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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO045

Shared genetics, pleiotropic loci, and drug repurposing in posttraumatic stress disorder and substance use disorders

SHARED GENETICS, PLEIOTROPIC LOCI, AND DRUG REPURPOSING IN POSTTRAUMATIC STRESS DISORDER AND SUBSTANCE USE DISORDERS

PTSD and substance use disorders share substantial genetic susceptibility, converging on 105 pleiotropic loci and 51 prioritized genes, with the FURIN protein emerging as a candidate therapeutic target and PI3K and mTOR inhibitors as candidate treatments.

The aim was to characterize the shared genetic architecture of posttraumatic stress disorder (PTSD) and substance use disorders (SUD), identify pleiotropic genes, and evaluate opportunities for drug repurposing. Data sources included the CSTC trauma cohort (n=3,561), GWAS summary statistics for PTSD- and SUD-related traits, GTEx v8 TWAS data, and UKB-PPP pQTL/Olink protein data; polygenic risk scores (PRS) assessed polygenic susceptibility, LDSC assessed genetic correlations, bidirectional Mendelian randomization (MR) tested the direction of causality, PLACO (P<5×10^-8) and PRIMO (PP ≥0.8) identified shared loci, and TWAS and at least five layers of evidence were used to prioritize genes. In the CSTC cohort, SUD-PRS was associated with PTSD symptoms: OR 1.13 per 1-standard-deviation increase (95% CI 1.01–1.26; p=0.030), and OR 1.50 at high PRS levels (95% CI 1.15–1.97; p=0.003), with a p-value for trend <0.001. LDSC estimated the genetic correlation of PTSD with SUD at 0.48, with cannabis use disorder at 0.53, with opioid use disorder at 0.53, with tobacco use disorder at 0.37, and with alcohol use disorder at 0.46. Across five PTSD–SUD pairs, 105 unique pleiotropic loci and 51 prioritized genes were identified, 17 of which were druggable; enrichment analyses implicated pathways related to synaptic signaling and plasticity, as well as brain-related tissues. In the GSMR2 analysis using 11 genetic instruments, plasma FURIN levels were associated with both PTSD (beta=-0.020) and SUD (beta=-0.048), and UKB Olink data showed a clear dose–response pattern in the cumulative incidence of SUD across baseline plasma FURIN quartiles (P<0.0001). In CMap-based drug repurposing, the most represented classes of compounds predicted to reverse the PTSD–SUD transcriptional signature were PI3K inhibitors (23 compounds), dopamine receptor antagonists (19), serotonin receptor antagonists and VEGFR inhibitors (17 each), EGFR inhibitors (15), and mTOR inhibitors (13). In conclusion, the findings indicate that PTSD and SUD share substantial genetic susceptibility and that multi-omics and drug repurposing analyses suggest biologically plausible therapeutic targets and drug classes.

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