HCRT, HOMER1, LMO3, OPRM1
                                                                   9  11  4
                                                Molecular Weight: 197.19 g/mol                                                            Metabolic genes: Substrate: COMT, CYP1A2, CYP2B6, CYP2C19, CYP2D6, CYP3A4,
                                                Mechanism: Levodopa circulates in the plasma to the blood–brain barrier,                  CYP3A5, DBH, DDC, G6PD, MAOB, TH, UGT1A1, UGT1A9
                                                where it crosses and is then converted by striatal enzymes to dopamine. Carbidopa inhibits the   Transporter genes: SLC22A1, SLC6A3, SLC15A1 (inhibitor). SLC16A10 (inhibitor),
                                                peripheral plasma breakdown of levodopa by inhibiting its carboxylation, and thereby increases   SLC7A5, SLC7A8
                                                available levodopa at the blood–brain barrier                                             Pleiotropic genes: ACE, ACHE
                                                Effect: Antiparkinsonian agents, dopamine precursors

                                                Name: Cabergoline                                                                         Pathogenic genes: BDNF, GSK3B
                                                IUPAC Name: Ergoline-8β-carboxamide, N-[3-(dimethylamino)propyl]-N-[(ethylamino)carbonil]-6-  Mechanistic genes: ADRA1A, ADRA1B,ADRA1D, ADRA2A, ADRA2B, ADRA2C, ADRB1,
                                                (2-propenyl)                                                                              ADRB2, AKT1, BDNF, CNR1, DRD1, DRD2, DRD3, DRD4, DRD5, GSK3B, HTR1A, HTR1B,
                                                Molecular Formula: C H N O                                                                HTR1D, HTR2A, HTR2B, HTR2C, HTR7
                                                                   26  37  5  2
                                                Molecular Weight: 451.60 g/mol                                                            Metabolic genes: Substrate: COMT, CYP1A2, CYP2B6, CYP2C19, CYP2D6, CYP3A4
                                                Mechanism: A long-acting dopamine receptor agonist.                                       (minor), CYP3A5, DDC
                                                Has high binding affinity for dopamine D2-receptors and lesser affinity for D1, α1- and α2-adrenergic,   Transporter genes: ABCB1
                                                and serotonin (5-HT1 and 5-HT2) receptors.
                                                Reduces serum prolactin concentrations by inhibiting release of prolactin from the anterior pituitary
                                                gland (agonist activity at D2 receptors)
                                                Effect: Antiparkinsonian agents, ergot-derivative dopamine receptor agonists
                                                Name: Rotigotine                                                                          Pathogenic genes: ANKK1, BDNF, LRRK2
                                                Molecular Formula: C H NOs                                                                Mechanistic genes: CCK, CCKAR, CCKBR, DRD1, DRD2, DRD3, DRD4, DRD5, GRIN2A,
                                                                   19  25
                                                Molecular Weight: 315.47 g/mol                                                            GRIN2B, HCRT, HOMER1, LMO3, OPRM1, HTR1A, ADRA2B
                                                Mechanism: A non-ergot dopamine receptor agonist with specificity for D3-, D2-, and D1-dopamine   Metabolic genes:
                                                receptors.                                                                                Substrate: COMT, MAOB, CYP3A4, CYP2D6
                                                Although the precise mechanism of action of Rotigotine is unknown,                        Inhibitor: CYP2D6, CYP2C19
                                                it is believed to be due to stimulation of postsynaptic dopamine D2-type autoreceptors within   Transporter genes: SLC22A1, SLC6A3
                                                substantia nigra in brain, leading to improved dopaminergic transmission in motor areas in basal   Pleiotropic genes: ACE, APOE
                                                ganglia, notably caudate nucleus/putamen regions
                                                Effect: Antiparkinsonian agents, non-ergot-derivative dopamine receptor agonists
                                                Name: Apomorphine                                                                         Pathogenic genes: PARK2
                                                Molecular Formula: C H NO HCl H O                                                         Mechanistic genes: ADRA2A, ADRA2B, ADRA2C, CALY, DRD1, DRD2, DRD3, DRD4,
                                                                   17  17  2  1/2  2
                                                Molecular Weight: 312.79 g/mol                                                            DRD5, HTR1A, HTR1B, HTR1D, HTR2A, HTR2B, HTR2C
                                                Mechanism: Stimulates postsynaptic D2-type receptors within the caudate-putamen in the brain   Metabolic genes:
                                                Effect: Antiparkinsonian agents, non-ergot-derivative dopamine receptor agonists          Substrate: COMT, CYP1A2 (minor), CYP2B6, CYP2C9 (minor), CYP2C19 (minor),
                                                                                                                                          CYP2D6, CYP3A4 (minor), CYP3A5, DDC, UGT1A1, UGT1A9, SULT1A1, SULT1A2,
                                                                                                                                          SULT1A3, SULT1E1, SULT1B1
                                                                                                                                          Inhibitor: CYP1A2 (weak), CYP2C19 (weak), CYP3A4 (weak)
                                                                                                                                          Transporter genes: SLC18A2
                                                Name: Amantadine                                                                          Pathogenic genes: PARK2
                                                IUPAC Name: Tricyclo[3.3.1.13,7]decan-1-amine, hydrochloride                              Mechanistic genes: CCR5, CXCR4, DRD1, DRD2, GRIN3A, CHRNA3, CHRNA4, CHRNA7
                                                Molecular Formula: C H NHCl                                                               Metabolic genes:
                                                                   10
                                                                     17
                                                Molecular Weight: 187.71 g/mol                                                            Substrate: COMT, CYP1A2, CYP2B6, CYP2C19, CYP2D6, CYP3A4, CYP3A5, DDC,
                                                Mechanism: Antiparkinsonian activity may be due to inhibition of dopamine reuptake into presynaptic  UGT1A1, UGT1A9
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