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WO2013156658A1 - Method for determining the probability that a subject will quit tobacco consumption in response to treatment with a nicotinic cholinergic receptor agonist - Google Patents

Method for determining the probability that a subject will quit tobacco consumption in response to treatment with a nicotinic cholinergic receptor agonist Download PDF

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Publication number
WO2013156658A1
WO2013156658A1 PCT/ES2013/070253 ES2013070253W WO2013156658A1 WO 2013156658 A1 WO2013156658 A1 WO 2013156658A1 ES 2013070253 W ES2013070253 W ES 2013070253W WO 2013156658 A1 WO2013156658 A1 WO 2013156658A1
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snps
snp
alleles
linkage block
allele
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Spanish (es)
French (fr)
Inventor
Carlos CORTIJO BRINGAS
José Javier MEANA MARTÍNEZ
Francisco Javier BALLESTEROS RODRÍGUEZ
África GARCÍA-ORAD CARLES
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Euskal Herriko Unibertsitatea
Genetracer Biotech SL
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Euskal Herriko Unibertsitatea
Genetracer Biotech SL
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    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12QMEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
    • C12Q1/00Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions
    • C12Q1/68Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions involving nucleic acids
    • C12Q1/6876Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes
    • C12Q1/6883Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for diseases caused by alterations of genetic material
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12QMEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
    • C12Q1/00Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions
    • C12Q1/68Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions involving nucleic acids
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12QMEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
    • C12Q2600/00Oligonucleotides characterized by their use
    • C12Q2600/106Pharmacogenomics, i.e. genetic variability in individual responses to drugs and drug metabolism
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12QMEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
    • C12Q2600/00Oligonucleotides characterized by their use
    • C12Q2600/156Polymorphic or mutational markers

Definitions

  • the present invention relates, in general, to methods for predicting success in cessation of tobacco use in response to a pharmacological treatment with an agonist drug of nicotinic cholinergic receptors, based on the presence of certain polymorphisms and, optionally, in combination, with some clinical variables.
  • Tobacco use is one of the biggest public health problems of today because it constitutes one of the main risk factors for various chronic diseases, for example, lung, cardiovascular and cancer diseases.
  • tobacco use continues to be widespread throughout the world. In fact, it is estimated that there are about 1 billion smokers in the world. In Spain alone, about 500,000 people a year become ill from passive smoking, 65% of them being young children. Likewise, tobacco smoke is responsible for bronchitis and pneumonia in children under 18 months, between approximately 25,000 and 51,000 cases per year, which require around 1,300 hospitalizations / year for that reason. On the other hand, the average number of non-smoking adults killed by lung cancer is about 400 cases annually.
  • Non-nicotinic drug therapy is carried out with the use of drugs that mimic the nicotine molecule and replace it in the fixation in nicotinic receptors, or through other medications with an approved indication to quit smoking; Among the most commonly used medications are bupropion, nortriptyline, varenicline and citisine. By administering these drugs, a success rate is obtained in attempts to quit tobacco consumption that doubles the rate obtained in their absence, so that these drugs contribute substantially to improving health and reducing the risk of premature mortality. (Fant et al. 2009, Handb Exp Pharmacol (192): 487-510).
  • TSN nicotine replacement therapy
  • chewing gum, patches, pills and inhalers chewing gum, patches, pills and inhalers
  • TSN nicotine replacement therapy
  • smoked nicotine substitutes can help overcome withdrawal from dependent smokers who quit smoking if used for short periods of time, not exceeding 9 weeks.
  • patches are used daily with a constant concentration of nicotine for 3 weeks and then they are exchanged for others with a lower dose of nicotine. Meanwhile the brain adapts to function without nicotine and acquires other healthy habits. The fact that the patches release nicotine steadily does not generate addiction since there is no blood nicotine peak that reinforces the desire to smoke.
  • TSN TSN
  • psychological support and pharmacological treatment with bupropion, varenicline or nortriptyline have been shown to have a clinically significant effect.
  • the efficacy of all treatments can be considered identical at 52 weeks (Aubin et al. 2008, Thorax 63 (8): 717-24).
  • Unfortunately, without treatment approximately 3-5% of smokers who wish to quit smoking It achieves one year abstinence rates, but many of those who achieve one year abstinence will fall within the next 2 years (World Health Organization, 2004).
  • Smoking represents a complex behavior that includes the beginning of tobacco consumption, its progression to regular use, dependence, abandonment and relapse. Together with environmental factors, there is evidence of the genetic influence on the establishment, maintenance and cessation of tobacco consumption. Association studies report a genotype influence of 40-60% (Uhl et al. 2007, BMC Genet 3: 8-10).
  • GWA genome association study
  • S Ps single nucleotide polymorphisms
  • the change of a single nucleotide can cause: (i) the substitution of an amino acid, if it is in an exonic sequence, varying the function of the protein, (ii) the modification of the amount of the protein, if the SNP is in a regulatory region, or (iii) the change in protein structure, if the change is in a splicing zone.
  • nicotine is the main psychoactive compound in tobacco
  • most of the candidate genes analyzed in pharmacogenetic studies have focused on nicotinic receptors and genes involved in nicotine metabolism.
  • genes involved in nicotine vulnerability are those genes linked to the dopaminergic neurotransmission pathways, especially those of the D2 receptor (DRD2) and the dopamine transporter (DAT or SLC6A3).
  • D2 receptor D2 receptor
  • DAT dopamine transporter
  • the enzymes of the dopaminergic metabolism COMT and MAO-B present interindividual variability that could contribute to the different responses to substances with addictive potential (Barrueco et al. 2005, Med Clin (Barc) 124 (6): 223-8).
  • the metabolism of nicotine is subject to genetic variants in the cytochrome P450, responsible for its metabolism to cotinine.
  • nicotinic cholinergic receptor subunits may affect the intensity of its effects.
  • CHRN nicotinic cholinergic receptor
  • CNS central nervous system
  • Tobacco use modifies the expression of other subunits such as a7 and a5, thus modifying the structure of the receptor and its coupled functions.
  • nicotine metabolism is very sensitive to SNPs in CYP2A6. Certain variants, such as * 2 and * 4 are less active, which means greater sensitivity to the adverse effects of nicotine patches.
  • Bupropion is a drug that uses the DAT dopamine transporter and the consequent dopaminergic modulation as a mechanism for smoking cessation. Certain variants of the DAT could represent a resistance to its effects. On the other hand, it has been described, in one of the few methodologically well-designed studies (Berrettini et al. 2007, Biol Psychiatry 61 (1): 111- 118), that bupropion responses may vary depending on the greater or lesser synaptic availability of dopamine controlled by COMT variants. The metabolism of bupropion is also dependent on cytochrome CYP2B6, thus some of its variants, for example, * 4, provides a greater clearance of bupropion and as a consequence, a lower efficacy thereof.
  • varenicline In the case of varenicline, given its recent commercial introduction, only a non-independent study of association with genetic variants focused on pharmacogenetics has been published (King et al. 2012, Neuropsychopharmacology 37: 641-650). In this study, continued abstinence is related in patients under treatment with varenicline during weeks 9-12 of treatment with SNPs present in genes related to cholinergic nicotinic receptors (CHRN) and in genes in union imbalance of the Chrl5q25 chromosomal region.
  • CHRN cholinergic nicotinic receptors
  • the genes related to nicotinic receptors described in this study refer to a pharmacological target of varenicline, which is not extensible to neurobiological dependence processes, since in the state of the art there is no evidence to indicate that the genes described in this study are related to neurobiological dependence processes, they are only described in their relationship with nicotine dependence.
  • the interrelation of the CHRNA5-CHRNA3-CHRNB4 cluster with dependence has not been reproduced in the latest meta-analyzes and published studies (Maes HH et al. 2004 Psychol Med 34 (7): 1251-6; Rodr ⁇ guez S et al .
  • SNPs single nucleotide polymorphisms
  • varenicline a nicotinic cholinergic receptor agonist drug.
  • the inventors conducted a study to determine the pharmacogenomic profile associated with the efficacy of a pharmacological treatment for smoking cessation based on varenicline, evaluating the results obtained in terms of withdrawal from smoking at 3 months (short-term efficacy) and 12 months ( long term effectiveness).
  • SNPs were genotyped in a total of 807 subjects, of which 479 had received, or were receiving, pharmacological treatment with varenicline, and the association of their genotypes with smoking cessation in response to said pharmacological treatment was found, finding that the alleles of certain SNPs, specifically the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and / or rs2023239, or any SNP of their corresponding linkage blocks, were significantly associated.
  • the SNPs identified in the present application are located in genes that are involved in neurobiological dependency processes, a process that involves the different brain reward systems (mesolimbic and mesocortical areas) and their neurotransmitters and receptors (Lingford-Hughes A & Nutt D 2003 Brit J Psych 182: 97-100; Neuroscience of Psychoactive Substance Use and Dependence 2004 WHO).
  • the SNP rs678188 is located in the PARD3 gene (partitioning defective 3)
  • the SNP rs9658498 is located in the NOS1 gene (nitric oxide synthase 1)
  • the SNP rs4821566 is located in the CSF2RB gene (colony stimulating factor 2 beta receptor)
  • the SNP rsl0891510 is located in the NCAM1 gene (neural cell adhesion molecule 1)
  • the SNP rsl 1932367 is located in the GRID2 gene (glutamate ionotrophic delta receptor)
  • the SNP rs2023239 is located in the CNR1 gene (cannabinoid receiver 1).
  • said SNP is selected from the group formed by SNPs rsl0891510, rsl 1932367, rs2023239 and any combination of said SNPs and / or the corresponding SNPs of their linkage blocks; these SNPs (or the corresponding SNPs of their linkage blocks), alone or in combination with each other, prove to be particularly useful for predicting the efficacy of the 12-month treatment response.
  • said SNP is SNP rs678188 and / or the corresponding SNPs of its linkage block.
  • Figure 1 shows the ROC curves corresponding to the univariate models
  • Figure 2 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to the SNP rs9658498.
  • Figure 3 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to the SNP rs4821566.
  • Figure 4 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to SNP rsl0891510.
  • Figure 5 shows the ROC curves corresponding to the univariate models
  • Figure 6 shows the ROC curves corresponding to the univariate (upper graph) and multivariate (lower graph) models in relation to SNP rs2023239.
  • the authors of the present invention have identified alleles of SNPs whose presence is related to a greater or lesser probability of success in abandonment. of tobacco consumption in response to a pharmacological treatment based on varenicline or drugs with a similar mechanism of action such as cytisine and dianicline, among others. Based on that finding, the methods of the present invention have been developed which are described in detail below.
  • kits of the invention may include means for extracting the sample from the subject.
  • the terms "abandonment” or “cessation” are used interchangeably, in relation to tobacco use, to refer to abstinence, termination or termination of tobacco consumption.
  • the abandonment of tobacco consumption can be (i) complete, when there is a total absence of consumption of any type or form of tobacco product from the moment in which it is decided to abandon its consumption, (ii) continued, when the subject who abandons tobacco use has relapses, continuous or punctual, during the 15 days after the date on which he decides to cease or abandon tobacco use, or (iii) punctual, when the subject abandons tobacco consumption for a period variable time although short, in general, a few weeks or months.
  • the cessation of tobacco use is a complete cessation.
  • the verbal declaration of cessation of tobacco consumption when it is inhaled (smoked), can be validated by determining the levels of carbon monoxide (CO) in exhaled air, being the most common technique cooximetry for such determination.
  • CO carbon monoxide
  • Levels of 10 or more ppm of CO in exhaled air correspond to smoking subjects.
  • tobacco refers to the abuse of tobacco consumption, causing the consumer of tobacco to suffer a physical and psychological dependence that generates a withdrawal syndrome.
  • Tobacco has addictive power mainly due to nicotine, which also has Antidepressant effects and symptomatic relief of anxiety.
  • the term “smoking” is sometimes used as a synonym for "tobacco addiction”; however, the term “smoking” is also used in relation to chronic intoxication that occurs due to tobacco abuse and groups the effects of repeated tobacco use and developed addiction.
  • Tobacco addiction constitutes a risk factor for respiratory and cardiovascular diseases, and is especially harmful during pregnancy.
  • Smoking is related to the occurrence of a high number of diseases, including several types of cancer, the most frequent being lung. In addition, tobacco not only harms active smokers, but also those who breathe the same air (passive smokers).
  • agonist refers to a compound capable of generating a response in a cell after binding to a cellular receptor.
  • the agonist compound binds to a receptor and has an intrinsic effect and, therefore, increases the basal activity of a receptor when it comes into contact with the receptor.
  • antagonist refers to a compound that by binding to a cellular receptor blocks the activation of said cellular receptor by the agonist.
  • the antagonist compound competes with the agonist compound for binding to a receptor, thereby blocking the action of the agonist on the receptor.
  • an antagonist also known as a "neutral” antagonist
  • Antagonists mediate their effects by binding to the active site or to allosteric sites in the receptors, or they can interact at unique binding sites that are not normally involved in the biological regulation of receptor activity.
  • the antagonist activity can be reversible or irreversible depending on the longevity of the antagonist-receptor complex, which, in turn, depends on the nature of the antagonist-receptor binding.
  • the agonists can be partial or complete.
  • a "partial agonist" is defined as a compound that has an affinity for a receptor, but unlike a complete agonist, it will cause only a small degree of the peculiar pharmacological response to the nature of the receptor involved, even if a high proportion of receptors are occupied by the compound ..
  • allele refers to one, two or more forms of a gene, locus or genetic polymorphism. Sometimes, different alleles can give rise to different phenotypes; however, other times, different alleles will have the same result in the expression of a gene. Most multicellular organisms have two sets of chromosomes, that is, they are diploid. These chromosomes are called homologous chromosomes. Diploid organisms have a copy of each gene (and an allele) on each chromosome. If both alleles are equal, they are homozygous. If the alleles are different, they are heterozygous.
  • linkage block or "haplotypic block”, as used herein, refers to the set of SNPs on a particular chromosome that are statistically associated and configure a haplotype (combination of genetic markers).
  • cytisine refers to the compound (1R, 5S) -l, 2,3,4,5,6-hexahydro-l, 5-methane-8H-pyrido [l, 2a] [1, 5] diazocine-8-one, of formula:
  • Cinsine is a plant alkaloid of relatively rigid conformation, of molecular structure similar to that of nicotine and acetylcholine.
  • Citisine is a natural insecticide found in the leaves of Cytisus laburnum and Ulex europaeus, among others.
  • the synthesis of citisine and derivatives has been described in Coe JW 2000 Org Lett 2: 4205-4208 and O'Neill BT et al. 2000 Org Lett 2: 4201-4204.
  • the term "citisine”, as used herein includes the derivatives mentioned in said scientific publications, among others.
  • Cisine is marketed under the brand name Tabex ® and is part of the group of agonist drugs of nicotinic cholinergic receptors and is a compound that has an affinity for the a4B2 subtype of neuronal nicotinic acetylcholine receptors.
  • Citisine is a natural insecticide found in the leaves of Cytisus laburnum and Ulex europaeus, among others. The synthesis of citisine and derivatives is described in Coe JW 2000 Org Lett 2: 4205-4208 and O'Neill BT et al. 2000 Org Lett 2: 4201-4204.
  • tobacco consumption includes any form of tobacco consumption, constituting the inhalation of the products of the combustion of tobacco its most common form of consumption.
  • smoking in the sense used in this description, refers to the action of sucking and firing tobacco smoke.
  • the first, or mainstream which is the one that when aspirating a draft passes through the inside of the cigarette until it reaches the lungs of the active smoker
  • the second, or secondary current which is the one that is released to the environment from the incandescent end of the cigarette and that can be inhaled by a subject breathing in that contaminated environment, said subject being the passive smoker.
  • inhaling tobacco smoke the average smoker consumes between 1 and 2 mg of nicotine per cigarette.
  • nicotine quickly reaches its maximum levels in the bloodstream and penetrates the brain.
  • cigarette smoking is the most common and popular form of tobacco consumption
  • other forms of smokeless tobacco consumption are also contemplated in the present invention, such as, for example, the consumption of tobacco powder or snuff and tobacco consumption to chew, that suppose forms of tobacco consumption by chewing, sucking, snorting, etc.
  • These smokeless tobacco products also contain nicotine.
  • nicotine is absorbed through the mucous membranes and reaches maximum levels in the blood and in the brain more slowly.
  • Electronic cigarettes Another form of tobacco consumption, whose prediction of success or failure of cessation of consumption in subjects undergoing treatment with varenicline also falls within the objectives of the methods provided by the present invention, is given by electronic cigarettes.
  • "Electronic cigarettes"("e-Cig") are devices that vaporize the substance contained in the cartridges, causing the expulsion of steam that mimics the smoke in the traditional cigarette and achieving a similar effect on the user.
  • the mouthpiece of the device contains a replaceable or refillable cartridge filled with liquid.
  • the main substances of said liquid are propylene glycol and / or vegetable glycerin, nicotine in different doses optionally (between 0 and 36 mg / ml in general), optional flavors and aromas.
  • dianicline refers to the compound (5aS, 8S, 10aR) -5a, 6.9, 10-tetrahydro, 7H, HH-8, 10a-methanopyrid [2 ', 3': 5.6] pyran [2 , 3-d] azepine and has as formula:
  • Dianicline is part of the group of agonist drugs of nicotinic cholinergic receptors and is a compound that has an affinity for the a4B2 subtype of neuronal nicotinic acetylcholine receptors.
  • nicotinic cholinergic receptor agonist drug is understood as that drug capable, after interaction with any of the nicotinic cholinergic receptor subunits, to modify cellular response processes and generate a biological response (Florez et al., Pharmacology Humana, 4th edition, Masson, Barcelona, 2003).
  • Illustrative, non-limiting examples of such drugs include cytisine, dianicline and varenicline, among others.
  • biological sample includes any biological material that can be obtained from a subject, susceptible to conservation and that can house information on the genetic endowment characteristic of the subject.
  • the sample of the invention can be of the cellular, tissue or fluid type.
  • the sample is of blood and / or saliva.
  • nicotine refers to an alkaloid compound found in the tobacco plant, responsible for the psychoactive and addictive effects of tobacco. Although about 5,000 chemical compounds have been identified in the different phases (gas, solid or particulate) of tobacco smoke, their nicotine content is what makes tobacco addictive. Nicotine is considered to be responsible for both tobacco addiction and the maintenance of smoking.
  • nicotine when inhaling tobacco smoke, nicotine is rapidly absorbed both in the oral mucosa and in the lungs, from where it passes to the circulatory system, distributed throughout the body, and, in 7-10 seconds, nicotine arrives to the brain, where it binds to the nicotinic receptors producing a stimulating and / or sedative, pleasant and rewarding effect, which triggers the appearance of dependence on tobacco (pharmacological or physical dependence).
  • the smoker adapts his nicotine inhalation pattern in terms of frequency, depth of inhalations and smoke retention time, depending on his own characteristics and the effect he intends to cause in each circumstance. These variations of the smoking pattern produce different concentrations of nicotine in the blood that yield different levels of nicotine supply to the body and different effects on its action.
  • Nicotine produces a series of effects in the body, among which are an increase in blood pressure, an increase in heart rate or tachycardia, an increase in blood glucose and an increase in bowel movement.
  • polymorphism refers to substitutions of a single nucleotide for another and that are observed in the general population at a frequency greater than 1%.
  • SNP single nucleotide polymorphism
  • SNP single nucleotide polymorphism
  • SNPs represent one of the most common forms of genetic variation, where each version of the sequence with respect to the polymorphic site is referred to as an allele of the polymorphic site. SNPs occur throughout the entire genome, both in extragenic regions and in coding regions or their regulatory sequences.
  • the change of a single nucleotide can cause: 1) the substitution of an amino acid, if it is in an exonic sequence, and vary the effectiveness of the protein's function; 2) modify the amount of the protein, if the SNP is in a regulatory region; or 3) change the structure of the protein, if the change is in a splicing zone.
  • Mutations can be used as diagnostic and / or prognostic tools for the identification of subjects with a predisposition to a disease or to a rapid evolution of the disease, genotyping the subject suffering from the disease and facilitating the development of medicines based on the knowledge generated on the role of proteins in the pathogenesis process.
  • S Ps can also be used as diagnostic and / or prognostic tools for the identification of subjects that respond well (or do not respond) or that present adverse effects to a specific therapy or to a specific pharmacological treatment since inherited interindividual differences In the pharmacokinetics and pharmacodynamics of drugs they are due to genetic variants that affect gene function or expression.
  • These polymorphisms affect drug metabolizing enzymes, transporters and drug targets and can have a great influence on the efficacy and safety of a particular drug therapy or therapy.
  • the genetic markers used in the invention are specific alleles at "polymorphic sites" associated with the success or failure of the cessation or abandonment of tobacco use by a subject under treatment with a cholinergic receptor agonist drug. nicotinics to stop using tobacco.
  • a nucleotide position in the genome in which more than one sequence is possible in a population is known as a "polymorphic site.”
  • a polymorphic site is only one nucleotide in length, the site is commonly called SP, as mentioned above, for example, if at a particular chromosomal location, a member of a population has an adenine (A) and another member of the population has a thymine (T) in the same position, so this position is a polymorphic site and, more specifically, the polymorphic site is an SNP.
  • Each version of the sequence with respect to the polymorphic site is known as an allele of the polymorphic site.
  • the SNP allows both an A allele and a T allele.
  • variants of the nucleotide sequence can lead to changes in the sequence of the encoded polypeptide, which affects their properties (activity alteration, distribution alteration, altered stability , etc.).
  • variants of the nucleotide sequence may result in changes that affect the transcription of a gene or the translation of its messenger RNA.
  • the alterations can be qualitative, quantitative, or both.
  • probability measures the frequency with which a result (or set of results) is obtained when conducting a randomized experiment, of which all possible outcomes are known, under sufficiently stable conditions.
  • propensity in combination with the cessation of tobacco use in response to a varenicline-based therapy, refers to the propensity, or actual probability, of a subject to abandon tobacco use in response to said therapy for a certain period of time, for example, for a period of at least 3 months, counted from the start of treatment with varenicline.
  • the probability can be "high” or "low.” As those skilled in the art will understand, the probability does not have to be 100% for all the subjects evaluated, although preferably it should be.
  • a subject is statistically significant or not, it can be determined without major complications, by a person skilled in the art, using different known tools of statistical evaluation, for example, by determining confidence intervals, determining the value of p, the Student test, Mann-Whitney test, etc. Additional information on these statistical tools can be found in Dowdy and Wearden, Statistics for Research, John Wiley & Sons, New York, 1983.
  • Preferred confidence intervals are at least 50%, at least 60%), at least 70%, at least 80%>, at least 90%, or at least 95%. P values are preferably 0, 1, 0.05, 0.02, 0.01 or less.
  • subject refers to a human being, female or male, and of any race or age.
  • the subject is an active consumer of tobacco, that is, consumes tobacco regularly or sporadically;
  • said subject is an active smoker.
  • a smoker of more than 20 cigarettes a day could be considered a "severe smoker "
  • a smoker of between 10 and 20 cigarettes at day could be considered a "moderate” smoker
  • a smoker of less than 10 cigarettes a day could be considered a "mild” smoker.
  • tobacco refers to a product processed from the leaves of several plants of the Nicotiana genus, including N. tabacum, N. petunoides, N rustica and N. polidiclia.
  • the N. tabacum species can be classified into four varieties, havanensis, brasilensis, virginica and purpurea, which are the origin of the different varieties used in the commercialization of tobacco.
  • the tobacco-based products to which the methods of the invention are directed related to the prediction of success or failure of cessation of consumption in subjects undergoing treatment with varenicline include those products that are made totally or partially of tobacco, contain nicotine, and whose consumption occurs, for example, when smoking, sucking, chewing or snorting them.
  • tobacco can be presented in the form of cigarettes [(also called cigarettes, cigarettes, etc.) that can be emboquillados or without filter, blond or black, "lights”, “semi-lights” or integers] , cigars, rolling tobacco, pipe smoking tobacco, snuff or snuff, etc.
  • treatment refers to the administration of a drug to alleviate or eliminate a pathology or to reduce or eliminate one or more symptoms associated with said pathology.
  • the treatment applied to the subject is a pharmacological treatment and is aimed at reducing or eliminating tobacco consumption in said subject and is based on the use of varenicline.
  • the subject to whom the treatment is directed is an active consumer of tobacco, for example, an active smoker.
  • personalized treatment or “personalized medicine”, as used herein, refers to the design and application of prevention, diagnosis and treatment interventions adapted to the patient's genetic substrate and the molecular profile of the disease.
  • varenicline refers to the compound 7,8,9, 10-tetrahydro-6, 10-methane-6H-pyrazino [2,3-h] [3] benzacepin, of the formula: and also includes its pharmaceutically acceptable salts, such as, for example, those mentioned in the international patent application W099 / 35131, as well as its derivatives, for example, N-formyl-varenicline and N-methyl-varenicline. Varenicline is marketed in Spain in the form of its tartrate salt under the brand Chantix ® or Champix ® .
  • Varenicline is part of the group of agonist drugs of nicotinic cholinergic receptors and is a compound that acts as a selective partial agonist of nicotinic acetylcholine receptors, which binds with great affinity and selectivity to the a4B2 subtype of neuronal nicotinic receptors of Acetylcholine
  • Varenicline is used in the treatment of various diseases, including, by way of illustration, not limitation, chronic inflammatory bowel diseases (including, but not limited to, ulcerative colitis, pyoderma gangrenosum and Crohn's disease), irritable bowel syndrome, dystonia spasmodic, chronic pain, acute pain, celiac disease, reservoritis, vasoconstriction, anxiety, panic disorder, depression, bipolar disorder, autism, sleep disorder, time shift ("jet lag"), amyotrophic lateral sclerosis (ALS), cognitive dysfunction , hypertension, bulimia, anorexia, obesity, cardiac arrhythmia, gastric acid hypersecretion, ulcer, pheochromocytoma, progressive supranuclear paralysis, addiction and chemical dependence (nicotine, tobacco products, alcohol, benzodiazepine, barbiturates, opioids, cocaine), headache, migraine, sudden attack, traumatic brain injury (TBI), obsessive-compulsive disorder, psychosis ,
  • the usual treatment for cessation of tobacco use with varenicline includes oral administration, twice a day, of 1 mg of compound, for 12 weeks Absorption is complete and systemic availability high. Maximum plasma concentrations typically occur at 3-4 hours after taking (Faessel HM et al. 2010, Clin Pharmacokinet 49 (12): 799-816).
  • Method for determining the probability that a subject will quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug (“first method of the invention").
  • the invention relates to a method for determining the probability that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors (hereinafter, "first method of the invention” ), which comprises determining in a biological sample of said subject, at least one allele of one or more of the single nucleotide polymorphisms (SNPs) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or of any SNP of its corresponding ligation blocks, where
  • SNPs single nucleotide polymorphisms
  • the invention also relates to a method for determining the probability of a subject quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug, which comprises determining in an biological sample of said subject, at least one allele of one or more of the S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or of any SP of its corresponding linkage blocks, where
  • At least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of their subjects is determined in a biological sample of the subject under study corresponding ligation blocks, and the results obtained are correlated with the probability (high or low) that the subject under study quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors.
  • nicotinic cholinergic receptor agonist drugs include cytisine, dianicline and varenicline.
  • said nicotinic cholinergic receptor agonist drug is varenicline.
  • the subject is a human being of any sex, race or age.
  • the subject is an active consumer of tobacco, for example, a smoker of cigars, electronic cigars, cigars or pipes, or a consumer of snuff or snuff.
  • said subject is an active consumer of tobacco who voluntarily wishes to stop using tobacco, or who must stop using tobacco, for example, by medical prescription.
  • the biological sample from the subject under study is a biological sample that contains a nucleic acid, for example, DNA, genomic DNA (cDNA), complementary DNA (cDNA), RNA, heterogeneous nuclear RNA (mRNA), mRNA, etc., of the subject to evaluate.
  • Said biological sample may be isolated or extracted from a tissue, or it may be present in a biological fluid, for example, blood, saliva, etc. Methods for the isolation of biological samples from cells and tissues are well known to those skilled in the art.
  • said biological sample is a blood or saliva sample.
  • the biological sample when it is a whole blood sample, it can be used directly in the practice of the first method of the invention.
  • it is necessary to first extract the nucleic acid from the biological samples for example, cells present in a biological fluid; in that case, the total nucleic acids extracted from said biological samples represents the work material.
  • the isolation of nucleic acids from a biological sample that contains can be performed by methods known to those skilled in the art [see for example, Sambrook et al, 2001 "Molecular Cloning: A Laboratory Manual", 3rd edition , Cold Spring Harbor Laboratory Press, New York, vol. 1.3]. Also, sometimes, it may be necessary to amplify the extracted nucleic acid before proceeding with its analysis.
  • nucleic acid amplification Numerous methods of nucleic acid amplification are known; many of them are based on an enzymatic reaction, for example, polymerase chain reaction (PCR), ligase chain reaction (LCR), rolling circle amplification assays, "rolling-circle”, etc. . Information on such nucleic acid amplification methods can be found in Sambrook et al, 2001 (cited supra).
  • one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of their corresponding binding blocks are analyzed, and the nucleotides are determined present in said SNPs, in particular, nucleotides present in the polymorphic site the SNP that allows to identify the corresponding allele of the SNP.
  • nucleotides present in one or more of said SNPs in the sample containing nucleic acid of the subject under study can be performed by any method or technique capable of determining nucleotides present in a polymorphic site.
  • SNP any method or technique capable of determining nucleotides present in a polymorphic site.
  • SNP sequencing, mini-sequencing, hybridization, restriction fragment analysis, oligonucleotide binding assays, allele-specific PCR, HRM (High Resolution Melt) analysis, etc., or by any combination of these methods.
  • the person skilled in the art can use any appropriate method or technique to achieve that determination.
  • Nucleotides present in SNPs and, in particular, at polymorphic sites can be detected from any strand of nucleic acid or from both strands.
  • Illustrative, non-limiting examples of suitable methods, techniques or systems for analyzing nucleotides present at the polymorphic sites of the SNPs identified in the present invention include mini-sequencing methods, nucleic acid sequencing, hybridization, restriction fragment analysis. , oligonucleotide ligation assays, allele-specific PCR, HRM analysis, nucleic acid matrices ("DNA arrays"), for example, the technology available from Aclara BioSciences, Affymetrix, Agilent Technologies, Illumina Inc., Ion Torrent, Fluidigm, Nanopore Tech etc., techniques based on changing the mobility of amplified nucleic acid fragments, single strand conformation polymorphisms (SSCP), denaturing gradient gel electrophoresis (DGGE), CMC ("chemical mismatch cleavage” ), WAVE analysis, etc., or by any combination of such methods. Additional information on the analysis of the nucleotides present in the polymorphic sites of the SNPs can be found in Sambrook
  • the first method of the invention comprises genotyping or determining at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or the corresponding alleles of the SNPs of their binding blocks, in the biological sample of the subject under study.
  • the first method of the invention comprises determining a single allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or the corresponding allele of any of the SNPs of its corresponding ligation blocks, that is, determining the nucleotide present in the polymorphic site of said SNP.
  • a single allele of SNP rs678188 is determined; In another particular embodiment, a single allele of SNP rs9658498 is determined; in another particular embodiment, a single allele of SNP rs4821566 is determined; in another particular embodiment, a single allele of SNP rsl0891510 is determined; in another particular embodiment, a single allele of SNP rsl 1932367 is determined; in another particular embodiment, a single allele of SNP rs2023239 is determined; while, in another particular embodiment, a single allele of any of the SNPs of the corresponding binding blocks of the SNPs is determined rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 or rs2023239.
  • the first method of the invention comprises determining the two alleles of one or more of said SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or of any of the SNPs of their corresponding binding blocks .
  • the two alleles of SNP rs678188 are determined; in another particular embodiment, the two alleles of SNP rs9658498 are determined; in another particular embodiment, the two alleles of SNP rs4821566 are determined; in another particular embodiment, the two alleles of SNP rsl0891510 are determined; in another particular embodiment, the two alleles of SNP rsl 1932367 are determined; in another particular embodiment, the two alleles of SNP rs2023239 are determined; while, in another embodiment In particular, the two alleles of any of the S Ps of the corresponding binding blocks of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 or rs2023239 are determined.
  • the first method of the invention comprises determining one or both alleles of any 1, 2, 3, 4, or 5 SNPs of any of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or of the SNPs of their corresponding ligation blocks, while in another particular embodiment, said method comprises determining one or both alleles of the 6 SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or the corresponding SNPs of their corresponding ligation blocks
  • the SNPs identified in the present invention associated with the probability (high or low) of a subject giving up tobacco use in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, or with the prediction of the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors, or with the selection of a subject for a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors, or with the Selection of a therapy to be administered to a subject in need of therapy to abandon consumption, have the following characteristics:
  • SNP rs678188 is located in the PARD3 gene (partitioning defective 3), on human chromosome 10 (lOpl 1.21), corresponds to the sequence [ACGCCGCCCATTTCCTATTTCCTACC [C / T] GTGCTGGATTTGCTGA AACCGTCAC] (SEQ ID NO: 1), and is located in the ligation block that extends from nucleotide 34484338 to nucleotide 34509032; SNP rs9658498 is located in the NOS1 (nitric oxide synthase /) gene, on human chromosome 12 (12q24.2-q24.31), corresponds to the sequence [GGTCTCTGATTGTAAAATGAACCAAA [C / T] GTAGCCTCTACCACC TTGCTTAGAA] (SEQ ID NO: 2), and is located in the linkage block that extends from nucleotide 117657521 to nucleotide 117681829;
  • SNP rs4821566 is located in the CSF2RB gene (colony stimulating factor 2 beta receptor), on human chromosome 22 (22ql3.1), corresponds to the sequence: [GGGATCATCCTCATATTCTTGCAAGA [C / G] GAAAAGTTT ACCAGTGAGAACTAGG] (SEQ ID NO: 3), and is located in the linkage block that extends from nucleotide 37306899 to nucleotide 37319081;
  • - SNP rsl0891510 is located in the NCAM1 gene ⁇ mural cell adhesion molecule /), on human chromosome 11 (1 lq23.1), corresponds to the sequence:
  • SNP rsl 1932367 is located in the GRID2 gene (glutamate ionotrophic delta receptor), on human chromosome 4 (4q22), corresponds to the sequence:
  • TACACACACA (SEQ ID NO: 5), and is located in the linkage block that extends from nucleotide 94555780 to nucleotide 94579593; Y
  • SNP rs2023239 is located in the CNR1 gene ⁇ cannabinoid receptor /), on human chromosome 6 (6ql4-ql5), corresponds to the sequence:
  • SNPs rs678188, rs9658, rs96548, rs96548, rs9658, rs9658, rs9658, rs9658, rs9658, rs9658 and rs2023239 correspond to SNPs as they are collected in the NCBI single site polymorphism database (dbSNP, NCBI, http://www.ncbi.nlm.nih.gov/snp; March 2011) and according to HapMap Genome Browser (version 24, Phase 1 & 2).
  • nucleotide positions indicated for the linkage blocks are defined according to the Haploview software version 4.2 (corresponding to the September 2009 version).
  • Polymorphic sites are the following:
  • polymorphic site of SNP rs678188 corresponds to position 27 of the sequence SEQ ID NO: 1;
  • polymorphic site of SNP rs9658498 corresponds to position 27 of the sequence SEQ ID NO: 2;
  • polymorphic site of SNP rs4821566 corresponds to position 27 of the sequence SEQ ID NO: 3;
  • polymorphic site of SNP rsl0891510 corresponds to position 27 of the sequence SEQ ID NO: 4;
  • polymorphic site of SNP rsl 1932367 corresponds to position 27 of the sequence SEQ ID NO: 5; Y
  • polymorphic site of SNP rs2023239 corresponds to position 27 of the sequence SEQ ID NO: 6.
  • the specific nucleotide present at the polymorphic site of said SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 allows to identify the corresponding allele; thus, the C allele of SNP rs678188 corresponds to the allele in which there is a C in the polymorphic site of said SNP; the T allele of SNP rs9658498 corresponds to the allele in which there is a T in the polymorphic site of said SNP; the G allele of SNP rs4821566 corresponds to the allele in which there is a G in the polymorphic site of said SNP; the G allele of SNP rsl0891510 corresponds to the allele in which there is a G in the polymorphic site of said SNP; the G allele of SNP rsl 1932367 corresponds to the allele in which there is a G
  • Example 1 Studies carried out by the inventors (Example 1) have allowed the identification of nucleotides present in the polymorphic sites of the SNPs described in this document associated with a high probability that the subject under study will quit smoking in response to a varenicline-based therapy. , sometimes referred to in this description as "alleles associated with a high probability that a subject will quit smoking in response to a therapy based on a agonist drug of nicotinic cholinergic receptors "or simply” alleles of success. "These” alleles of success "are shown in Table 1.
  • the success alleles indicated in Table 1 correspond to the TOP strand of the DNA according to the Ilumina nomenclature for the identification of DNA strands.
  • the simplest case for the denomination of a strand occurs when one of the possible variations of the SNP is an adenine (A), and the remaining variation is either a cytosine (C) or a guanine (G).
  • the sequence of that SNP is called TOP.
  • T thymine
  • BOT sequence of this SNP is called BOT.
  • the SNP is a [A / T] or a [C / G]
  • Illumina uses a "sequential walk" technique to name the strand [A / T] and [C / G] of the SNPs.
  • the actual SNP is considered to be in the 'n' position.
  • the sequences immediately before and after the SNP are ' ⁇ - and' ⁇ +, respectively.
  • two base pairs before the SNP are at 'n-2' and two base pairs after the SNP 'n + 2', etc.
  • the sequential walk continues until an unambiguous pairing occurs (A / G, A / C, T / C, or T / G).
  • nucleotide A or T of the first unambiguous pair when nucleotide A or T of the first unambiguous pair is on the 5 'side of the SNP, then the sequence is called TOP.
  • nucleotide A or T of the first unambiguous pair is on the 3 'side of the SNP, then the sequence is called BOT.
  • the first method of the invention once at least one of the alleles of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / is determined in a biological sample of said subject or of any SNP of its corresponding linkage blocks, it is possible to determine the likelihood that the subject under study will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, for example, varenicline, cytisine, dianicline, or any other drug with a similar mechanism of action.
  • an agonist drug of nicotinic cholinergic receptors for example, varenicline, cytisine, dianicline, or any other drug with a similar mechanism of action.
  • the establishment of the probability (high or low) for the subject under study to quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors can be carried out based on the presence or absence of success alleles (that is, based on the presence or absence of nucleotides present at the polymorphic sites of said SNPs associated with a probability (high or low) that the subject under study quit smoking in response to therapy based on a nicotinic cholinergic receptor agonist drug) of said SNPS in the genome of the subject under study. Therefore, as previously mentioned:
  • the first method of the invention - the presence of both alleles C of the S P rs678188, or of the corresponding alleles of the S Ps of its linkage block;
  • high applied to the probability that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, as used herein, refers to the frequency with which a result is obtained, in this case, that a subject stops using tobacco in response to a treatment with an agonist drug of nicotinic cholinergic receptors, is greater than 50%.
  • the specific nucleotide present at the polymorphic site of said SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 allows to identify the corresponding allele; thus, the T allele of SNP rs678188 corresponds to the allele in which there is a T in the polymorphic site of said SNP; the C allele of SNP rs9658498 corresponds to the allele in which there is a C in the polymorphic site of said SNP; the C allele of SNP rs4821566 corresponds to the allele in which there is a C in the polymorphic site of said SNP; the T allele of SNP rsl0891510 corresponds to the allele in which there is a T in the polymorphic site of said SNP; the A allele of SNP rsl 1932367 corresponds to the allele in which there is an A at
  • the term "low” applied to the likelihood that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors refers to the frequency with which it obtains a result, in this case, that a subject stops using tobacco in response to a treatment with a nicotinic cholinergic receptor agonist drug, is less than 50%.
  • SNPs rs678188, rs9658498 and rs4821566 formed by SNPs rs678188, rs9658498 and rs4821566; these SNPs are related to a high probability that a subject in response to a therapy based on an agonist drug of nicotinic cholinergic receptors will quit smoking for a period of at least 3 months from the start of said therapy; Y
  • SNPs rsl0891510, rsl 1932367 and rs2023239 are related to a high probability that a subject in response to a therapy based on an agonist drug of nicotinic cholinergic receptors will quit smoking for a period of at least 12 months from the start of said therapy.
  • the first method of the invention contemplates the possibility of analyzing the presence or absence in a biological sample of said subject at least one of the alleles of one or more of the SNPs rs678188, rs9658498, rs4821566 or any combination of said SNPs, and / or the corresponding SNPs of their linkage block, wherein
  • the first method of the invention contemplates the possibility of analyzing the presence or absence in a biological sample of said subject at least one of the alleles of one or more of the SNPs rs678188, rs9658498, rs4821566 or any combination of said SNPs, and / or the corresponding SNPs of their linkage block, where
  • the first method of the invention contemplates the possibility of analyzing the presence or absence in a biological sample of said subject at least one allele of one or more of the SNPs rsl0891510, rsl 1932367 and rs2023239, or any combination of said SNPs, and / or the corresponding SNPs of their linkage block, wherein
  • the first method of the invention contemplates the possibility of analyzing the presence or absence in a biological sample of said subject at least one allele of one or more of the SNPs rsl0891510, rsl 1932367 and rs2023239, or any combination of said SNPs, and / or the corresponding SNPs of their linkage block, wherein
  • the first method of the invention makes it possible to establish the probability that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors. If said probability is high, for example, due to the presence of a successful allele in at least one of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 or rs2023239 (Table 1), or the corresponding alleles of the SNPs of its linkage block, then said subject may be an a priori appropriate candidate to receive a therapy based on a agonist drug of nicotinic cholinergic receptors in order to quit smoking, for example, varenicline, cytisine or dianicline, among others. On the contrary, if said probability is low, then said subject is not an appropriate a priori candidate to receive a therapy based on an agonist drug of nicotinic choline
  • the inventors have studied the possible influence of clinical variables, such as subjective stress, reasons for smoking and dependence according to the Fagerstrom scale, on the results of efficacy of said therapy based on an agonist drug of nicotinic cholinergic receptors with the in order to abandon tobacco consumption, as well as its role as confusing or modifying variables of the association studied, through the use of multiple logistic regression models.
  • the first method of the invention further comprises analyzing at least one clinical variable related to tobacco consumption.
  • said clinical variable related to tobacco consumption is selected from the group consisting of subjective stress, reasons for smoking, dependence according to the Fagerstrom scale, and Any of your combinations.
  • This probabilistic model based on the determination of at least one of the alleles of one or more of the SNPs identified in the present invention, or of the corresponding alleles of the SNPs of its linkage block, optionally together with a structured clinical evaluation, constitutes a valuable tool for predicting success or failure, based on a high or low probability, of smoking cessation by a subject, in response to treatment with an agonist drug of nicotinic cholinergic receptors, for example, varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action.
  • an agonist drug of nicotinic cholinergic receptors for example, varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action.
  • the specialist eg, a doctor
  • the specialist may optimize the therapeutic care of the subject by choosing, from the outset, the most appropriate therapy based on the probability (high or low) that the subject quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug and closely monitor the subjects under treatment. Therefore, the methods and means provided by the present invention can help physicians select the therapy to quit smoking more appropriate for a subject.
  • side effects associated with treatment with nicotinic cholinergic receptor agonists in subjects whose treatment with that drug is ineffective can be avoided.
  • Second method of the invention Method for predicting the efficacy of a therapy to quit smoking based on a nicotinic cholinergic receptor agonist drug.
  • the invention in another aspect, relates to a method for predicting the efficacy of a therapy for quitting tobacco use based on an agonist drug of nicotinic cholinergic receptors in a subject (hereinafter, "second method of the invention"), comprising determining in an biological sample of said subject at least one allele of one or more of the single nucleotide polymorphisms (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SP of their corresponding blocks ligation
  • S Ps single nucleotide polymorphisms
  • the invention also relates to a method of predicting the efficacy of a therapy for quitting tobacco use based on an agonist drug of nicotinic cholinergic receptors in a subject, which comprises determining in a biological sample of said subject, at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or of any SNP of its corresponding ligation blocks, wherein
  • predict the efficacy of a therapy refers to the determination of the result obtained by a subject in response to a therapy to quit based tobacco use.
  • a nicotinic cholinergic receptor agonist drug for example, varenicline, cytisine and dianicline, among others.
  • At least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of their subjects is determined in a biological sample of the subject under study corresponding ligation blocks, and the results obtained are correlated with the prediction of the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject.
  • nicotinic cholinergic receptor agonist drugs include cytisine, dianicline and varenicline.
  • said nicotinic cholinergic receptor agonist drug is varenicline.
  • the prediction that such therapy will be effective or ineffective in a subject can be carried out based on the presence or absence of the success alleles (i.e., based on the presence or absence of nucleotides present at the polymorphic sites of said SNPs associated with a prediction that said therapy based on a nicotinic cholinergic receptor agonist drug will be effective or ineffective) of said SNPS in the genome of the subject under study.
  • Such alleles of success in this case, alleles whose presence is associated with a prediction that therapy based on an agonist drug of nicotinic cholinergic receptors will be effective
  • Table 1 In a particular embodiment, of the second method of the invention:
  • the second method of the invention contemplates the possibility of determining at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566 or any combination of said SNPs, and / or the corresponding SNPs of their block of ligation where
  • said therapy based on a nicotinic cholinergic receptor agonist drug will be effective in a subject for a period of at least 3 months from the start of said therapy.
  • the second method of the invention contemplates the possibility of determining at least one allele of one or more of the SNPs rsl0891510, rsl 1932367, rs2023239, or any combination of said SNPs, and / or the corresponding SNPs of its linkage block, where
  • said therapy based on a nicotinic cholinergic receptor agonist drug will be effective in a subject for a period of at least 12 months from the start of said therapy.
  • the second method of the invention further comprises analyzing at least one clinical variable related to tobacco consumption.
  • said clinical variable related to tobacco consumption is selected from the group consisting of subjective stress, reasons for smoking, dependence according to the Fagerstrom scale, and any of your combinations
  • the combination of SNPs with clinical variables generally provides better models.
  • the second method of the invention makes it possible to predict the efficacy of a therapy for abandoning tobacco consumption based on an agonist drug of nicotinic cholinergic receptors in a subject, so that if the result of said prediction is that the therapy will be effective, then the subject can be treated with a nicotinic cholinergic receptor agonist drug to quit smoking, while, otherwise, if the result of such prediction were that the therapy will be ineffective, then the subject should not be treated with a agonist drug of nicotinic cholinergic receptors.
  • nicotinic cholinergic receptor agonist drugs include varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action.
  • This predictive model based on the determination of at least one of the alleles of one or more of the SNPs identified in the present invention, or of the corresponding alleles of the SNPs of its linkage block, optionally together with a structured clinical evaluation, constitutes a valuable tool for predicting the efficacy or ineffectiveness of a treatment with an agonist drug of nicotinic cholinergic receptors, for example, varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action.
  • an agonist drug of nicotinic cholinergic receptors for example, varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action.
  • the specialist eg, a doctor
  • the specialist will be able to optimize the therapeutic attention to the subject by choosing, from the outset, the most appropriate therapy based on the prediction of the efficacy or ineffectiveness of the subject quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, and closely monitor the subjects under treatment.
  • the methods and means provided by the present invention can help physicians select the therapy to quit smoking more appropriate for a subject.
  • side effects associated with treatment with nicotinic cholinergic receptor agonists in subjects whose treatment with that drug is ineffective can be avoided.
  • said nicotinic cholinergic receptor agonist drug is varenicline.
  • the invention relates to a method for selecting a subject for a therapy to quit tobacco use based on a nicotinic cholinergic receptor agonist drug (hereinafter, "third method of the invention"), which comprises determining in a biological sample of said subject at least one allele of one or more of the single nucleotide polymorphisms (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SP of its corresponding ligation blocks, where said subject is selected for said therapy if he has
  • S Ps single nucleotide polymorphisms
  • a subject is selected for a therapy to quit smoking based on a nicotinic cholinergic receptor agonist drug, when said subject has
  • the characteristics of the biological sample, the subject, the SNPs (rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239) and their corresponding ligation blocks, as well as those of their polymorphic sites, have already been mentioned previously in relation to the first method of the invention, as well as the methods for detrminating said SNPs and identifying the nucleotides present at the polymorphic sites of said SNPs; All this is incorporated into this method by reference.
  • At least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of its subjects is determined in a biological sample of the subject under study corresponding ligation blocks, and the results obtained are correlated with the possibility of selecting a subject to receive a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject.
  • nicotinic cholinergic receptor agonist drugs include cytisine, dianicline and varenicline.
  • said nicotinic cholinergic receptor agonist drug is varenicline.
  • the selection of the subject can be carried out based on the presence or absence of the alleles of success (ie, based on the presence or absence of the nucleotides present at the polymorphic sites of said S Ps associated with a prediction that said therapy based on a nicotinic cholinergic receptor agonist drug will be effective) of said SNPS in the genome of the subject under study.
  • Such alleles of success in this case, alleles whose presence is associated with a prediction that therapy based on an agonist drug of nicotinic cholinergic receptors will be effective
  • Table 1 are mentioned in Table 1.
  • the third method of the invention further comprises analyzing at least one clinical variable related to tobacco consumption.
  • said clinical variable related to tobacco consumption is selected from the group consisting of subjective stress, reasons for smoking, dependence according to the Fagerstrom scale, and Any of your combinations. The combination of SNPs with clinical variables generally provides better models.
  • the third method of the invention allows selecting a subject to receive a therapy to quit smoking based on an agonist drug of the nicotinic cholinergic receptors, so that if the subject is selected then said subject can be treated with an agonist drug. of nicotinic cholinergic receptors to quit smoking, while, otherwise, if the subject is not selected for such therapy then the subject should not be treated with a nicotinic cholinergic receptor agonist drug.
  • This selective model based on the determination of at least one of the alleles of one or more of the SNPs identified in the present invention, or of the corresponding alleles of the SNPs of its linkage block, optionally together with a structured clinical evaluation, constitutes A valuable tool for predicting the efficacy or ineffectiveness of a treatment with an agonist drug of nicotinic cholinergic receptors in a subject.
  • the specialist eg, a physician
  • receptor agonist drugs Nicotinic cholinergics include varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action.
  • the invention relates to a method for selecting a therapy for a subject in need of therapy to quit smoking (hereinafter, "fourth method of the invention"), which comprises determining in a biological sample of said subject at least one allele of one or more of the single nucleotide polymorphisms (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of their corresponding linker blocks, wherein a therapy is selected for abandon tobacco use based on a nicotinic cholinergic receptor agonist drug if said subject has
  • S Ps single nucleotide polymorphisms
  • a therapy is selected to quit smoking based on a nicotinic cholinergic receptor agonist drug, when said subject has
  • the characteristics of the biological sample, the subject, the SNPs (rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239) and their corresponding ligation blocks, as well as those of their polymorphic sites, have already been mentioned previously in relation to the first method of the invention, as well as the methods for detrminating said SNPs and identifying the nucleotides present at the polymorphic sites of said SNPs; All this is incorporated into this method by reference.
  • At least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of its subjects is determined in a biological sample of the subject under study corresponding ligation blocks, and the results obtained are correlated with the possibility of selecting a therapy for a subject in need of receiving therapy to quit smoking.
  • the selection of such therapy can be carried out based on the presence or absence of the success alleles (i.e., based on the presence or absence of nucleotides present at the polymorphic sites of said SNPs associated with a prediction that said therapy based on a nicotinic cholinergic receptor agonist drug will be effective) of said SNPS in the genome of the subject under study.
  • success alleles i.e., based on the presence or absence of nucleotides present at the polymorphic sites of said SNPs associated with a prediction that said therapy based on a nicotinic cholinergic receptor agonist drug will be effective
  • Such alleles of success are mentioned in Table 1.
  • the fourth method of the invention further comprises analyzing at least one clinical variable related to tobacco consumption.
  • said clinical variable related to tobacco consumption is selected from the group consisting of subjective stress, reasons for smoking, dependence according to the Fagerstrom scale, and Any of your combinations. The combination of SNPs with clinical variables generally provides better models.
  • the fourth method of the invention allows to select a therapy to abandon the consumption of tobacco to be administered to a subject based on an agonist drug of the nicotinic cholinergic receptors, so that such therapy is selected, among other therapies to quit smoking , when the genotype of the subject to be subjected to therapy has the previously mentioned characteristics, while, otherwise, if the subject does not have those characteristics, then one would have to select a therapy to quit the consumption of tobacco that was not based on drugs Nicotinic cholinergic receptor agonists.
  • This selective model based on the determination of at least one of the alleles of one or more of the SNPs identified in the present invention, or of the corresponding alleles of the SNPs of its linkage block, optionally together with a structured clinical evaluation, constitutes A valuable tool for predicting the efficacy or ineffectiveness of a treatment with an agonist drug of nicotinic cholinergic receptors in a subject.
  • the specialist eg, a doctor
  • the therapy to be administered to the subject in particular, a therapy based on an agonist drug of nicotinic cholinergic receptors (or other therapy based on others drugs), and closely monitor the efficacy of said selected therapy in subjects undergoing such therapy.
  • nicotinic cholinergic receptor agonist drugs include varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action. Kits of the invention
  • kits of the invention comprising at least one reagent for determining the presence of at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239, and / or the corresponding SNPs of its linkage block, and / or at least one reagent for determining the nucleotide present at the polymorphic site of said SNPs.
  • kit of the invention comprising at least one reagent for determining the presence of at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239, and / or the corresponding SNPs of its linkage block, and / or at least one reagent for determining the nucleotide present at the polymorphic site of said SNPs.
  • the kit of the invention comprises at least one reagent for determining the presence of a single SNP selected from the group consisting of SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and the corresponding SNPs of their blocks ligation, and at least one reagent to determine the nucleotide present in the polymorphic site of said SNP.
  • the kit of the invention comprises at least one reagent necessary to determine the presence of any 1, 2, 3, 4, 5, or even 6, SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 , and / or in the corresponding SNPs of their linkage blocks, and / or at least one reagent necessary to determine the nucleotide present in said SNPs.
  • the kit of the invention may also include means for extracting the sample from the subject and / or means or reagents for amplifying the nucleic acid present in said sample.
  • kits of the invention include one or more reagents for use in accordance with the present invention in suitable containers and packaging materials, including tubes, vials, and packaging techniques such as shrink wrapping and blow molding.
  • Materials suitable for inclusion in a kit according to the present invention comprise one or more of the following: pairs of PCR-specific primers (oligonucleotides) that hybridize with domains of the DNA or cDNA sequence flanking the SNPs of interest (SNPs) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and the corresponding SNPs of their linkage blocks); reagents capable of amplifying a domain of a specific sequence, either in the CDNA or cDNA without having to perform the PCR; reagents necessary to discriminate between the different alleles in the sequence of the domains amplified by PCR and PCR-not amplification (for example, restriction endonucleases,
  • Kits comprising one or more allele-specific oligonucleotides or polymorphism-specific or pairs of oligonucleotides are specifically contemplated, where each pair of allele-specific oligonucleotides or polymorphism-specific is directed to one of the polymorphism cited herein, i.e. S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 and / or the corresponding SNPs of their linkage blocks.
  • S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 and / or the corresponding SNPs of their linkage blocks i.e. S Ps rs678188, rs9658498, rs4821566, rsl0891510,
  • kits comprising a set of probes, comprising a plurality of oligonucleotide probes that interrogate SNPs selected from the group consisting of SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 and / or the corresponding SNPs of their linkage blocks, wherein said oligonucleotide probes account for at least 50% of the oligonucleotide probes of the probe set.
  • said set of probes comprising a plurality of oligonucleotide probes that interrogate for SNPs selected among said SNPs, wherein said oligonucleotide probes account for at least 50% of the oligonucleotide probes of the probe set, constitutes a further embodiment of this invention.
  • the kit comprises one or more pairs of polymorphism-specific or allele-specific oligonucleotides directed to two or more of the SNPs cited above, while another embodiment contemplates one or more oligonucleotides or pairs of polymorphism-specific or allele-specific oligonucleotides targeting all SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and / or the corresponding SNPs of their ligation blocks
  • the kit of the invention allows prediction of success in smoking cessation in response to a therapy based on an agonist drug of nicotinic cholinergic receptors. Therefore, in another aspect, the invention relates to the use of the kit of the invention for:
  • the invention relates to the use of at least one SNP to: determine the likelihood that a subject will quit smoking in response to therapy based on an agonist drug of nicotinic cholinergic receptors; or for
  • S P is selected from the group consisting of S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and any combination thereof and / or any SNP of their corresponding linkage blocks.
  • said SNP is selected from the group consisting of SNPs rs678188, rs9658498, rs4821566, or any combination of said SNPs, and / or the corresponding SNPs of its linkage block.
  • said SNP is it selects from the group formed by the SNPs rsl0891510, rsl 1932367, rs2023239, or any combination of said SNPs, and / or the corresponding SNPs of its linkage block.
  • the invention relates to a therapy for abandoning tobacco use based on an agonist drug of nicotinic cholinergic receptors for use in the treatment of a subject in need of therapy to abandon tobacco use, wherein said subject is selected by the third method of the invention.
  • said nictoinic cholinergic receptor agonist drug is selected from varenicline, cytisine and dianicline, preferably carenicline.
  • Nucleic acid samples can be genotyped to determine the alleles that are present in a particular gene region of interest, for example, the position of a particular SNP, by methods well known in the state of the art.
  • Candidate SNPs were identified by 3 different strategies, mainly aimed at including SNPs with a potential functional impact on protein structure and / or gene expression, as well as from the information of common variations throughout a given gene.
  • nsSNPs SNPs located in potential regions (5 'upstream, 5'-UTR, coding region, splicing sites, first intron, 3'-UTR and downstream 3').
  • SNPs were searched from 20 kilobases (kb) upstream 5 'from the start codon to 10 kb downstream 3' from the stop codon for a given gene.
  • the SNPs included in this group were those with a possible functional effect, specifically those that alter potential binding sites to transcription factors such as those that can be predicted through the use of Pupas View software (Conde et al. 2005, Nucleic Acid Res 33: W501-5) and SNPs located in conserved sequences between species, as determined by the use of UCSC Genome Browser Datábase (http://genome.ucsc.edu/index.html).
  • target SNPs were selected.
  • the main objective of this selection was to identify a set of SNPs targeting almost all known SNPs in a gene, including those located in potential regulatory regions that showed no evidence of functionality.
  • the target SNPs were defined as common SNPs with an estimated R2 greater than 0.8 (r2> 0.8) with other SNPs in subjects with European ancestry (CEU) in the HapMap database (Tagger, Haploview 3.2 ) (Barrett et al, 2005, Bioinformatics 21 (2): 263-265).
  • CEU European ancestry
  • SNPs with a described frequency of minor allele greater than 5% were selected in Caucasian populations of HapMap-CEU and PERLEGEN-EUR-Panel North America (ENSEMBL genome browser v. 3.3 -3.6; www.ensembl.org), with the objective of guaranteeing informative SNPs. All selected SNPs were filtered using the Illumina technology criteria (score> 0.6 or GoldengateValidated Status, Illumina Inc., San Diego, USA). The genotyping of SNPs was carried out at the National Genotyping Center (CeGen), Spain, using the Illumina Bead Array system (Illumina Inc., San Diego; USA).
  • Illumina Bead Array technology is based on particles ("beads") of 3 ⁇ that self-aggregate in microwells on one of the substrates: fiber optic beams or flat silica surfaces. When the particles are randomly assembled on one of these 2 substrates, they are arranged with a uniform separation of approximately 5.7 mm. Each particle is coated by hundreds of thousands of copies of a specific oligonucleotide that acts by capturing the sequences in one of Illumina's assays. On average, each type of particle is represented 30 times per sample, allowing a high degree of accuracy. The GoldenGate Genotyping assay genotyping assay was selected.
  • allele-specific oligonucleotides hybridize to gDNA, extend and bind to a locus-specific oligonucleotide (LSO).
  • PCR was carried out using universal primers.
  • the products of the multiplex reaction were hybridized for detection and analysis to a universal Sentrix Array.
  • the results obtained in DNA samples of blood duplicates were consistent with all SNPs genotyped by this method.
  • the DNA was quantified at the National Genotyping Center (CeGen) using the PicoGreen technique and diluted to a final concentration of 50 ng / ml. With this technique, the DNA concentration was determined by a fluorescent marker (PicoGreen ® , Molecular Probes) that binds to double stranded DNA and subsequent quantification in a fluorimeter.
  • PicoGreen ® fluorescent marker that binds to double stranded DNA and subsequent quantification in a fluorimeter.
  • TSN nicotine replacement therapy
  • the clinical results were related to the efficacy of pharmacological treatments.
  • the efficacy was evaluated 3 and 12 months after the start of treatment, according to previously established withdrawal criteria such as carbon monoxide measurement, clinical interviews and patient information.
  • candidate genes 80 candidate genes were selected based on their biological relevance and literature search as well as based on the bets of the candidate candidate genes.
  • 384 SNPs, insertion / deletion and tandem repeats were analyzed. For each gene the selection of the SNP was based on the following criteria:
  • SNPs located in regions that may influence the function of the gene upstream, 5'UTR, coding region, splicing sites, intron 1, 3'UTR and downstream).
  • the results shown below present the adjustment of two prediction models.
  • the first is a univariate model that only includes the genotype as an explanatory variable, while the second also includes clinical variables (subjective stress, reasons for smoking, and dependence according to the Fagerstrom scale).
  • the explanatory power of both models has been checked using the likelihood ratio test for nested models. A significant value indicates the need to explain the result through the multivariate model, while a non-significant p-value implies that the univariate model (genotype) would be sufficient to explain the result.
  • the C / T and C / C genotypes are associated with greater withdrawal at 3 months, with the C allele being the most important factor in explaining the success of withdrawal.
  • the prediction is better for the multivariate model (66% based on the area under the curve) than for the univariate.
  • the significance of «-value for nested models indicates that the multivariate model is significantly better than the univariate in predicting the outcome.
  • Figure 1 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to the SNP rs678188. rs9658498 (Chr 12; US 1)
  • Figure 2 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to the SNP rs9658498.
  • rs4821566 Chor 22; CSF2RB
  • SNPs rs678188, rs9658498 and rs4821566 have a predictive value of efficacy at three months of a pharmacological treatment for smoking cessation based on varenicline when analyzed together.
  • T the most important factor in the explanation of failure in withdrawal.
  • the prediction is better for the multivariate model (64% based on the area under the curve) than for the univariate.
  • the significance of «-value for nested models indicates that the multivariate model is significantly better than the univariate in predicting the outcome.
  • Figure 4 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to SNP rsl0891510. rsl 1932367 (Chr 4; GRID2)
  • Figure 5 shows the ROC curves corresponding to the univariate (upper graph) and multivariate (lower graph) models in relation to SNP rsl 1932367. rs2023239 (Chr 6; CNR1)
  • the C / T and C / C genotypes are associated with greater abstinence at 12 months, with the C allele being the most important factor in explaining success in withdrawal.
  • the prediction is better for the multivariate model (66% based on the area under the curve) than for the univariate.
  • the significance of «-value for nested models indicates that the multivariate model is significantly better than the univariate in predicting the outcome.
  • Figure 6 shows the ROC curves corresponding to the univariate (upper graph) and multivariate (lower graph) models in relation to SNP rs2023239.
  • AAIGRT Upstream intergenic transcriptional regulator
  • AANF Upstream non-functional
  • AARR Upstream regulatory region
  • AARRP Upstream promoter region regulator
  • AART Upstream transcriptional regulator
  • ABNF Downstream non-functional
  • ABRT Downstream transcriptional regulator
  • CG CpG Site
  • IGNF Non-functional intergenic
  • IGRT Intergenic transcriptional regulator
  • IP Intronic enhancer
  • IRT Intronic transcriptional regulator
  • ISI Intronic without information
  • ND Data not available.
  • AAIGRT Upstream intergenic transcriptional regulator
  • AANI Upstream no information
  • AARR Upstream regulatory region
  • AARRP Upstream promoter region regulator
  • AART Upstream transcriptional regulator
  • ABNF Downstream non-functional
  • ABRT Downstream transcriptional regulator
  • CG CpG Site
  • IGNF Non-functional intergenic
  • IGRT Intergenic transcriptional regulator
  • IP Intronic enhancer
  • IRT Intronic transcriptional regulator
  • ISI Intronic without information
  • ND Data not available.
  • SEQUENCE LISTING means "LIST OF SEQUENCES”.

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Description

MÉTODO PARA PREDECIR EL ÉXITO EN EL ABANDONO DEL CONSUMO DE TABACO EN RESPUESTA A UN TRATAMIENTO FARMACOLÓGICO  METHOD FOR PREACHING SUCCESS IN THE ABANDONMENT OF TOBACCO CONSUMPTION IN RESPONSE TO A PHARMACOLOGICAL TREATMENT

CAMPO DE LA INVENCIÓN FIELD OF THE INVENTION

La presente invención se relaciona, en general, con métodos para predecir el éxito en el cese del consumo de tabaco en respuesta a un tratamiento farmacológico con un fármaco agonista de los receptores colinérgicos nicotínicos, basados en la presencia de determinados polimorfismos y, opcionalmente, en combinación, con unas variables clínicas.  The present invention relates, in general, to methods for predicting success in cessation of tobacco use in response to a pharmacological treatment with an agonist drug of nicotinic cholinergic receptors, based on the presence of certain polymorphisms and, optionally, in combination, with some clinical variables.

ANTECEDENTES DE LA INVENCIÓN BACKGROUND OF THE INVENTION

El consumo de tabaco es uno de los mayores problemas de salud pública de nuestros días ya que constituye uno de los principales factores de riesgo de diversas enfermedades crónicas, por ejemplo, enfermedades pulmonares, cardiovasculares y cáncer. A pesar de ello, el consumo de tabaco continúa estando muy extendido en todo el mundo. De hecho, se calcula que hay cerca de 1 billón de fumadores en el mundo. Tan solo en España, unas 500.000 personas al año enferman por tabaquismo pasivo, siendo el 65% de ellas niños de corta edad. Asimismo, el humo del tabaco es responsable de bronquitis y neumonía en menores de 18 meses, entre 25.000 y 51.000 casos al año aproximadamente, que obligan a alrededor de 1.300 hospitalizaciones/año por ese motivo. Por otro lado, el promedio de adultos no fumadores fallecidos por cáncer de pulmón es de unos 400 casos anuales. A todo esto hay que agregar el alto número de afectados (entre 6.000 y 11.000 aproximadamente) de infarto de miocardio o angina de pecho que también han requerido hospitalización. A pesar de esto, en España el 31,8% de los adultos son fumadores actuales, y esta tasa se ha mantenido estable durante los últimos años (Plan Nacional sobre Drogas, 2009).  Tobacco use is one of the biggest public health problems of today because it constitutes one of the main risk factors for various chronic diseases, for example, lung, cardiovascular and cancer diseases. Despite this, tobacco use continues to be widespread throughout the world. In fact, it is estimated that there are about 1 billion smokers in the world. In Spain alone, about 500,000 people a year become ill from passive smoking, 65% of them being young children. Likewise, tobacco smoke is responsible for bronchitis and pneumonia in children under 18 months, between approximately 25,000 and 51,000 cases per year, which require around 1,300 hospitalizations / year for that reason. On the other hand, the average number of non-smoking adults killed by lung cancer is about 400 cases annually. To all this we must add the high number of affected (between 6,000 and 11,000 approximately) of myocardial infarction or angina pectoris that have also required hospitalization. Despite this, in Spain 31.8% of adults are current smokers, and this rate has remained stable during the last years (National Drug Plan, 2009).

En los países en los que ya se ha establecido la educación contra el tabaco, por ejemplo España, más del 80% de los fumadores están interesados en abandonar el consumo de tabaco y más del 40% de personas intentan dejar de fumar cada año (Shiffman et al. 2008, Am J Prev Med, 35(2): 158-176).  In countries where tobacco education has already been established, for example Spain, more than 80% of smokers are interested in quitting tobacco use and more than 40% of people try to quit smoking every year (Shiffman et al. 2008, Am J Prev Med, 35 (2): 158-176).

Se distinguen dos líneas terapéuticas principales en el abordaje del tratamiento de la dependencia a la nicotina: la terapia farmacológica no nicotínica y la terapia sustitutiva de nicotina ya que la nicotina es el principal compuesto psicoactivo en el tabaco. En ambos casos, se considera que el coadyuvante de la predisposición psicológica y su abordaje cognitivo-conductual, es esencial para conseguir superar la dependencia. Two main therapeutic lines are distinguished in the approach to the treatment of nicotine dependence: non-nicotinic drug therapy and therapy Nicotine substitute since nicotine is the main psychoactive compound in tobacco. In both cases, it is considered that the coadjuvant of the psychological predisposition and its cognitive-behavioral approach is essential to overcome the dependence.

La terapia farmacológica no nicotínica se lleva a cabo con el uso de medicamentos que imitan la molécula de la nicotina y la sustituyen en la fijación en los receptores nicotínicos, o mediante otros medicamentos con indicación aprobada para abandonar el consumo de tabaco; entre los medicamentos más empleados, se encuentran el bupropión, la nortriptilina, la vareniclina y la citisina. Mediante la administración de estos fármacos se obtiene una tasa de éxito en los intentos de abandonar el consumo de tabaco que duplica la tasa obtenida en ausencia de los mismos, por lo que dichos fármacos contribuyen sustancialmente a mejorar la salud y a reducir el riesgo de mortalidad prematura (Fant et al. 2009, Handb Exp Pharmacol (192):487-510).  Non-nicotinic drug therapy is carried out with the use of drugs that mimic the nicotine molecule and replace it in the fixation in nicotinic receptors, or through other medications with an approved indication to quit smoking; Among the most commonly used medications are bupropion, nortriptyline, varenicline and citisine. By administering these drugs, a success rate is obtained in attempts to quit tobacco consumption that doubles the rate obtained in their absence, so that these drugs contribute substantially to improving health and reducing the risk of premature mortality. (Fant et al. 2009, Handb Exp Pharmacol (192): 487-510).

La terapia basada en administrar nicotina en dosis limitadas a través de medios alternativos (chicles, parches, pastillas e inhaladores), conocida como terapia sustitutiva de nicotina (TSN), presenta el problema de su contraindicación para aquellos con problemas precisamente derivados del consumo de nicotina a través del tabaco e incluso la posibilidad de que ella misma cree adicción. No obstante, los sustitutos de nicotina fumada pueden ayudar a superar la abstinencia de los fumadores dependientes que dejan de fumar si se usan durante plazos cortos, no superiores a 9 semanas. En general, se utilizan parches diariamente con una concentración constante de nicotina durante 3 semanas y luego se van cambiando por otros con menor dosis de nicotina. Mientras tanto el cerebro se adapta a funcionar sin nicotina y adquiere otros hábitos saludables. El hecho de que los parches liberen la nicotina en forma constante no genera adicción ya que no se produce un pico de nicotina en sangre que es lo que refuerza el deseo de fumar.  Therapy based on administering nicotine in limited doses through alternative means (chewing gum, patches, pills and inhalers), known as nicotine replacement therapy (TSN), presents the problem of its contraindication for those with problems precisely derived from the consumption of nicotine through tobacco and even the possibility that she herself creates addiction. However, smoked nicotine substitutes can help overcome withdrawal from dependent smokers who quit smoking if used for short periods of time, not exceeding 9 weeks. In general, patches are used daily with a constant concentration of nicotine for 3 weeks and then they are exchanged for others with a lower dose of nicotine. Meanwhile the brain adapts to function without nicotine and acquires other healthy habits. The fact that the patches release nicotine steadily does not generate addiction since there is no blood nicotine peak that reinforces the desire to smoke.

La TSN, el apoyo psicológico, y el tratamiento farmacológico con bupropión, vareniclina o nortriptilina han demostrado tener un efecto clínicamente significativo. Actualmente, la eficacia de todos los tratamientos puede considerarse idéntica a las 52 semanas (Aubin et al. 2008, Thorax 63(8):717-24). Desafortunadamente, sin tratamiento, aproximadamente el 3-5% de los fumadores que desean dejar de fumar logra tasas de abstinencia de un año, pero muchos de los que logran una abstinencia al año recaerán en los próximos 2 años (Organización Mundial de la Salud, 2004). TSN, psychological support, and pharmacological treatment with bupropion, varenicline or nortriptyline have been shown to have a clinically significant effect. Currently, the efficacy of all treatments can be considered identical at 52 weeks (Aubin et al. 2008, Thorax 63 (8): 717-24). Unfortunately, without treatment, approximately 3-5% of smokers who wish to quit smoking It achieves one year abstinence rates, but many of those who achieve one year abstinence will fall within the next 2 years (World Health Organization, 2004).

El tabaquismo representa un comportamiento complejo que incluye el inicio en el consumo del tabaco, su progresión al uso regular, dependencia, abandono y recaída. Junto con los factores ambientales, existen evidencias de la influencia genética en el establecimiento, mantenimiento y cese del consumo de tabaco. Estudios de asociación refieren una influencia del genotipo del 40-60% (Uhl et al. 2007, BMC Genet 3 :8-10).  Smoking represents a complex behavior that includes the beginning of tobacco consumption, its progression to regular use, dependence, abandonment and relapse. Together with environmental factors, there is evidence of the genetic influence on the establishment, maintenance and cessation of tobacco consumption. Association studies report a genotype influence of 40-60% (Uhl et al. 2007, BMC Genet 3: 8-10).

La información genética puede ser de utilidad para identificar a los fumadores con posibilidades razonadas de abandonar el consumo de tabaco frente a los que carecen de ellas. De hecho, se han descrito polimorfismos de genes específicos que contribuyen a la variabilidad de la respuesta cognitiva a la nicotina, la cual influye en el proceso de dependencia de la abstinencia, e influyen en los procesos del inicio, la adicción y cese de su consumo. Por todo ello, es de esperar que las variaciones genéticas puedan influir en la respuesta fármaco-terapéutica de los fármacos utilizados en el abandono del consumo de tabaco. Dado que la nicotina es el principal componente psicoadictivo del tabaco, la mayoría de los genes candidatos en estudios farmacogenéticos se centran en los receptores nicotínicos involucrados en el metabolismo de la nicotina. Sin embargo, otros genes con relevancia biológica, con demostradas variaciones fenotípicas y genotípicas, pueden afectar a la eficacia de los fármacos utilizados para abandonar el consumo de tabaco.  Genetic information can be useful to identify smokers with reasonable possibilities of quitting tobacco use against those who lack them. In fact, specific gene polymorphisms have been described that contribute to the variability of the cognitive response to nicotine, which influences the process of dependence on withdrawal, and influences the processes of initiation, addiction and cessation of consumption. . Therefore, it is expected that genetic variations can influence the pharmaco-therapeutic response of the drugs used in smoking cessation. Since nicotine is the main psychoadictive component of tobacco, most candidate genes in pharmacogenetic studies focus on nicotinic receptors involved in nicotine metabolism. However, other genes with biological relevance, with proven phenotypic and genotypic variations, may affect the efficacy of the drugs used to quit smoking.

Un estudio de asociación del genoma completo (GWA) ha identificado diferentes genes involucrados en el éxito de la abstinencia entre sujetos tratados con mecamilamina y TSN (Uhl et al. 2007, BMC Genet 3 :8-10). Además, una reciente revisión sistemática ha identificado 75 genes asociados a 13 rutas metabólicas diferentes que parecen influir en el abandono del consumo de tabaco (Wang & Li 2010, Neuropsychopharmacology 35(3):702-719). Las variantes farmacogenéticas que selectivamente distinguen entre la respuesta terapéutica a TSN y bupropión también han sido publicadas (Uhl et al. 2008, Arch Gen Psychiatry 65(6):683-693).  A complete genome association study (GWA) has identified different genes involved in the success of withdrawal among subjects treated with mecamilamina and TSN (Uhl et al. 2007, BMC Genet 3: 8-10). In addition, a recent systematic review has identified 75 genes associated with 13 different metabolic pathways that appear to influence smoking cessation (Wang & Li 2010, Neuropsychopharmacology 35 (3): 702-719). Pharmacogenetic variants that selectively distinguish between the therapeutic response to TSN and bupropion have also been published (Uhl et al. 2008, Arch Gen Psychiatry 65 (6): 683-693).

Los estudios farmacogenéticos constituyen un método poderoso para identificar variantes genéticas que contribuyen a establecer las bases de las enfermedades complejas, entre las que se incluyen las adicciones (Detera-Wadleigh & McMahon 2004, Int Rev Psychiatry 16(4):301-310). Los polimorfismos más frecuentes conocidos actualmente son los polimorfismos de un solo nucleótido (S Ps). Los S Ps se producen a lo largo de todo el genoma, tanto en regiones extragénicas como en regiones codificantes o en sus secuencias reguladoras. El cambio de un solo nucleótido puede causar: (i) la sustitución de un aminoácido, si está en una secuencia exónica, variando la función de la proteína, (ii) la modificación de la cantidad de la proteína, si el SNP está en una región reguladora, o (iii) el cambio de la estructura de la proteína, si el cambio está en una zona de splicing. Estas diferencias individuales proporcionan la base del modelo de la farmacogenética. Pharmacogenetic studies are a powerful method to identify genetic variants that help establish the basis of complex diseases, including addictions (Detera-Wadleigh & McMahon 2004, Int Rev Psychiatry 16 (4): 301-310). The most frequent polymorphisms known currently they are single nucleotide polymorphisms (S Ps). S Ps occur throughout the genome, both in extragenic regions and in coding regions or in their regulatory sequences. The change of a single nucleotide can cause: (i) the substitution of an amino acid, if it is in an exonic sequence, varying the function of the protein, (ii) the modification of the amount of the protein, if the SNP is in a regulatory region, or (iii) the change in protein structure, if the change is in a splicing zone. These individual differences provide the basis of the pharmacogenetic model.

Dado que la nicotina es el principal compuesto psicoactivo en el tabaco, la mayoría de los genes candidatos analizados en estudios de farmacogenética se han centrado en los receptores nicotínicos y genes implicados en el metabolismo de la nicotina. Entre los genes implicados en la vulnerabilidad a nicotina se encuentran aquellos genes vinculados a las vías de la neurotransmisión dopaminérgica, especialmente los del receptor D2 (DRD2) y el transportador de dopamina (DAT o SLC6A3). Igualmente, las enzimas del metabolismo dopaminérgico COMT y MAO-B presentan variabilidad interindividual que podría contribuir a las diferentes respuestas ante sustancias con potencial adictivo (Barrueco et al. 2005, Med Clin (Barc) 124(6):223-8). Por otro lado, el metabolismo de la nicotina está sujeto a variantes genéticas en el citocromo P450, encargado de su metabolismo a cotinina.  Since nicotine is the main psychoactive compound in tobacco, most of the candidate genes analyzed in pharmacogenetic studies have focused on nicotinic receptors and genes involved in nicotine metabolism. Among the genes involved in nicotine vulnerability are those genes linked to the dopaminergic neurotransmission pathways, especially those of the D2 receptor (DRD2) and the dopamine transporter (DAT or SLC6A3). Likewise, the enzymes of the dopaminergic metabolism COMT and MAO-B present interindividual variability that could contribute to the different responses to substances with addictive potential (Barrueco et al. 2005, Med Clin (Barc) 124 (6): 223-8). On the other hand, the metabolism of nicotine is subject to genetic variants in the cytochrome P450, responsible for its metabolism to cotinine.

En el caso de la TSN, se ha sugerido que variantes en las subunidades del receptor colinérgico nicotínico pueden afectar a la intensidad de los efectos de la misma. El tipo más frecuente de receptor colinérgico nicotínico (CHRN) presente en el sistema nervioso central (SNC) es el α4β2. El consumo de tabaco modifica la expresión de otras subunidades como la a7 y la a5, modificando así la estructura del receptor y de sus funciones acopladas. Por otro lado, el metabolismo de nicotina es muy sensible a los SNPs en el CYP2A6. Ciertas variantes, tales como la *2 y la *4 son menos activas, lo que supone mayor sensibilidad a los efectos adversos de los parches de nicotina.  In the case of TSN, it has been suggested that variants in the nicotinic cholinergic receptor subunits may affect the intensity of its effects. The most common type of nicotinic cholinergic receptor (CHRN) present in the central nervous system (CNS) is α4β2. Tobacco use modifies the expression of other subunits such as a7 and a5, thus modifying the structure of the receptor and its coupled functions. On the other hand, nicotine metabolism is very sensitive to SNPs in CYP2A6. Certain variants, such as * 2 and * 4 are less active, which means greater sensitivity to the adverse effects of nicotine patches.

El bupropión es un fármaco que utiliza el transportador de dopamina DAT y la consecuente modulación dopaminérgica como mecanismo de ayuda en la deshabituación tabáquica. Ciertas variantes del DAT podrían representar una resistencia a los efectos del mismo. Por otro lado, se ha descrito, en uno de los pocos estudios metodológicamente bien diseñados (Berrettini et al. 2007, Biol Psychiatry 61(1): 111- 118), que las respuestas a bupropión pueden variar en función de la mayor o menor disponibilidad sináptica de dopamina controlada por variantes de la COMT. El metabolismo de bupropión también es dependiente del citocromo CYP2B6, así alguna de sus variantes, por ejemplo, la *4, proporciona un mayor aclaramiento de bupropión y como consecuencia, una menor eficacia del mismo. Bupropion is a drug that uses the DAT dopamine transporter and the consequent dopaminergic modulation as a mechanism for smoking cessation. Certain variants of the DAT could represent a resistance to its effects. On the other hand, it has been described, in one of the few methodologically well-designed studies (Berrettini et al. 2007, Biol Psychiatry 61 (1): 111- 118), that bupropion responses may vary depending on the greater or lesser synaptic availability of dopamine controlled by COMT variants. The metabolism of bupropion is also dependent on cytochrome CYP2B6, thus some of its variants, for example, * 4, provides a greater clearance of bupropion and as a consequence, a lower efficacy thereof.

En el caso de la vareniclina, dada su reciente introducción comercial, únicamente se ha publicado un estudio no independiente de asociación con variantes genéticas centrado en farmacogenética (King et al. 2012, Neuropsychopharmacology 37:641-650). En dicho estudio se relaciona la abstinencia continuada en pacientes bajo tratamiento con vareniclina durante las semanas 9-12 de tratamiento con SNP presentes en genes relacionados con receptores nicotínicos colinérgicos (CHRN) y en genes en desequilibrio de unión de la región cromosómica Chrl5q25. Sin embargo, los genes relacionados con receptores nicotínicos descritos en este estudio hacen referencia a una diana farmacológica de vareniclina, lo cual no es extensible a los procesos neurobiológicos de dependencia, puesto que en el estado de la técnica no hay evidencias que indiquen que los genes descritos en dicho estudio estén relacionados con procesos neurobiológicos de dependencia, únicamente están descritos en su relación con dependencia a nicotina. Por otro lado, la interrelación del cluster CHRNA5-CHRNA3- CHRNB4 con dependencia no ha sido reproducida en los últimos meta-análisis y estudios publicados (Maes HH et al. 2004 Psychol Med 34(7): 1251-6; Rodríguez S et al. 2011 J Psychopharmacol 25(7):915-23; Wang J & Li MD 2010 Neuropsychopharmacology 35(3):702-19; Trinidad DR et al. 2011 Am J Public Health 101(4):699-706; Budulac SE et al. 2012 PLoS One 7(3):e33386; De Ruyck K et al. 2010 Pharmacogenomics 11(8): 1053-6; Verde Z et al. 2011 PLoS One 6(10):e26668, Marques- Vidal P et al. 2011 Nicotine Tob Res 13(9):833-9).  In the case of varenicline, given its recent commercial introduction, only a non-independent study of association with genetic variants focused on pharmacogenetics has been published (King et al. 2012, Neuropsychopharmacology 37: 641-650). In this study, continued abstinence is related in patients under treatment with varenicline during weeks 9-12 of treatment with SNPs present in genes related to cholinergic nicotinic receptors (CHRN) and in genes in union imbalance of the Chrl5q25 chromosomal region. However, the genes related to nicotinic receptors described in this study refer to a pharmacological target of varenicline, which is not extensible to neurobiological dependence processes, since in the state of the art there is no evidence to indicate that the genes described in this study are related to neurobiological dependence processes, they are only described in their relationship with nicotine dependence. On the other hand, the interrelation of the CHRNA5-CHRNA3-CHRNB4 cluster with dependence has not been reproduced in the latest meta-analyzes and published studies (Maes HH et al. 2004 Psychol Med 34 (7): 1251-6; Rodríguez S et al . 2011 J Psychopharmacol 25 (7): 915-23; Wang J & Li MD 2010 Neuropsychopharmacology 35 (3): 702-19; Trinidad DR et al. 2011 Am J Public Health 101 (4): 699-706; Budulac SE et al. 2012 PLoS One 7 (3): e33386; De Ruyck K et al. 2010 Pharmacogenomics 11 (8): 1053-6; Verde Z et al. 2011 PLoS One 6 (10): e26668, Marques- Vidal P et al. 2011 Nicotine Tob Res 13 (9): 833-9).

Dado que las variaciones genéticas influyen en las respuestas farmacoterapéuticas a los medicamentos utilizados para dejar de fumar, sería conveniente conocer la relación entre estos dos factores. El aumento de la probabilidad de un sujeto de abandonar el consumo del tabaco presenta un escenario prometedor en el que la farmacogenómica podría proporcionar mejoras sustanciales para la salud.  Since genetic variations influence pharmacotherapeutic responses to medications used to quit smoking, it would be convenient to know the relationship between these two factors. The increased likelihood of a subject abandoning tobacco use presents a promising scenario in which pharmacogenomics could provide substantial health improvements.

Por tanto, sigue existiendo la necesidad de realizar estudios que permitan determinar el éxito derivado del uso de fármacos dirigidos al abandono del consumo de tabaco, en particular, de fármacos agonistas de los receptores colinérgicos nicotínicos, entre los que se encuentran la vareniclina, la citisina y la dianiclina, entre otros. Por ello, se hace necesario el desarrollo de metodologías que permitan determinar el éxito de un tratamiento farmacológico con dichos fármacos en el cese del consumo de tabaco. Therefore, there is still a need for studies to determine the success derived from the use of drugs aimed at abandoning drug use. tobacco, in particular, from nicotinic cholinergic receptor agonist drugs, among which are varenicline, cytisine and dianicline, among others. Therefore, it is necessary to develop methodologies to determine the success of a drug treatment with these drugs in the cessation of smoking.

COMPENDIO DE LA INVENCIÓN SUMMARY OF THE INVENTION

Los autores de la presente invención han identificado unos polimorfismos de nucleótido único (SNPs) cuya presencia, opcionalmente junto a un compendio de variables clínicas, está relacionada con una mayor o menor probabilidad de éxito en el abandono del consumo de tabaco en respuesta a un tratamiento farmacológico basado en vareniclina, un fármaco agonista de los receptores colinérgicos nicotínicos. Los inventores realizaron un estudio para determinar el perfil farmacogenómico asociado con la eficacia de un tratamiento farmacológico para dejar de fumar basado en vareniclina, evaluándose los resultados obtenidos en términos de abstinencia de consumo tabáquico a 3 meses (eficacia a corto plazo) y a 12 meses (eficacia a largo plazo). Se genotiparon 384 SNPs en un total de 807 sujetos, de los cuales 479 habían recibido, o estaban recibiendo, tratamiento farmacológico con vareniclina, y se estudió la asociación de sus genotipos con el abandono del consumo de tabaco en respuesta a dicho tratamiento farmacológico encontrándose que los alelos de determinados SNPs, concretamente de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y/o rs2023239, o cualquier SNP de sus correspondientes bloques de ligamiento, estaban significativamente asociados. Los SNP identificados en la presente solicitud se localizan en genes que están implicados en procesos neurobiológicos de dependencia, un proceso que implica a los diferentes sistemas de recompensa cerebral (áreas mesolímbicas y mesocortical) y a sus neurotransmisores y receptores (Lingford-Hughes A & Nutt D 2003 Brit J Psych 182: 97-100; Neuroscience of Psychoactive Substance Use and Dependence 2004 WHO). Así, el SNP rs678188 se localiza en el gen PARD3 (partitioning defective 3), el SNP rs9658498 se localiza en el gen NOS1 (nitric oxide synthase 1), el SNP rs4821566 se localiza en el gen CSF2RB (colony stimulating factor 2 receptor beta), el SNP rsl0891510 se localiza en el gen NCAM1 (neural cell adhesión molecule 1), el SNP rsl 1932367 se localiza en el gen GRID2 (glutamate receptor ionotrophic delta) y el SNP rs2023239 se localiza en el gen CNR1 (cannabinoid receptor 1). Estos genes han sido descritos en la literatura en relación a procesos neurobiológicos de dependencia en todos los casos, tal como en Weruaga E at al. 2002 J Neurosci Res 67: 689-697 (en relación al gen NOS), Chen P et al. 2011 World J Biol Psychiatry 12(3): 233-238 (en relación al gen CSFR2B), Nelson EC et al. 2013 JAMA Psychiatry: E1-E9 (en relación al gen NCAM1), Nikpay M et al. 2012 Hypertension Res 35: 585-591 (en relación al gen GRID2) y Benyamina A et al. 2010 Addiction Biol 16: 1-6 (en relación al gen CNR1). Este hallazgo abre la puerta a unos nuevos predictores genéticos útiles en la predicción del éxito en el abandono del consumo de tabaco por un sujeto en respuesta a un tratamiento farmacológico basado en un fármaco agonista de los receptores colinérgicos nicotínicos, tales como, por ejemplo, vareniclina, citisina y dianiclina, entre otros. Basándose en estos hallazgos, los inventores han desarrollado los métodos de la presente invención. La información proporcionada por dichos métodos puede ser utilizada eficientemente por el especialista en el diseño de tratamientos personalizados para el abandono del consumo de tabaco. The authors of the present invention have identified single nucleotide polymorphisms (SNPs) whose presence, optionally together with a compendium of clinical variables, is related to a greater or lesser probability of success in quitting tobacco use in response to a treatment Pharmacological based on varenicline, a nicotinic cholinergic receptor agonist drug. The inventors conducted a study to determine the pharmacogenomic profile associated with the efficacy of a pharmacological treatment for smoking cessation based on varenicline, evaluating the results obtained in terms of withdrawal from smoking at 3 months (short-term efficacy) and 12 months ( long term effectiveness). 384 SNPs were genotyped in a total of 807 subjects, of which 479 had received, or were receiving, pharmacological treatment with varenicline, and the association of their genotypes with smoking cessation in response to said pharmacological treatment was found, finding that the alleles of certain SNPs, specifically the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and / or rs2023239, or any SNP of their corresponding linkage blocks, were significantly associated. The SNPs identified in the present application are located in genes that are involved in neurobiological dependency processes, a process that involves the different brain reward systems (mesolimbic and mesocortical areas) and their neurotransmitters and receptors (Lingford-Hughes A & Nutt D 2003 Brit J Psych 182: 97-100; Neuroscience of Psychoactive Substance Use and Dependence 2004 WHO). Thus, the SNP rs678188 is located in the PARD3 gene (partitioning defective 3), the SNP rs9658498 is located in the NOS1 gene (nitric oxide synthase 1), the SNP rs4821566 is located in the CSF2RB gene (colony stimulating factor 2 beta receptor) , the SNP rsl0891510 is located in the NCAM1 gene (neural cell adhesion molecule 1), the SNP rsl 1932367 is located in the GRID2 gene (glutamate ionotrophic delta receptor) and the SNP rs2023239 is located in the CNR1 gene (cannabinoid receiver 1). These genes have been described in the literature in relation to neurobiological processes of dependence in all cases, as in Weruaga E at al. 2002 J Neurosci Res 67: 689-697 (in relation to the NOS gene), Chen P et al. 2011 World J Biol Psychiatry 12 (3): 233-238 (in relation to the CSFR2B gene), Nelson EC et al. 2013 JAMA Psychiatry: E1-E9 (in relation to the NCAM1 gene), Nikpay M et al. 2012 Hypertension Res 35: 585-591 (in relation to the GRID2 gene) and Benyamina A et al. 2010 Addiction Biol 16: 1-6 (in relation to the CNR1 gene). This finding opens the door to new genetic predictors useful in predicting success in smoking cessation by a subject in response to a pharmacological treatment based on an agonist drug of nicotinic cholinergic receptors, such as, for example, varenicline. , citisine and dianicline, among others. Based on these findings, the inventors have developed the methods of the present invention. The information provided by these methods can be used efficiently by the specialist in the design of personalized treatments for smoking cessation.

Los aspectos inventivos de la presente invención se mencionan en las reivindicaciones.  The inventive aspects of the present invention are mentioned in the claims.

En una realización particular, aplicable a todos y cada uno de los aspectos inventivos de la invención objeto de la presente solicitud de patente [método para determinar la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, método para predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto, método para seleccionar un sujeto para una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de receptores colinérgicos nicotínicos, método para seleccionar una terapia para un sujeto en necesidad de terapia para abandonar el consumo de tabaco, kit que comprende al menos un reactivo necesario para determinar la presencia de al menos un alelo de uno o más de los S P según la presente invención, uso del kit anterior y uso de un SNP de acuerdo a la presente invención], dicho SNP se selecciona del grupo formado por los SNP rs678188, rs9658498, rs4821566 y cualquier combinación de dichos SNP y/o correspondientes SNP de sus bloques de ligamiento; estos SNP (o los correspondientes SNP de sus bloques de ligamiento), por sí solos o combinados entre sí, pueden ser utilizados para predecir la eficacia de la respuesta al tratamiento a 3 meses. Alternativamente, en una realización particular, aplicable a todos y cada uno de los aspectos inventivos de la invención objeto de la presente solicitud de patente, dicho SNP se selecciona del grupo formado por los SNP rsl0891510, rsl 1932367, rs2023239 y cualquier combinación de dichos SNP y/o de los correspondientes SNP de sus bloques de ligamiento; estos SNP (o los correspondientes SNP de sus bloques de ligamiento), por sí solos o combinados entre sí, resultan ser particularmente útiles para predecir la eficacia de la respuesta al tratamiento a 12 meses. In a particular embodiment, applicable to each and every one of the inventive aspects of the invention object of the present patent application [method to determine the probability that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, a method to predict the efficacy of a therapy to quit tobacco use based on an agonist drug of nicotinic cholinergic receptors in a subject, a method to select a subject for a therapy to quit tobacco use based on a nicotinic cholinergic receptor agonist drug, a method for selecting a therapy for a subject in need of therapy to quit smoking, a kit comprising at least one reagent necessary to determine the presence of at least one allele of one or more of the SP according to the present invention, use of the previous kit and use of an SNP according to the pres [invention]], said SNP is selected from the group consisting of SNPs rs678188, rs9658498, rs4821566 and any combination of said SNPs and / or corresponding SNPs of their linkage blocks; these SNPs (or the corresponding SNPs of their linkage blocks), alone or in combination with each other, can be used to predict the effectiveness of the response to treatment at 3 months. Alternatively, in a particular embodiment, applicable to each and every one of the inventive aspects of the invention object of the present patent application, said SNP is selected from the group formed by SNPs rsl0891510, rsl 1932367, rs2023239 and any combination of said SNPs and / or the corresponding SNPs of their linkage blocks; these SNPs (or the corresponding SNPs of their linkage blocks), alone or in combination with each other, prove to be particularly useful for predicting the efficacy of the 12-month treatment response.

En otra realización particular y preferida, aplicable a todos y cada uno de los aspectos inventivos de la invención objeto de la presente solicitud de patente, dicho SNP es el SNP rs678188 y/o los correspondientes SNP de su bloque de ligamiento.  In another particular and preferred embodiment, applicable to each and every one of the inventive aspects of the invention object of the present patent application, said SNP is SNP rs678188 and / or the corresponding SNPs of its linkage block.

BREVE DESCRIPCIÓN DE LAS FIGURAS BRIEF DESCRIPTION OF THE FIGURES

La Figura 1 muestra las curvas ROC correspondientes a los modelos univariado Figure 1 shows the ROC curves corresponding to the univariate models

(gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rs678188. (upper graph) and multivariate (lower graph) in relation to SNP rs678188.

La Figura 2 muestra las curvas ROC correspondientes a los modelos univariado (gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rs9658498.  Figure 2 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to the SNP rs9658498.

La Figura 3 muestra las curvas ROC correspondientes a los modelos univariado (gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rs4821566.  Figure 3 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to the SNP rs4821566.

La Figura 4 muestra las curvas ROC correspondientes a los modelos univariado (gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rsl0891510. La Figura 5 muestra las curvas ROC correspondientes a los modelos univariadoFigure 4 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to SNP rsl0891510. Figure 5 shows the ROC curves corresponding to the univariate models

(gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rsl 1932367. (upper graph) and multivariate (lower graph) in relation to SNP rsl 1932367.

La Figura 6 muestra las curvas ROC correspondientes a los modelos univariado (gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rs2023239. DESCRIPCIÓN DETALLADA DE LA INVENCIÓN  Figure 6 shows the ROC curves corresponding to the univariate (upper graph) and multivariate (lower graph) models in relation to SNP rs2023239. DETAILED DESCRIPTION OF THE INVENTION

Los autores de la presente invención han identificado unos alelos de SNPs cuya presencia está relacionada con una mayor o menor probabilidad de éxito en el abandono del consumo de tabaco en respuesta a un tratamiento farmacológico basado en vareniclina o fármacos con similar mecanismo de acción como por ejemplo citisina y dianiclina, entre otros. Basándose en ese hallazgo, se han desarrollado los métodos de la presente invención los cuales se describen a continuación en detalle. The authors of the present invention have identified alleles of SNPs whose presence is related to a greater or lesser probability of success in abandonment. of tobacco consumption in response to a pharmacological treatment based on varenicline or drugs with a similar mechanism of action such as cytisine and dianicline, among others. Based on that finding, the methods of the present invention have been developed which are described in detail below.

Para evitar dudas, los métodos de la invención se llevan a cabo con una muestra que previamente es retirada del sujeto. Los kits de la invención, descritos a continuación, pueden incluir medios para extraer la muestra del sujeto.  For the avoidance of doubt, the methods of the invention are carried out with a sample that is previously removed from the subject. The kits of the invention, described below, may include means for extracting the sample from the subject.

Definiciones Definitions

Las siguientes definiciones se presentan para ilustrar y definir el sentido y alcance de distintos términos y expresiones utilizadas para describir la propia invención.  The following definitions are presented to illustrate and define the meaning and scope of different terms and expressions used to describe the invention itself.

En la presente invención, se emplean indistintamente los términos "abandono" o "cese", en relación con el consumo de tabaco, para hacer referencia a la abstinencia, terminación o finalización, del consumo de tabaco. El abandono del consumo de tabaco puede ser (i) completo, cuando se produce una total ausencia de consumo de cualquier tipo o forma de producto de tabaco desde el momento en el que se decide abandonar su consumo, (ii) continuado, cuando el sujeto que abandona el consumo de tabaco tiene recaídas, continuas o puntuales, durante los 15 días posteriores a la fecha en la que decide cesar o abandonar el consumo de tabaco, o (iii) puntual, cuando el sujeto abandona el consumo de tabaco durante un periodo de tiempo variable aunque corto, en general, de unas semanas o meses. Ventajosamente, el cese del consumo de tabaco es un cese completo. En la práctica clínica, la declaración verbal de cese de consumo de tabaco, cuando éste es inhalado (fumado), puede ser validada mediante la determinación de los niveles de monóxido de carbono (CO) en aire espirado, siendo la cooximetría la técnica más habitual para dicha determinación. Niveles de 10 ó más ppm de CO en el aire espirado corresponden a sujetos fumadores. Niveles de 6 a 10 ppm a fumadores esporádicos, y cifras por debajo de 6 ppm a no fumadores. In the present invention, the terms "abandonment" or "cessation" are used interchangeably, in relation to tobacco use, to refer to abstinence, termination or termination of tobacco consumption. The abandonment of tobacco consumption can be (i) complete, when there is a total absence of consumption of any type or form of tobacco product from the moment in which it is decided to abandon its consumption, (ii) continued, when the subject who abandons tobacco use has relapses, continuous or punctual, during the 15 days after the date on which he decides to cease or abandon tobacco use, or (iii) punctual, when the subject abandons tobacco consumption for a period variable time although short, in general, a few weeks or months. Advantageously, the cessation of tobacco use is a complete cessation. In clinical practice, the verbal declaration of cessation of tobacco consumption, when it is inhaled (smoked), can be validated by determining the levels of carbon monoxide (CO) in exhaled air, being the most common technique cooximetry for such determination. Levels of 10 or more ppm of CO in exhaled air correspond to smoking subjects. Levels of 6 to 10 ppm for sporadic smokers, and figures below 6 ppm for non-smokers.

La expresión "adicción o dependencia al tabaco", tal como aquí se utiliza, hace referencia al abuso del consumo de tabaco, provocando que el consumidor de tabaco sufra una dependencia física y psicológica que genera un síndrome de abstinencia. El tabaco tiene poder adictivo debido principalmente a la nicotina, la cual también tiene efectos antidepresivos y de alivio sintomático de la ansiedad. El término "tabaquismo" se utiliza, en ocasiones, como sinónimo de "adicción al tabaco"; no obstante, el término "tabaquismo" también se emplea en relación con una intoxicación crónica que se produce por el abuso del tabaco y agrupa los efectos del consumo reiterado del tabaco y de la adicción desarrollada. La adicción al tabaco constituye un factor de riesgo de enfermedades respiratorias y cardiovasculares, y es especialmente perjudicial durante el embarazo. El tabaquismo está relacionado con la aparición de un alto número de enfermedades, entre ellas varios tipos de cáncer, siendo el más frecuente el de pulmón. Además, el tabaco no sólo perjudica a los fumadores activos, sino también a los que respiran el mismo aire (fumadores pasivos). The expression "addiction or dependence on tobacco", as used herein, refers to the abuse of tobacco consumption, causing the consumer of tobacco to suffer a physical and psychological dependence that generates a withdrawal syndrome. Tobacco has addictive power mainly due to nicotine, which also has Antidepressant effects and symptomatic relief of anxiety. The term "smoking" is sometimes used as a synonym for "tobacco addiction"; however, the term "smoking" is also used in relation to chronic intoxication that occurs due to tobacco abuse and groups the effects of repeated tobacco use and developed addiction. Tobacco addiction constitutes a risk factor for respiratory and cardiovascular diseases, and is especially harmful during pregnancy. Smoking is related to the occurrence of a high number of diseases, including several types of cancer, the most frequent being lung. In addition, tobacco not only harms active smokers, but also those who breathe the same air (passive smokers).

El término "agonista" se refiere a un compuesto capaz de generar una respuesta en una célula tras unirse a un receptor celular. El compuesto agonista se une a un receptor y tiene un efecto intrínseco y, por tanto, aumenta la actividad basal de un receptor cuando entra en contacto con el receptor. Por otro lado, el término "antagonista" se refiere a un compuesto que al unirse a un receptor celular bloquea la activación de dicho receptor celular por parte del agonista. El compuesto antagonista compite con el compuesto agonista por unirse a un receptor, bloqueando de ese modo la acción del agonista en el receptor. Sin embargo, un antagonista (también conocido como antagonista "neutro") no tiene ningún efecto sobre la actividad constitutiva del receptor. Los antagonistas median sus efectos mediante la unión al sitio activo o a los sitios alostéricos en los receptores, o pueden interaccionar en sitios de unión únicos que normalmente no están implicados en la regulación biológica de la actividad del receptor. La actividad antagonista puede ser reversible o irreversible dependiendo de la longevidad del complejo antagonista-receptor, que, a su vez, depende de la naturaleza de la unión antagonista-receptor. Asimismo, los agonistas pueden ser parciales o completos. Un "agonista parcial" se define como un compuesto que tiene afinidad por un receptor, pero a diferencia de un agonista completo, provocará sólo un pequeño grado de la respuesta farmacológica peculiar para la naturaleza del receptor implicado, incluso si una alta proporción de receptores están ocupados por el compuesto..  The term "agonist" refers to a compound capable of generating a response in a cell after binding to a cellular receptor. The agonist compound binds to a receptor and has an intrinsic effect and, therefore, increases the basal activity of a receptor when it comes into contact with the receptor. On the other hand, the term "antagonist" refers to a compound that by binding to a cellular receptor blocks the activation of said cellular receptor by the agonist. The antagonist compound competes with the agonist compound for binding to a receptor, thereby blocking the action of the agonist on the receptor. However, an antagonist (also known as a "neutral" antagonist) has no effect on the constitutive activity of the receptor. Antagonists mediate their effects by binding to the active site or to allosteric sites in the receptors, or they can interact at unique binding sites that are not normally involved in the biological regulation of receptor activity. The antagonist activity can be reversible or irreversible depending on the longevity of the antagonist-receptor complex, which, in turn, depends on the nature of the antagonist-receptor binding. Also, the agonists can be partial or complete. A "partial agonist" is defined as a compound that has an affinity for a receptor, but unlike a complete agonist, it will cause only a small degree of the peculiar pharmacological response to the nature of the receptor involved, even if a high proportion of receptors are occupied by the compound ..

El término "alelo", tal como aquí se utiliza, se refiere a una, dos o más formas de un gen, locus o polimorfismo genético. A veces, los diferentes alelos pueden dar lugar a diferentes fenotipos; sin embargo, otras veces, los diferentes alelos tendrán el mismo resultado en la expresión de un gen. La mayoría de los organismos multicelulares tienen dos juegos de cromosomas, es decir, que son diploides. Estos cromosomas se denominan cromosomas homólogos. Los organismos diploides tienen una copia de cada gen (y un alelo) en cada cromosoma. Si ambos alelos son iguales, son homocigotos. Si los alelos son diferentes, son heterocigotos. The term "allele", as used herein, refers to one, two or more forms of a gene, locus or genetic polymorphism. Sometimes, different alleles can give rise to different phenotypes; however, other times, different alleles will have the same result in the expression of a gene. Most multicellular organisms have two sets of chromosomes, that is, they are diploid. These chromosomes are called homologous chromosomes. Diploid organisms have a copy of each gene (and an allele) on each chromosome. If both alleles are equal, they are homozygous. If the alleles are different, they are heterozygous.

El término "bloque de ligamiento" o "bloque haplotípico", tal como aquí se utiliza, hace referencia al conjunto de SNPs en un cromosoma particular que están estadísticamente asociados y configuran un haplotipo (combinación de marcadores genéticos).  The term "linkage block" or "haplotypic block", as used herein, refers to the set of SNPs on a particular chromosome that are statistically associated and configure a haplotype (combination of genetic markers).

El término "citisina", tal como aquí se utiliza, se refiere al compuesto (1R,5S)- l,2,3,4,5,6-hexahidro-l,5-metano-8H-pirido[l,2a][l,5] diazocina-8-ona, de fórmula:  The term "cytisine", as used herein, refers to the compound (1R, 5S) -l, 2,3,4,5,6-hexahydro-l, 5-methane-8H-pyrido [l, 2a] [1, 5] diazocine-8-one, of formula:

Figure imgf000012_0001
La citisina es un alcaloide vegetal de conformación relativamente rígida, de estructura molecular similar a la de la nicotina y de la acetilcolina. La citisina es un insecticida natural que se encuentra en las hojas de Cytisus laburnum y Ulex europaeus, entre otros. Se ha descrito la síntesis de citisina y derivados en Coe JW 2000 Org Lett 2:4205- 4208 y O'Neill BT et al. 2000 Org Lett 2:4201-4204. El término "citisina", tal como aquí se utiliza incluye los derivados mencionados en dichas publicaciones científicas, entre otros.
Figure imgf000012_0001
Citisine is a plant alkaloid of relatively rigid conformation, of molecular structure similar to that of nicotine and acetylcholine. Citisine is a natural insecticide found in the leaves of Cytisus laburnum and Ulex europaeus, among others. The synthesis of citisine and derivatives has been described in Coe JW 2000 Org Lett 2: 4205-4208 and O'Neill BT et al. 2000 Org Lett 2: 4201-4204. The term "citisine", as used herein includes the derivatives mentioned in said scientific publications, among others.

La citisina se comercializa bajo la marca Tabex® y se encuadra dentro del grupo de los fármacos agonistas de los receptores colinérgicos nicotínicos y es un compuesto que tiene afinidad por el subtipo a4B2 de los receptores nicotínicos neuronales de la acetilcolina. La citisina es un insecticida natural que se encuentra en las hojas de Cytisus laburnum y Ulex europaeus, entre otros. La síntesis de citisina y derivados se describe en Coe JW 2000 Org Lett 2:4205-4208 y O'Neill BT et al. 2000 Org Lett 2:4201-4204. Citisine is marketed under the brand name Tabex ® and is part of the group of agonist drugs of nicotinic cholinergic receptors and is a compound that has an affinity for the a4B2 subtype of neuronal nicotinic acetylcholine receptors. Citisine is a natural insecticide found in the leaves of Cytisus laburnum and Ulex europaeus, among others. The synthesis of citisine and derivatives is described in Coe JW 2000 Org Lett 2: 4205-4208 and O'Neill BT et al. 2000 Org Lett 2: 4201-4204.

La expresión "consumo de tabaco", tal como aquí se utiliza, incluye cualquier forma de consumo de tabaco, constituyendo la inhalación de los productos de la combustión del tabaco su forma de consumo más habitual. El término "fumar", en el sentido utilizado en esta descripción, hace referencia a la acción de aspirar y despedir el humo del tabaco. Al consumir un cigarrillo se producen 2 tipos de corrientes de humo: (i) la primera, o corriente principal, que es aquella que al aspirar una calada pasa por el interior del cigarrillo hasta alcanzar los pulmones del fumador activo; y (ii) la segunda, o corriente secundaria, que es la que se desprende al ambiente desde el extremo incandescente del cigarrillo y que puede ser inhalada por un sujeto que respira en ese entorno contaminado, siendo dicho sujeto el fumador pasivo. Al inhalar el humo del tabaco, el fumador promedio consume entre 1 y 2 mg de nicotina por cigarrillo. Cuando el tabaco se fuma, la nicotina llega rápidamente a sus niveles máximos en el torrente sanguíneo y penetra en el cerebro. The term "tobacco consumption", as used herein, includes any form of tobacco consumption, constituting the inhalation of the products of the combustion of tobacco its most common form of consumption. The term "smoking", in the sense used in this description, refers to the action of sucking and firing tobacco smoke. When consuming a cigarette, there are 2 types of smoke currents: (i) the first, or mainstream, which is the one that when aspirating a draft passes through the inside of the cigarette until it reaches the lungs of the active smoker; and (ii) the second, or secondary current, which is the one that is released to the environment from the incandescent end of the cigarette and that can be inhaled by a subject breathing in that contaminated environment, said subject being the passive smoker. When inhaling tobacco smoke, the average smoker consumes between 1 and 2 mg of nicotine per cigarette. When tobacco is smoked, nicotine quickly reaches its maximum levels in the bloodstream and penetrates the brain.

Aunque fumar cigarrillos es la forma más habitual y popular de consumo de tabaco, en la presente invención también se contemplan otras formas de consumo de tabaco sin humo, tales como, por ejemplo, el consumo de tabaco en polvo o rapé y el consumo de tabaco para mascar, que suponen formas de consumo de tabaco mediante masticado, chupado, esnifado, etc. Estos productos de tabaco sin humo también contienen nicotina. En el caso de no inhalar el humo, por ejemplo, al fumar pipas o cigarros, o al consumir tabaco sin humo, la nicotina se absorbe a través de las membranas de las mucosas y alcanza los niveles máximos en la sangre y en el cerebro más lentamente.  Although cigarette smoking is the most common and popular form of tobacco consumption, other forms of smokeless tobacco consumption are also contemplated in the present invention, such as, for example, the consumption of tobacco powder or snuff and tobacco consumption to chew, that suppose forms of tobacco consumption by chewing, sucking, snorting, etc. These smokeless tobacco products also contain nicotine. In the case of not inhaling the smoke, for example, when smoking pipes or cigars, or when consuming smokeless tobacco, nicotine is absorbed through the mucous membranes and reaches maximum levels in the blood and in the brain more slowly.

Otra forma de consumo de tabaco, cuya predicción de éxito o fracaso de cese de consumo en sujetos sometidos a tratamiento con vareniclina también cae dentro de los objetivos de los métodos proporcionados por la presente invención, viene dada por los cigarrillos electrónicos. Los "cigarrillos electrónicos" ("e-Cig") son aparatos que vaporizan la sustancia contenida en los cartuchos, provocando la expulsión de vapor que imita al humo en el cigarrillo tradicional y consiguiendo en el usuario un efecto similar. La boquilla del aparato contiene un cartucho recambiable o recargable lleno de líquido. Las principales sustancias de dicho líquido son propilenglicol y/o glicerina vegetal, nicotina en diferentes dosis de modo opcional (entre 0 y 36 mg/ml en general), sabores y aromas opcionales. El término "dianiclina" se refiere al compuesto (5aS,8S,10aR)-5a,6,9, 10- tetrahidro,7H, HH-8, 10a-metanopirido[2',3':5,6]pirano[2,3-d]azepina y tiene como fórmula: Another form of tobacco consumption, whose prediction of success or failure of cessation of consumption in subjects undergoing treatment with varenicline also falls within the objectives of the methods provided by the present invention, is given by electronic cigarettes. "Electronic cigarettes"("e-Cig") are devices that vaporize the substance contained in the cartridges, causing the expulsion of steam that mimics the smoke in the traditional cigarette and achieving a similar effect on the user. The mouthpiece of the device contains a replaceable or refillable cartridge filled with liquid. The main substances of said liquid are propylene glycol and / or vegetable glycerin, nicotine in different doses optionally (between 0 and 36 mg / ml in general), optional flavors and aromas. The term "dianicline" refers to the compound (5aS, 8S, 10aR) -5a, 6.9, 10-tetrahydro, 7H, HH-8, 10a-methanopyrid [2 ', 3': 5.6] pyran [2 , 3-d] azepine and has as formula:

Figure imgf000014_0001
La dianiclina se encuadra dentro del grupo de los fármacos agonistas de los receptores colinérgicos nicotínicos y es un compuesto que tiene afinidad por el subtipo a4B2 de los receptores nicotínicos neuronales de la acetilcolina.
Figure imgf000014_0001
Dianicline is part of the group of agonist drugs of nicotinic cholinergic receptors and is a compound that has an affinity for the a4B2 subtype of neuronal nicotinic acetylcholine receptors.

El término "fármaco agonista de los receptores colinérgicos nicotínicos" se entiende como aquel fármaco con capacidad para, tras la interacción con alguna de las subunidades del receptor colinérgico nicotínico, modificar procesos de respuesta celular y generar una respuesta biológica (Florez et al., Farmacología Humana, 4a Edición, Masson, Barcelona, 2003). Ejemplos ilustrativos, no limitativos, de dichos fármacos incluyen citisina, dianiclina y vareniclina, entre otros. The term "nicotinic cholinergic receptor agonist drug" is understood as that drug capable, after interaction with any of the nicotinic cholinergic receptor subunits, to modify cellular response processes and generate a biological response (Florez et al., Pharmacology Humana, 4th edition, Masson, Barcelona, 2003). Illustrative, non-limiting examples of such drugs include cytisine, dianicline and varenicline, among others.

El término "muestra biológica", tal como aquí se utiliza, incluye cualquier material biológico que se puede obtener de un sujeto, susceptible de conservación y que pueda albergar información sobre la dotación genética característica del sujeto. La muestra de la invención puede ser de tipo celular, tisular o fluida. En una realización particular de la invención, la muestra es de sangre y/o de saliva.  The term "biological sample", as used herein, includes any biological material that can be obtained from a subject, susceptible to conservation and that can house information on the genetic endowment characteristic of the subject. The sample of the invention can be of the cellular, tissue or fluid type. In a particular embodiment of the invention, the sample is of blood and / or saliva.

El término "nicotina", tal como aquí se utiliza, se refiere a un compuesto alcaloide que se encuentra en la planta del tabaco, responsable de los efectos psicoactivos y adictivos del tabaco. Aunque se han identificado cerca de 5.000 compuestos químicos en las distintas fases (gaseosa, sólida o de partículas) del humo del tabaco, su contenido en nicotina es lo que convierte al tabaco en adictivo. Se considera que la nicotina es la responsable tanto de la adicción al tabaco como del mantenimiento del hábito tabáquico. A modo de ejemplo, al inhalar el humo del tabaco, la nicotina se absorbe rápidamente tanto en la mucosa oral como en los pulmones, desde donde pasa al aparato circulatorio distribuyéndose por todo el organismo, y, en 7-10 segundos, la nicotina llega al cerebro, donde se une a los receptores nicotínicos produciendo un efecto estimulante y/o sedante, placentero y gratificante, que desencadena la aparición de dependencia al tabaco (dependencia farmacológica o física). En general, el fumador adapta su patrón de inhalación de nicotina en cuanto a frecuencia, profundidad de las inhalaciones y tiempo de retención del humo, en función de sus propias características y del efecto que pretenda provocarse en cada circunstancia. Estas variaciones del patrón de fumar producen distintas concentraciones de nicotina en sangre que rinden diferentes niveles de oferta de nicotina al organismo y diferentes efectos en su acción. Cuando el fumador deja de fumar durante un tiempo comienza a tener una serie de síntomas que son lo que causa el síndrome de abstinencia. Además de esta dependencia farmacológica o física, la nicotina también ocasiona una dependencia psicológica y social que depende fundamentalmente de la configuración de la personalidad de cada fumador. La nicotina produce una serie de efectos en el organismo entre los que destacan incremento de la tensión arterial, incremento de la frecuencia cardiaca o taquicardia, incremento de la glucemia e incremento del movimiento intestinal. The term "nicotine," as used herein, refers to an alkaloid compound found in the tobacco plant, responsible for the psychoactive and addictive effects of tobacco. Although about 5,000 chemical compounds have been identified in the different phases (gas, solid or particulate) of tobacco smoke, their nicotine content is what makes tobacco addictive. Nicotine is considered to be responsible for both tobacco addiction and the maintenance of smoking. As an example, when inhaling tobacco smoke, nicotine is rapidly absorbed both in the oral mucosa and in the lungs, from where it passes to the circulatory system, distributed throughout the body, and, in 7-10 seconds, nicotine arrives to the brain, where it binds to the nicotinic receptors producing a stimulating and / or sedative, pleasant and rewarding effect, which triggers the appearance of dependence on tobacco (pharmacological or physical dependence). In general, the smoker adapts his nicotine inhalation pattern in terms of frequency, depth of inhalations and smoke retention time, depending on his own characteristics and the effect he intends to cause in each circumstance. These variations of the smoking pattern produce different concentrations of nicotine in the blood that yield different levels of nicotine supply to the body and different effects on its action. When the smoker quits smoking for a while, he begins to have a series of symptoms that are what causes the withdrawal syndrome. In addition to this pharmacological or physical dependence, nicotine also causes a psychological and social dependence that depends fundamentally on the personality configuration of each smoker. Nicotine produces a series of effects in the body, among which are an increase in blood pressure, an increase in heart rate or tachycardia, an increase in blood glucose and an increase in bowel movement.

Los polimorfismos genéticos más comunes son los S Ps y las variaciones en el número de copias (VNCs). Tal como aquí se utiliza, el término "polimorfismo" se refiere a sustituciones de un único nucleótido por otro y que se observan en la población general en una frecuencia mayor que el 1%. En un caso concreto, cuando dicha variación en la secuencia de nucleótidos se produce en un solo nucleótido (A, C, T y G), se conoce como "SNP" (del inglés "single nucleotide polymorphism" o "polimorfismo de un sólo nucleótido").  The most common genetic polymorphisms are S Ps and variations in the number of copies (VNCs). As used herein, the term "polymorphism" refers to substitutions of a single nucleotide for another and that are observed in the general population at a frequency greater than 1%. In a specific case, when said variation in the nucleotide sequence occurs in a single nucleotide (A, C, T and G), it is known as "SNP" (from the English "single nucleotide polymorphism" or "single nucleotide polymorphism" ").

Los SNPs representan una de las formas más comunes de variación genética, en donde cada versión de la secuencia con respecto al sitio polimórfico es referida como un alelo del sitio polimórfico. Los SNPs se producen a lo largo de todo el genoma, tanto en regiones extragénicas como en regiones codificantes o sus secuencias reguladoras. El cambio de un solo nucleótido puede causar: 1) la sustitución de un aminoácido, si está en una secuencia exónica, y variar la eficacia de la función de la proteína; 2) modificar la cantidad de la proteína, si el SNP está en una región reguladora; ó 3) cambiar la estructura de la proteína, si el cambio está en una zona de splicing.  SNPs represent one of the most common forms of genetic variation, where each version of the sequence with respect to the polymorphic site is referred to as an allele of the polymorphic site. SNPs occur throughout the entire genome, both in extragenic regions and in coding regions or their regulatory sequences. The change of a single nucleotide can cause: 1) the substitution of an amino acid, if it is in an exonic sequence, and vary the effectiveness of the protein's function; 2) modify the amount of the protein, if the SNP is in a regulatory region; or 3) change the structure of the protein, if the change is in a splicing zone.

Las mutaciones se pueden utilizar como herramientas diagnósticas y/o pronosticas para la identificación de sujetos con predisposición a una enfermedad o a una rápida evolución de la enfermedad, genotipando al sujeto que padece la enfermedad y facilitando el desarrollo de medicamentos basado en el conocimiento generado sobre el papel de las proteínas en el proceso de patogénesis. Asimismo, los S Ps también se puede utilizar como herramientas diagnósticas y/o pronosticas para la identificación de sujetos que respondan bien (o que no respondan) o que presenten efectos adversos a una terapia concreta o a un tratamiento farmacológico determinado ya que las diferencias interindividuales heredadas en la farmacocinética y farmacodinámica de los fármacos se deben a variantes genéticas que afectan a la función o expresión génica. Estos polimorfismos afectan a enzimas metabolizadoras de fármacos, transportadores y dianas de fármacos y pueden tener una gran influencia en la eficacia y seguridad de una terapia o tratamiento farmacológico determinados. Mutations can be used as diagnostic and / or prognostic tools for the identification of subjects with a predisposition to a disease or to a rapid evolution of the disease, genotyping the subject suffering from the disease and facilitating the development of medicines based on the knowledge generated on the role of proteins in the pathogenesis process. Likewise, S Ps can also be used as diagnostic and / or prognostic tools for the identification of subjects that respond well (or do not respond) or that present adverse effects to a specific therapy or to a specific pharmacological treatment since inherited interindividual differences In the pharmacokinetics and pharmacodynamics of drugs they are due to genetic variants that affect gene function or expression. These polymorphisms affect drug metabolizing enzymes, transporters and drug targets and can have a great influence on the efficacy and safety of a particular drug therapy or therapy.

En algunas realizaciones de la presente invención, los marcadores genéticos utilizados en la invención son alelos específicos en "sitios polimórficos" asociados con el éxito o fracaso del cese o abandono del consumo de tabaco por un sujeto bajo tratamiento con un fármaco agonista de los receptores colinérgicos nicotínicos para dejar de consumir tabaco. Una posición nucleotídica en el genoma en la que es posible más de una secuencia en una población, se conoce como un "sitio polimórfico". Cuando un sitio polimórfico es de un solo nucleótido de longitud, el sitio comúnmente se llama S P, tal como se mencionó anteriormente, por ejemplo, si en una localización cromosómica particular, un miembro de una población tiene una adenina (A) y otro miembro de la población tiene una timina (T) en la misma posición, entonces esta posición es un sitio polimórfico y, más concretamente, el sitio polimórfico es un SNP. Cada versión de la secuencia con respecto al sitio polimórfico se conoce como un alelo del sitio polimórfico. Así, en el ejemplo anterior, el SNP permite tanto un alelo A como un alelo T. Estos alelos son "variantes alélicas". Variantes de la secuencia de nucleótidos, ya sea en regiones codificantes o no codificantes, pueden dar lugar a cambios en la secuencia del polipéptido codificado, lo que afecta a las propiedades de los mismos (alteración de la actividad, alteración de la distribución, estabilidad alterada, etc.). Por otra parte, las variantes de la secuencia de nucleótidos, ya sean en regiones codificantes o no codificantes, pueden dar lugar a cambios que afectan a la transcripción de un gen o de la traducción de su ARN mensajero. En todos los casos, las alteraciones pueden ser cualitativas, cuantitativas, o ambas. El término "probabilidad", tal como aquí se utiliza, mide la frecuencia con la que se obtiene un resultado (o conjunto de resultados) al llevar a cabo un experimento aleatorio, del que se conocen todos los resultados posibles, bajo condiciones suficientemente estables. Dicho término "probabilidad", en combinación con el cese del consumo de tabaco en respuesta a una terapia basada en vareniclina, tal como aquí se utiliza, se refiere a la propensión, o probabilidad real, de un sujeto de abandonar el consumo de tabaco en respuesta a dicha terapia durante un periodo de tiempo determinado, por ejemplo, durante un periodo de, al menos, 3 meses, contado desde el inicio del tratamiento con vareniclina. La probabilidad puede ser "alta" o "baja". Como entenderán los técnicos en la materia, la probabilidad no tiene por qué ser del 100% para todos los sujetos evaluados, aunque preferentemente debería ser así. Dicho término, sin embargo, requiere que una parte estadísticamente significativa de los sujetos que abandonan el consumo de tabaco en respuesta al tratamiento farmacológico con vareniclina puedan ser identificados como sujetos que tienen una probabilidad alta de obtener un resultado determinado, en concreto, abandonar el consumo de tabaco. Si un sujeto es estadísticamente significativo o no, puede ser determinado sin grandes complicaciones, por un técnico en la materia, utilizando distintas herramientas conocidas de evaluación estadística, por ejemplo, mediante la determinación de intervalos de confianza, la determinación del valor de p, el test de Student, el test de Mann-Whitney, etc. Información adicional sobre estas herramientas estadísticas pueden encontrarse en Dowdy y Wearden, Statistics for Research, John Wiley & Sons, New York, 1983. Los intervalos de confianza preferidos son de al menos 50%, al menos 60%), al menos 70%, al menos 80%>, al menos 90%, o al menos 95%. Los valores de p son, preferentemente, 0, 1, 0,05, 0,02, 0,01 ó inferiores. In some embodiments of the present invention, the genetic markers used in the invention are specific alleles at "polymorphic sites" associated with the success or failure of the cessation or abandonment of tobacco use by a subject under treatment with a cholinergic receptor agonist drug. nicotinics to stop using tobacco. A nucleotide position in the genome in which more than one sequence is possible in a population is known as a "polymorphic site." When a polymorphic site is only one nucleotide in length, the site is commonly called SP, as mentioned above, for example, if at a particular chromosomal location, a member of a population has an adenine (A) and another member of the population has a thymine (T) in the same position, so this position is a polymorphic site and, more specifically, the polymorphic site is an SNP. Each version of the sequence with respect to the polymorphic site is known as an allele of the polymorphic site. Thus, in the previous example, the SNP allows both an A allele and a T allele. These alleles are "allelic variants". Variants of the nucleotide sequence, whether in coding or non-coding regions, can lead to changes in the sequence of the encoded polypeptide, which affects their properties (activity alteration, distribution alteration, altered stability , etc.). On the other hand, variants of the nucleotide sequence, whether in coding or non-coding regions, may result in changes that affect the transcription of a gene or the translation of its messenger RNA. In all cases, the alterations can be qualitative, quantitative, or both. The term "probability", as used herein, measures the frequency with which a result (or set of results) is obtained when conducting a randomized experiment, of which all possible outcomes are known, under sufficiently stable conditions. Said term "probability", in combination with the cessation of tobacco use in response to a varenicline-based therapy, as used herein, refers to the propensity, or actual probability, of a subject to abandon tobacco use in response to said therapy for a certain period of time, for example, for a period of at least 3 months, counted from the start of treatment with varenicline. The probability can be "high" or "low." As those skilled in the art will understand, the probability does not have to be 100% for all the subjects evaluated, although preferably it should be. This term, however, requires that a statistically significant part of the subjects who quit smoking in response to pharmacological treatment with varenicline can be identified as subjects that have a high probability of obtaining a certain result, specifically, abandoning consumption. tobacco. If a subject is statistically significant or not, it can be determined without major complications, by a person skilled in the art, using different known tools of statistical evaluation, for example, by determining confidence intervals, determining the value of p, the Student test, Mann-Whitney test, etc. Additional information on these statistical tools can be found in Dowdy and Wearden, Statistics for Research, John Wiley & Sons, New York, 1983. Preferred confidence intervals are at least 50%, at least 60%), at least 70%, at least 80%>, at least 90%, or at least 95%. P values are preferably 0, 1, 0.05, 0.02, 0.01 or less.

El término "sujeto", tal como aquí se utiliza, se refiere a un ser humano, de sexo femenino o masculino, y de cualquier raza o edad. En una realización particular, el sujeto es un consumidor activo de tabaco, es decir, consume tabaco de forma habitual o de forma esporádica; en una realización más concreta, dicho sujeto es un fumador activo. Aunque no existe unanimidad acerca de quiénes deberían ser considerados fumadores leves, moderados o severos, ni del límite exacto que separa el fumador habitual del esporádico, a modo de ejemplo, un fumador de más de 20 cigarrillos al día podría ser considerado un fumador "severo", un fumador de entre 10 y 20 cigarrillos al día podría ser considerado un fumador "moderado", y un fumador de menos de 10 cigarrillos al día podría ser considerado un fumador "leve". Asimismo, aunque no se ha establecido el tiempo necesario para considerar a un fumador como "ex-fumador", lo más habitual es considerar el plazo de un año de cese o abandono completo de consumo de tabaco. Por otra parte, se consideran "no fumadores" aquellos sujetos que no han tenido una exposición al tabaco de forma activa ni mantenida. The term "subject", as used herein, refers to a human being, female or male, and of any race or age. In a particular embodiment, the subject is an active consumer of tobacco, that is, consumes tobacco regularly or sporadically; In a more concrete embodiment, said subject is an active smoker. Although there is no unanimity about who should be considered mild, moderate or severe smokers, or the exact limit that separates the habitual smoker from the sporadic, by way of example, a smoker of more than 20 cigarettes a day could be considered a "severe smoker ", a smoker of between 10 and 20 cigarettes at day could be considered a "moderate" smoker, and a smoker of less than 10 cigarettes a day could be considered a "mild" smoker. Also, although the time necessary to consider a smoker as an "ex-smoker" has not been established, the most common is to consider the term of one year of complete cessation or abandonment of tobacco use. On the other hand, those subjects who have not had an active or maintained exposure to tobacco are considered "non-smokers".

El término "tabaco", tal como aquí se utiliza, se refiere a un producto procesado a partir de las hojas de varias plantas del género Nicotiana, entre ellas N. tabacum, N. petunoides, N rustica y N. polidiclia. La especie N. tabacum puede clasificarse en cuatro variedades, havanensis, brasilensis, virginica y purpurea, que son el origen de las distintas variedades usadas en la comercialización del tabaco. Los productos a base de tabaco a los que se dirigen los métodos de la invención relacionados con la predicción de éxito o fracaso de cese de consumo en sujetos sometidos a tratamiento con vareniclina incluyen aquellos productos que están hechos total o parcialmente de tabaco, contienen nicotina, y cuyo consumo se produce, por ejemplo, al fumarlos, chuparlos, masticarlos o esnifarlos. A modo ilustrativo, no limitativo, el tabaco puede presentarse en forma de cigarros [(también denominados cigarrillos, pitillos, etc.) que pueden ser emboquillados o sin filtro, rubios o negros, "lights", "semi-lights" o enteros], puros, tabaco para liar, tabaco para fumar en pipa, tabaco en polvo o rapé, etc.  The term "tobacco", as used herein, refers to a product processed from the leaves of several plants of the Nicotiana genus, including N. tabacum, N. petunoides, N rustica and N. polidiclia. The N. tabacum species can be classified into four varieties, havanensis, brasilensis, virginica and purpurea, which are the origin of the different varieties used in the commercialization of tobacco. The tobacco-based products to which the methods of the invention are directed related to the prediction of success or failure of cessation of consumption in subjects undergoing treatment with varenicline include those products that are made totally or partially of tobacco, contain nicotine, and whose consumption occurs, for example, when smoking, sucking, chewing or snorting them. By way of illustration, not limitation, tobacco can be presented in the form of cigarettes [(also called cigarettes, cigarettes, etc.) that can be emboquillados or without filter, blond or black, "lights", "semi-lights" or integers] , cigars, rolling tobacco, pipe smoking tobacco, snuff or snuff, etc.

El término "tratamiento" o "terapia", tal como aquí se utiliza, hace referencia a la administración de un fármaco para aliviar o eliminar una patología o para reducir o eliminar uno o más síntomas asociados a dicha patología. En el contexto de la presente invención, el tratamiento aplicado al sujeto es un tratamiento de tipo farmacológico y está dirigido a reducir o eliminar el consumo de tabaco en dicho sujeto y está basado en el empleo de vareniclina. En una realización particular, el sujeto a quien está dirigido el tratamiento es un consumidor activo de tabaco, por ejemplo, un fumador activo.  The term "treatment" or "therapy", as used herein, refers to the administration of a drug to alleviate or eliminate a pathology or to reduce or eliminate one or more symptoms associated with said pathology. In the context of the present invention, the treatment applied to the subject is a pharmacological treatment and is aimed at reducing or eliminating tobacco consumption in said subject and is based on the use of varenicline. In a particular embodiment, the subject to whom the treatment is directed is an active consumer of tobacco, for example, an active smoker.

El término "tratamiento personalizado" o "medicina personalizada", tal como aquí se utiliza, se refiere al diseño y aplicación de intervenciones de prevención, diagnóstico y tratamiento adaptado el sustrato genético del paciente y al perfil molecular de la enfermedad.  The term "personalized treatment" or "personalized medicine", as used herein, refers to the design and application of prevention, diagnosis and treatment interventions adapted to the patient's genetic substrate and the molecular profile of the disease.

El término "vareniclina" tal como aquí se utiliza, se refiere al compuesto 7,8,9, 10-tetrahidro-6, 10-metano-6H-pirazino[2,3-h][3]benzacepina, de fórmula:

Figure imgf000019_0001
e incluye también sus sales farmacéuticamente aceptables, tales como, por ejemplo, las mencionadas en la solicitud de patente internacional W099/35131, así como sus derivados, por ejemplo, N-formil-vareniclina y N-metil-vareniclina. La vareniclina se comercializa en España en forma de su sal de tartrato bajo la marca Chantix® o Champix®. The term "varenicline" as used herein refers to the compound 7,8,9, 10-tetrahydro-6, 10-methane-6H-pyrazino [2,3-h] [3] benzacepin, of the formula:
Figure imgf000019_0001
and also includes its pharmaceutically acceptable salts, such as, for example, those mentioned in the international patent application W099 / 35131, as well as its derivatives, for example, N-formyl-varenicline and N-methyl-varenicline. Varenicline is marketed in Spain in the form of its tartrate salt under the brand Chantix ® or Champix ® .

La vareniclina se encuadra dentro del grupo de los fármacos agonistas de los receptores colinérgicos nicotínicos y es un compuesto que actúa como agonista parcial selectivo de los receptores nicotínicos de acetilcolina, que se une con gran afinidad y selectividad al subtipo a4B2 de los receptores nicotínicos neuronales de la acetilcolina.  Varenicline is part of the group of agonist drugs of nicotinic cholinergic receptors and is a compound that acts as a selective partial agonist of nicotinic acetylcholine receptors, which binds with great affinity and selectivity to the a4B2 subtype of neuronal nicotinic receptors of Acetylcholine

La vareniclina se emplea en el tratamiento de diversas enfermedades, incluyendo, a modo ilustrativo, no limitativo, las enfermedades inflamatorias crónicas del intestino (incluyendo, sin limitarse a, colitis ulcerosa, pioderma gangrenoso y enfermedad de Crohn), síndrome del intestino irritable, distonía espasmódica, dolor crónico, dolor agudo, enfermedad celiaca, reservoritis, vasoconstricción, ansiedad, trastorno de pánico, depresión, trastorno bipolar, autismo, trastorno del sueño, desacomodación horaria ( "jet lag"), esclerosis lateral amiotrófica (ALS), disfunción cognitiva, hipertensión, bulimia, anorexia, obesidad, arritmia cardiaca, hipersecreción ácida gástrica, úlcera, feocromocitoma, parálisis supranuclear progresiva, adicción y dependencia química (nicotina, productos de tabaco, alcohol, benzodiacepina, barbitúricos, opioides, cocaína), dolor de cabeza, migraña, ataque súbito, lesión cerebral traumática (TBI), trastorno obsesivo-compulsivo, psicosis, corea de Huntington, disquinesia tardía, hiperquinesia, dislexia, esquizofrenia, demencia multiinfarto, decaimiento cognitivo asociado a edad, epilepsia, demencia senil de la enfermedad de Alzheimer, enfermedad de Parkinson, trastorno por déficit de atención (ADHD) y síndrome de Gilíes de la Tourette.  Varenicline is used in the treatment of various diseases, including, by way of illustration, not limitation, chronic inflammatory bowel diseases (including, but not limited to, ulcerative colitis, pyoderma gangrenosum and Crohn's disease), irritable bowel syndrome, dystonia spasmodic, chronic pain, acute pain, celiac disease, reservoritis, vasoconstriction, anxiety, panic disorder, depression, bipolar disorder, autism, sleep disorder, time shift ("jet lag"), amyotrophic lateral sclerosis (ALS), cognitive dysfunction , hypertension, bulimia, anorexia, obesity, cardiac arrhythmia, gastric acid hypersecretion, ulcer, pheochromocytoma, progressive supranuclear paralysis, addiction and chemical dependence (nicotine, tobacco products, alcohol, benzodiazepine, barbiturates, opioids, cocaine), headache, migraine, sudden attack, traumatic brain injury (TBI), obsessive-compulsive disorder, psychosis , Huntington's chorea, tardive dyskinesia, hyperkinesia, dyslexia, schizophrenia, multi-infarct dementia, age-related cognitive decline, epilepsy, senile dementia of Alzheimer's disease, Parkinson's disease, attention deficit disorder (ADHD) and Gilies syndrome Tourette

El tratamiento habitual para el cese del consumo de tabaco con vareniclina comprende la administración oral, dos veces al día, de 1 mg de compuesto, durante 12 semanas. La absorción es completa y la disponibilidad sistémica alta. Las concentraciones máximas en plasma ocurren típicamente a las 3-4 horas de la toma (Faessel HM et al. 2010, Clin Pharmacokinet 49(12):799-816). Método para determinar la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos ("primer método de la invención"). The usual treatment for cessation of tobacco use with varenicline includes oral administration, twice a day, of 1 mg of compound, for 12 weeks Absorption is complete and systemic availability high. Maximum plasma concentrations typically occur at 3-4 hours after taking (Faessel HM et al. 2010, Clin Pharmacokinet 49 (12): 799-816). Method for determining the probability that a subject will quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug ("first method of the invention").

En un aspecto, la invención se relaciona con un método para determinar la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos (en adelante, "primer método de la invención"), que comprende determinar en una muestra biológica de dicho sujeto, al menos un alelo de uno o más de los polimorfismos de un solo nucleótido (SNP) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o de cualquier SNP de sus correspondientes bloques de ligamiento, en donde In one aspect, the invention relates to a method for determining the probability that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors (hereinafter, "first method of the invention" ), which comprises determining in a biological sample of said subject, at least one allele of one or more of the single nucleotide polymorphisms (SNPs) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or of any SNP of its corresponding ligation blocks, where

la presencia de al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one C allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block;

- la presencia de al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  - the presence of at least one G allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I

la presencia de al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento;  the presence of at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block;

es indicativa de una alta probabilidad de que dicho sujeto abandone el consumo de tabaco en respuesta a dicha terapia. It is indicative of a high probability that said subject will quit smoking in response to said therapy.

En una realización alternativa del primer método de la invención, la invención también se relaciona con un método para determinar la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, que comprende determinar en una muestra biológica de dicho sujeto, al menos un alelo de uno o más de los S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o de cualquier S P de sus correspondientes bloques de ligamiento, en donde In an alternative embodiment of the first method of the invention, the invention also relates to a method for determining the probability of a subject quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug, which comprises determining in an biological sample of said subject, at least one allele of one or more of the S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or of any SP of its corresponding linkage blocks, where

la presencia de al menos un alelo T del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo C del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one C allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block;

- la presencia de al menos un alelo C del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of at least one C allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo T del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo A del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of at least one A allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I

la presencia de al menos un alelo T del SNP rs2023239, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs2023239, or of the corresponding alleles of the SNPs of its linkage block;

es indicativa de una baja probabilidad de que dicho sujeto cese el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos. It is indicative of a low probability that said subject will cease tobacco consumption in response to a therapy based on an agonist drug of nicotinic cholinergic receptors.

De acuerdo con el primer método de la invención, en una muestra biológica del sujeto bajo estudio se determina al menos un alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o de cualquier SNP de sus correspondientes bloques de ligamiento, y se correlacionan los resultados obtenidos con la probabilidad (alta o baja) de que el sujeto bajo estudio abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos. Ejemplos ilustrativos, no limitativos, de fármacos agonistas de los receptores colinérgicos nicotínicos incluyen citisina, dianiclina y vareniclina. En una realización particular, dicho fármaco agonista de los receptores colinérgicos nicotínicos es vareniclina.  In accordance with the first method of the invention, at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of their subjects is determined in a biological sample of the subject under study corresponding ligation blocks, and the results obtained are correlated with the probability (high or low) that the subject under study quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors. Illustrative, non-limiting examples of nicotinic cholinergic receptor agonist drugs include cytisine, dianicline and varenicline. In a particular embodiment, said nicotinic cholinergic receptor agonist drug is varenicline.

El sujeto es un ser humano de cualquier sexo, raza o edad. En una realización particular, el sujeto es un consumidor activo de tabaco, por ejemplo, un fumador de cigarros, cigarros electrónicos, puros o pipa, o bien un consumidor de tabaco en polvo o rapé. En una realización aún más particular, dicho sujeto es un consumidor activo de tabaco que voluntariamente desea dejar de consumir tabaco, o bien que debe dejar de consumir tabaco, por ejemplo, por prescripción médica. The subject is a human being of any sex, race or age. In a particular embodiment, the subject is an active consumer of tobacco, for example, a smoker of cigars, electronic cigars, cigars or pipes, or a consumer of snuff or snuff. In an even more particular embodiment, said subject is an active consumer of tobacco who voluntarily wishes to stop using tobacco, or who must stop using tobacco, for example, by medical prescription.

La muestra biológica procedente del sujeto bajo estudio es una muestra biológica que contiene un ácido nucleico, por ejemplo, ADN, ADN genómico (ADNg), ADN complementario (ADNc), ARN, ARN nuclear heterogéneo (ARNnh), ARNm, etc., del sujeto a evaluar. Dicha muestra biológica puede ser aislada o extraída de un tejido, o puede estar presente en un fluido biológico, por ejemplo, sangre, saliva, etc. Los métodos para el aislamiento de muestras biológicas a partir de células y tejidos son bien conocidos por los técnicos en la materia. En una realización particular, dicha muestra biológica es una muestra de sangre o de saliva.  The biological sample from the subject under study is a biological sample that contains a nucleic acid, for example, DNA, genomic DNA (cDNA), complementary DNA (cDNA), RNA, heterogeneous nuclear RNA (mRNA), mRNA, etc., of the subject to evaluate. Said biological sample may be isolated or extracted from a tissue, or it may be present in a biological fluid, for example, blood, saliva, etc. Methods for the isolation of biological samples from cells and tissues are well known to those skilled in the art. In a particular embodiment, said biological sample is a blood or saliva sample.

En general, cuando la muestra biológica es una muestra de sangre completa, ésta se puede utilizar directamente en la puesta en práctica del primer método de la invención. Sin embargo, en otras ocasiones, es necesario extraer, en primer lugar, el ácido nucleico de las muestras biológicas, por ejemplo, células presentes en un fluido biológico; en ese caso, el total de ácidos nucleicos extraídos de dichas muestras biológicas representa el material de trabajo. El aislamiento de los ácidos nucleicos a partir de una muestra biológica que los contiene se puede realizar por métodos conocidos por los técnicos en la materia [véase, por ejemplo, Sambrook et al, 2001 "Molecular Cloning: A Laboratory Manual", 3a edición, Cold Spring Harbor Laboratory Press, Nueva York, vol. 1.3]. Asimismo, en ocasiones, puede ser necesario amplificar el ácido nucleico extraído antes de proceder a su análisis. Se conocen numerosos métodos de amplificación de ácidos nucleicos; muchos de ellos se basan en una reacción enzimática, por ejemplo, la reacción en cadena de la polimerasa (PCR), la reacción en cadena de la ligasa (LCR), ensayos de amplificación de círculo rodante ("rolling- circle"), etc. Información sobre dichos métodos de amplificación de ácidos nucleicos puede encontrarse en Sambrook et al, 2001 (citado supra). In general, when the biological sample is a whole blood sample, it can be used directly in the practice of the first method of the invention. However, on other occasions, it is necessary to first extract the nucleic acid from the biological samples, for example, cells present in a biological fluid; in that case, the total nucleic acids extracted from said biological samples represents the work material. The isolation of nucleic acids from a biological sample that contains can be performed by methods known to those skilled in the art [see for example, Sambrook et al, 2001 "Molecular Cloning: A Laboratory Manual", 3rd edition , Cold Spring Harbor Laboratory Press, New York, vol. 1.3]. Also, sometimes, it may be necessary to amplify the extracted nucleic acid before proceeding with its analysis. Numerous methods of nucleic acid amplification are known; many of them are based on an enzymatic reaction, for example, polymerase chain reaction (PCR), ligase chain reaction (LCR), rolling circle amplification assays, "rolling-circle", etc. . Information on such nucleic acid amplification methods can be found in Sambrook et al, 2001 (cited supra).

Después de aislar y amplificar (si es necesario) el ácido nucleico, se analiza uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o cualquier SNP de sus correspondientes bloques de ligamiento, y se determinan los nucleótidos presentes en dichos SNPs, en particular, los nucleótidos presentes en el sitio polimórfico el SNP que permite identificar el correspondiente alelo del SNP. After isolating and amplifying (if necessary) the nucleic acid, one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of their corresponding binding blocks are analyzed, and the nucleotides are determined present in said SNPs, in particular, nucleotides present in the polymorphic site the SNP that allows to identify the corresponding allele of the SNP.

Los técnicos en la materia reconocerán fácilmente que el análisis de los nucleótidos presentes en uno o más de dichos SNPs en la muestra que contiene ácido nucleico del sujeto bajo estudio se puede realizar por cualquier método o técnica capaz de determinar los nucleótidos presentes en un sitio polimórfico (e.g., SNP), por ejemplo, mediante secuenciación, mini-secuenciación, hibridación, análisis de los fragmentos de restricción, ensayos de ligamiento de oligonucleótidos, PCR alelo-específica, análisis HRM (High Resolution Melt), etc., o mediante cualquier combinación de dichos métodos. El experto en la materia puede utilizar cualquier método o técnica apropiada para conseguir esa determinación. Los nucleótidos presentes en los SNP y, en particular, en los sitios polimórficos, se pueden detectar a partir de cualquier hebra de ácido nucleico o a partir de ambas hebras.  Those skilled in the art will readily recognize that the analysis of nucleotides present in one or more of said SNPs in the sample containing nucleic acid of the subject under study can be performed by any method or technique capable of determining nucleotides present in a polymorphic site. (eg, SNP), for example, by sequencing, mini-sequencing, hybridization, restriction fragment analysis, oligonucleotide binding assays, allele-specific PCR, HRM (High Resolution Melt) analysis, etc., or by any combination of these methods. The person skilled in the art can use any appropriate method or technique to achieve that determination. Nucleotides present in SNPs and, in particular, at polymorphic sites, can be detected from any strand of nucleic acid or from both strands.

Ejemplos ilustrativos, no limitativos, de métodos, técnicas o sistemas adecuados para analizar los nucleótidos presentes en los sitios polimórficos de los SNPs identificados en la presente invención incluyen métodos de mini-secuenciación, secuenciación de ácidos nucleicos, hibridación, análisis de los fragmentos de restricción, ensayos de ligamiento de oligonucleótidos, PCR alelo-específica, análisis HRM, matrices de ácidos nucleicos ("DNA arrays"), por ejemplo, la tecnología disponible en Aclara BioSciences, Affymetrix, Agilent Technologies, Illumina Inc., Ion Torrent, Fluidigm, Nanopore Tech etc., técnicas basadas en el cambio de la movilidad de los fragmentos amplificados de ácidos nucleicos, polimorfismos en la conformación de una sola hebra (SSCP), electroforesis en gel de gradiente desnaturalizante (DGGE), CMC ("chemical mismatch cleavage"), análisis de WAVE, etc., o mediante cualquier combinación de dichos métodos. Información adicional sobre el análisis de los nucleótidos presentes en los sitios polimórficos de los SNPs puede encontrarse en Sambrook et al, 2001, citado supra, así como, por ejemplo, en la solicitud de patente norteamericana US2007/0105128.  Illustrative, non-limiting examples of suitable methods, techniques or systems for analyzing nucleotides present at the polymorphic sites of the SNPs identified in the present invention include mini-sequencing methods, nucleic acid sequencing, hybridization, restriction fragment analysis. , oligonucleotide ligation assays, allele-specific PCR, HRM analysis, nucleic acid matrices ("DNA arrays"), for example, the technology available from Aclara BioSciences, Affymetrix, Agilent Technologies, Illumina Inc., Ion Torrent, Fluidigm, Nanopore Tech etc., techniques based on changing the mobility of amplified nucleic acid fragments, single strand conformation polymorphisms (SSCP), denaturing gradient gel electrophoresis (DGGE), CMC ("chemical mismatch cleavage" ), WAVE analysis, etc., or by any combination of such methods. Additional information on the analysis of the nucleotides present in the polymorphic sites of the SNPs can be found in Sambrook et al, 2001, cited above, as well as, for example, in US patent application US2007 / 0105128.

El primer método de la invención comprende genotipar o determinar al menos un alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, y/o los alelos correspondientes de los SNPs de sus bloques de ligamiento, en la muestra biológica del sujeto bajo estudio. Por tanto, en una realización particular, el primer método de la invención comprende determinar un único alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, y/o el alelo correspondiente de cualquiera de los SNPs de sus correspondientes bloques de ligamiento, es decir, determinar el nucleótido presente en el sitio polimórfico de dicho SNP. Así, en una realización particular, se determina un único alelo del SNP rs678188; en otra realización particular, se determina un único alelo del SNP rs9658498; en otra realización particular, se determina un único alelo del SNP rs4821566; en otra realización particular, se determina un único alelo del SNP rsl0891510; en otra realización particular, se determina un único alelo del SNP rsl 1932367; en otra realización particular, se determina un único alelo del SNP rs2023239; mientras que, en otra realización particular, se determina un único alelo de cualquiera de los SNPs de los correspondientes bloques de ligamiento de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 o rs2023239. Más adelante se proporcionar información sobre los bloques de ligamiento de dichos SNPs. El experto en la materia puede obtener información sobre los SNPs presentes en un bloque de ligamiento de un SNP determinado utilizando bases de datos apropiadas, por ejemplo, la base de datos International HapMap Project (www.hapmap.org y http://hapmap.ncbi.nlm.nih.gov/) y/o programas apropiados tales como el programa Haploview utilizando el método de intervalos de confianza o algoritmo de Gabriel (Gabriel et al, Science, 2002, 296(5576):225-9) o cualquier otra versión más actualizada (Barrett et al., 2005, Bioinformatics 21(2):263-265). The first method of the invention comprises genotyping or determining at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or the corresponding alleles of the SNPs of their binding blocks, in the biological sample of the subject under study. Therefore, in a particular embodiment, the first method of the invention comprises determining a single allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or the corresponding allele of any of the SNPs of its corresponding ligation blocks, that is, determining the nucleotide present in the polymorphic site of said SNP. Thus, in a particular embodiment, a single allele of SNP rs678188 is determined; In another particular embodiment, a single allele of SNP rs9658498 is determined; in another particular embodiment, a single allele of SNP rs4821566 is determined; in another particular embodiment, a single allele of SNP rsl0891510 is determined; in another particular embodiment, a single allele of SNP rsl 1932367 is determined; in another particular embodiment, a single allele of SNP rs2023239 is determined; while, in another particular embodiment, a single allele of any of the SNPs of the corresponding binding blocks of the SNPs is determined rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 or rs2023239. Information on the linkage blocks of said SNPs will be provided below. The person skilled in the art can obtain information on the SNPs present in a linkage block of a particular SNP using appropriate databases, for example, the International HapMap Project database (www.hapmap.org and http: // hapmap. ncbi.nlm.nih.gov/) and / or appropriate programs such as the Haploview program using Gabriel's confidence interval method or algorithm (Gabriel et al, Science, 2002, 296 (5576): 225-9) or any another more updated version (Barrett et al., 2005, Bioinformatics 21 (2): 263-265).

En otra realización particular, el primer método de la invención comprende determinar los dos alelos de uno o más de dichos SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, y/o de cualquiera de los SNPs de sus correspondientes bloques de ligamiento. Así, en una realización particular, se determinan los dos alelos del SNP rs678188; en otra realización particular, se determinan los dos alelos del SNP rs9658498; en otra realización particular, se determinan los dos alelos del SNP rs4821566; en otra realización particular, se determinan los dos alelos del SNP rsl0891510; en otra realización particular, se determinan los dos alelos del SNP rsl 1932367; en otra realización particular, se determinan los dos alelos del SNP rs2023239; mientras que, en otra realización particular, se determinan los dos alelos de cualquiera de los S Ps de los correspondientes bloques de ligamiento de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 o rs2023239. In another particular embodiment, the first method of the invention comprises determining the two alleles of one or more of said SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or of any of the SNPs of their corresponding binding blocks . Thus, in a particular embodiment, the two alleles of SNP rs678188 are determined; in another particular embodiment, the two alleles of SNP rs9658498 are determined; in another particular embodiment, the two alleles of SNP rs4821566 are determined; in another particular embodiment, the two alleles of SNP rsl0891510 are determined; in another particular embodiment, the two alleles of SNP rsl 1932367 are determined; in another particular embodiment, the two alleles of SNP rs2023239 are determined; while, in another embodiment In particular, the two alleles of any of the S Ps of the corresponding binding blocks of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 or rs2023239 are determined.

En otra realización particular, el primer método de la invención comprende determinar uno o ambos alelos de 1, 2, 3, 4, ó 5 SNPs cualesquiera de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, y/o de los SNPs de sus correspondientes bloques de ligamiento, mientras que en otra realización particular, dicho método comprende determinar uno o ambos alelos de los 6 SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, y/o de los SNPs de sus correspondientes bloques de ligamiento.  In another particular embodiment, the first method of the invention comprises determining one or both alleles of any 1, 2, 3, 4, or 5 SNPs of any of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or of the SNPs of their corresponding ligation blocks, while in another particular embodiment, said method comprises determining one or both alleles of the 6 SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or the corresponding SNPs of their corresponding ligation blocks

Los SNPs identificados en la presente invención, asociados con la probabilidad (alta o baja) de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, o con la predicción de la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos, o con la selección de un sujeto para una terapia para abandonar el consumo de tabaco basada en en un fármaco agonista de los receptores colinérgicos nicotínicos, o con la selección de una terapia a administrar a un sujeto en necesidad de terapia para abandonar el consumo, presentan las siguientes características:  The SNPs identified in the present invention, associated with the probability (high or low) of a subject giving up tobacco use in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, or with the prediction of the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors, or with the selection of a subject for a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors, or with the Selection of a therapy to be administered to a subject in need of therapy to abandon consumption, have the following characteristics:

el SNP rs678188 se localiza en el gen PARD3 (partitioning defective 3), en el cromosoma 10 humano (lOpl 1.21), corresponde a la secuencia [ACGCCGCCCATTTCCTATTTCCTACC[C/T]GTGCTGGATTTGCTGA AACCGTCAC] (SEQ ID NO: 1), y está situado en el bloque de ligamiento que se extiende desde el nucleótido 34484338 hasta el nucleótido 34509032; el SNP rs9658498 se localiza en el gen NOS1 (nitric oxide synthase /), en el cromosoma 12 humano (12q24.2-q24.31), corresponde a la secuencia [GGTCTCTGATTGTAAAATGAACCAAA[C/T]GTAGCCTCTACCACC TTGCTTAGAA] (SEQ ID NO: 2), y está situado en el bloque de ligamiento que se extiende desde el nucleótido 117657521 hasta el nucleótido 117681829;  SNP rs678188 is located in the PARD3 gene (partitioning defective 3), on human chromosome 10 (lOpl 1.21), corresponds to the sequence [ACGCCGCCCATTTCCTATTTCCTACC [C / T] GTGCTGGATTTGCTGA AACCGTCAC] (SEQ ID NO: 1), and is located in the ligation block that extends from nucleotide 34484338 to nucleotide 34509032; SNP rs9658498 is located in the NOS1 (nitric oxide synthase /) gene, on human chromosome 12 (12q24.2-q24.31), corresponds to the sequence [GGTCTCTGATTGTAAAATGAACCAAA [C / T] GTAGCCTCTACCACC TTGCTTAGAA] (SEQ ID NO: 2), and is located in the linkage block that extends from nucleotide 117657521 to nucleotide 117681829;

el SNP rs4821566 se localiza en el gen CSF2RB (colony stimulating factor 2 receptor beta), en el cromosoma 22 humano (22ql3.1), corresponde a la secuencia: [GGGATCATCCTCATATTCTTGCAAGA[C/G]GAAAAGTTT ACCAGTGAGAACTAGG] (SEQ ID NO: 3), y está situado en el bloque de ligamiento que se extiende desde el nucleótido 37306899 hasta el nucleótido 37319081; SNP rs4821566 is located in the CSF2RB gene (colony stimulating factor 2 beta receptor), on human chromosome 22 (22ql3.1), corresponds to the sequence: [GGGATCATCCTCATATTCTTGCAAGA [C / G] GAAAAGTTT ACCAGTGAGAACTAGG] (SEQ ID NO: 3), and is located in the linkage block that extends from nucleotide 37306899 to nucleotide 37319081;

- el SNP rsl0891510 se localiza en el gen NCAM1 {mural cell adhesión molecule /), en el cromosoma 11 humano (1 lq23.1), corresponde a la secuencia:  - SNP rsl0891510 is located in the NCAM1 gene {mural cell adhesion molecule /), on human chromosome 11 (1 lq23.1), corresponds to the sequence:

[CCTTTGCAGAAAGAAGGAAATCACAT[G/T]ATGTACAAACGTTGT TAATTACTCA] (SEQ ID NO: 4), y está situado en el bloque de ligamiento que se extiende desde el nucleótido 112999832 hasta el nucleótido [CCTTTGCAGAAAGAAGGAAATCACAT [G / T] ATGTACAAACGTTGT TAATTACTCA] (SEQ ID NO: 4), and is located in the linkage block that extends from nucleotide 112999832 to nucleotide

113008370; 113008370;

el SNP rsl 1932367 se localiza en el gen GRID2 (glutamate receptor ionotrophic delta), en el cromosoma 4 humano (4q22), corresponde a la secuencia:  SNP rsl 1932367 is located in the GRID2 gene (glutamate ionotrophic delta receptor), on human chromosome 4 (4q22), corresponds to the sequence:

[ATTCC AGAACTTAAAACCACAAATTT[A/G]C ACTGCACTTGAAAA [ATTCC AGAACTTAAAACCACAAATTT [A / G] C ACTGCACTTGAAAA

TACACACACA] (SEQ ID NO: 5), y está situado en el bloque de ligamiento que se extiende desde el nucleótido 94555780 hasta el nucleótido 94579593; y TACACACACA] (SEQ ID NO: 5), and is located in the linkage block that extends from nucleotide 94555780 to nucleotide 94579593; Y

el SNP rs2023239 se localiza en el gen CNR1 {cannabinoid receptor /), en el cromosoma 6 humano (6ql4-ql5), corresponde a la secuencia: SNP rs2023239 is located in the CNR1 gene {cannabinoid receptor /), on human chromosome 6 (6ql4-ql5), corresponds to the sequence:

[CTAGGTTTGTGGATGTGCCAGGACCA[C/T]GTAAGGAACAGCTCT CTCATATATT] (SEQ ID NO: 6), y está situado en el bloque de ligamiento que se extiende desde el nucleótido 88858648 hasta el nucleótido 88864063. Los SNP rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239 de acuerdo a la presente invención corresponden a los SNP tal como quedan recogidos en la base de datos de polimorfismos de sitio único del NCBI (dbSNP, NCBI, http://www.ncbi.nlm.nih.gov/snp; Marzo 2011) y de acuerdo a HapMap Genome Browser (versión 24, Fase 1&2). Las posiciones de nucleótidos indicadas para los bloques de ligamiento se definen de acuerdo al software Haploview versión 4.2 (correspondiente a la versión de Septiembre de 2009). Los sitios polimórficos (posiciones de nucleótidos dentro del genoma en las que es posible que haya más de una secuencia de nucleótidos en una población) presentes en dichos SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239 a los que se hace referencia en la presente invención son los siguientes: [CTAGGTTTGTGGATGTGCCAGGACCA [C / T] GTAAGGAACAGCTCT CTCATATATT] (SEQ ID NO: 6), and is located in the ligation block that extends from nucleotide 88858648 to nucleotide 88864063. SNPs rs678188, rs9658, rs96548, rs96548, rs9658, rs9658, rs9658, rs9658, rs9658, rs9658, rs9658, rs9658 and rs2023239 according to the present invention correspond to SNPs as they are collected in the NCBI single site polymorphism database (dbSNP, NCBI, http://www.ncbi.nlm.nih.gov/snp; March 2011) and according to HapMap Genome Browser (version 24, Phase 1 & 2). The nucleotide positions indicated for the linkage blocks are defined according to the Haploview software version 4.2 (corresponding to the September 2009 version). Polymorphic sites (nucleotide positions within the genome where it is possible that there is more than one nucleotide sequence in a population) present in said SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 referred to in the present invention are the following:

el sitio polimórfico del SNP rs678188 corresponde a la posición 27 de la secuencia SEQ ID NO: 1;  the polymorphic site of SNP rs678188 corresponds to position 27 of the sequence SEQ ID NO: 1;

- el sitio polimórfico del SNP rs9658498 corresponde a la posición 27 de la secuencia SEQ ID NO: 2;  - the polymorphic site of SNP rs9658498 corresponds to position 27 of the sequence SEQ ID NO: 2;

el sitio polimórfico del SNP rs4821566 corresponde a la posición 27 de la secuencia SEQ ID NO: 3;  the polymorphic site of SNP rs4821566 corresponds to position 27 of the sequence SEQ ID NO: 3;

el sitio polimórfico del SNP rsl0891510 corresponde a la posición 27 de la secuencia SEQ ID NO: 4;  the polymorphic site of SNP rsl0891510 corresponds to position 27 of the sequence SEQ ID NO: 4;

el sitio polimórfico del SNP rsl 1932367 corresponde a la posición 27 de la secuencia SEQ ID NO: 5; y  the polymorphic site of SNP rsl 1932367 corresponds to position 27 of the sequence SEQ ID NO: 5; Y

el sitio polimórfico del SNP rs2023239 corresponde a la posición 27 de la secuencia SEQ ID NO: 6.  the polymorphic site of SNP rs2023239 corresponds to position 27 of the sequence SEQ ID NO: 6.

El nucleótido concreto presente en el sitio polimórfico de dichos SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239 permite identificar el alelo correspondiente; así, el alelo C del SNP rs678188 corresponde al alelo en el que hay una C en el sitio polimórfico de dicho SNP; el alelo T del SNP rs9658498 corresponde al alelo en el que hay una T en el sitio polimórfico de dicho SNP; el alelo G del SNP rs4821566 corresponde al alelo en el que hay una G en el sitio polimórfico de dicho SNP; el alelo G del SNP rsl0891510 corresponde al alelo en el que hay una G en el sitio polimórfico de dicho SNP; el alelo G del SNP rsl 1932367 corresponde al alelo en el que hay una G en el sitio polimórfico de dicho SNP; el alelo C del SNP rs2023239 corresponde al alelo en el que hay una C en el sitio polimórfico de dicho SNP.  The specific nucleotide present at the polymorphic site of said SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 allows to identify the corresponding allele; thus, the C allele of SNP rs678188 corresponds to the allele in which there is a C in the polymorphic site of said SNP; the T allele of SNP rs9658498 corresponds to the allele in which there is a T in the polymorphic site of said SNP; the G allele of SNP rs4821566 corresponds to the allele in which there is a G in the polymorphic site of said SNP; the G allele of SNP rsl0891510 corresponds to the allele in which there is a G in the polymorphic site of said SNP; the G allele of SNP rsl 1932367 corresponds to the allele in which there is a G in the polymorphic site of said SNP; the C allele of SNP rs2023239 corresponds to the allele in which there is a C in the polymorphic site of said SNP.

Estudios realizados por los inventores (Ejemplo 1) han permitido identificar los nucleótidos presentes en los sitios polimórficos de los SNPs descritos en este documento asociados con una alta probabilidad de que el sujeto bajo estudio abandone el consumo de tabaco en respuesta a una terapia basada en vareniclina, en ocasiones referidos en esta descripción como "alelos asociados con una alta probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos" o simplemente "alelos de éxito". Dichos "alelos de éxito" se recogen en la Tabla 1. Studies carried out by the inventors (Example 1) have allowed the identification of nucleotides present in the polymorphic sites of the SNPs described in this document associated with a high probability that the subject under study will quit smoking in response to a varenicline-based therapy. , sometimes referred to in this description as "alleles associated with a high probability that a subject will quit smoking in response to a therapy based on a agonist drug of nicotinic cholinergic receptors "or simply" alleles of success. "These" alleles of success "are shown in Table 1.

Tabla 1 Table 1

Alelos asociados con una alta probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos ("alelos de éxito") para los distintos SNPs identificados en la presente invención Alleles associated with a high probability that a subject will quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug ("success alleles") for the various SNPs identified in the present invention

Figure imgf000028_0001
Figure imgf000028_0001

Los alelos de éxito indicados en la Tabla 1 corresponden a la hebra TOP del ADN según la nomenclatura de Ilumina para la identificación de hebras de ADN. Como es sabido, el caso más sencillo para la denominación de una hebra se da cuando una de las variaciones posibles del SNP es una adenina (A), y la variación restante es bien una citosina (C) o una guanina (G). En ese caso, la secuencia de ese SNP se denomina TOP. De forma similar a las normas de complementariedad inversa, cuando una de las variaciones posibles del SNP es una timina (T), y la variación restante es bien una C o una G, la secuencia de este SNP se denomina BOT. Si el SNP es un [A/T] o un [C/G], entonces no se aplican las normas anteriores. Illumina utiliza una técnica de "paseo secuencial" para denominar a la hebra [A/T] y [C/G] de los SNP. Para este método de paseo secuencial, el SNP real se considera que está en la posición 'n' . Las secuencias inmediatamente antes y después del SNP son 'η- y 'η+ , respectivamente. De forma similar, dos pares de bases antes del SNP se encuentran en 'n-2' y dos pares de base después del SNP 'n+2', etc. Empleando este método, el paseo secuencial continúa hasta que se presente un emparejamiento no ambiguo (A/G, A/C, T/C, o T/G). Para designar la hebra, cuando el nucleótido A o T del primer par no ambiguo se encuentra en el lado 5' del SNP, entonces la secuencia se denomina TOP. Cuando el nucleótido A o T del primer par no ambiguo se encuentra en el lado 3' del SNP, entonces la secuencia se denomina BOT. The success alleles indicated in Table 1 correspond to the TOP strand of the DNA according to the Ilumina nomenclature for the identification of DNA strands. As is known, the simplest case for the denomination of a strand occurs when one of the possible variations of the SNP is an adenine (A), and the remaining variation is either a cytosine (C) or a guanine (G). In that case, the sequence of that SNP is called TOP. Similar to the rules of inverse complementarity, when one of the possible variations of the SNP is a thymine (T), and the remaining variation is either a C or a G, the sequence of this SNP is called BOT. If the SNP is a [A / T] or a [C / G], then the above rules do not apply. Illumina uses a "sequential walk" technique to name the strand [A / T] and [C / G] of the SNPs. For this sequential walk method, the actual SNP is considered to be in the 'n' position. The sequences immediately before and after the SNP are 'η- and' η +, respectively. Similarly, two base pairs before the SNP are at 'n-2' and two base pairs after the SNP 'n + 2', etc. Using this method, the sequential walk continues until an unambiguous pairing occurs (A / G, A / C, T / C, or T / G). To designate the strand, when nucleotide A or T of the first unambiguous pair is on the 5 'side of the SNP, then the sequence is called TOP. When nucleotide A or T of the first unambiguous pair is on the 3 'side of the SNP, then the sequence is called BOT.

De acuerdo con el primer método de la invención, una vez que se determina en una muestra biológica de dicho sujeto al menos uno de los alelos de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, y/o de cualquier SNP de sus correspondientes bloques de ligamiento, es posible determinar la probabilidad de que el sujeto bajo estudio abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, por ejemplo, vareniclina, citisina, dianiclina, o cualquier otro fármaco con un mecanismo de acción similar. El establecimiento de la probabilidad (alta o baja) de que el sujeto bajo estudio abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos se puede llevar a cabo en base a la presencia o ausencia de los alelos de éxito (es decir, en base a la presencia o ausencia de los nucleótidos presentes en los sitios polimórficos de dichos SNPs asociados con una probabilidad (alta o baja) de que el sujeto bajo estudio abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos) de dichos SNPS en el genoma del sujeto bajo estudio. Por tanto, como se ha mencionado previamente:  According to the first method of the invention, once at least one of the alleles of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / is determined in a biological sample of said subject or of any SNP of its corresponding linkage blocks, it is possible to determine the likelihood that the subject under study will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, for example, varenicline, cytisine, dianicline, or any other drug with a similar mechanism of action. The establishment of the probability (high or low) for the subject under study to quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors can be carried out based on the presence or absence of success alleles (that is, based on the presence or absence of nucleotides present at the polymorphic sites of said SNPs associated with a probability (high or low) that the subject under study quit smoking in response to therapy based on a nicotinic cholinergic receptor agonist drug) of said SNPS in the genome of the subject under study. Therefore, as previously mentioned:

la presencia de al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one C allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block;

- la presencia de al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of at least one G allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of at least one G allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I

la presencia de al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento; es indicativa de una alta probabilidad de que dicho sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos. the presence of at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block; it is indicative of a high probability that said subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors.

Asimismo, en una realización particular, del primer método de la invención: - la presencia de ambos alelos C del S P rs678188, o de los alelos correspondientes de los S Ps de su bloque de ligamiento;  Also, in a particular embodiment, of the first method of the invention: - the presence of both alleles C of the S P rs678188, or of the corresponding alleles of the S Ps of its linkage block;

la presencia de ambos alelos T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both T alleles of the SNP rs9658498, or of the corresponding alleles of the SNPs of their linkage block;

la presencia de ambos alelos G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of the SNP rs4821566, or of the corresponding alleles of the SNPs of their linkage block;

la presencia de ambos alelos G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block;

la presencia de ambos alelos G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of both G alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; I

- la presencia de ambos alelos C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento;  - the presence of both C alleles of SNP rs2023239, or of the corresponding alleles of SNPs of their linkage block;

es indicativa de una alta probabilidad de que dicho sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos. it is indicative of a high probability that said subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors.

El término "alta" aplicado a la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, tal como aquí se utiliza, se refiere a que la frecuencia con la que se obtiene un resultado, en este caso, que un sujeto deje de consumir tabaco en respuesta a un tratamiento con un fármaco agonista de los receptores colinérgicos nicotínicos, es superior al 50%.  The term "high" applied to the probability that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, as used herein, refers to the frequency with which a result is obtained, in this case, that a subject stops using tobacco in response to a treatment with an agonist drug of nicotinic cholinergic receptors, is greater than 50%.

Alternativamente, tal como se ha mencionado previamente, en base a los resultados obtenidos en la presente invención, se puede establecer que:  Alternatively, as previously mentioned, based on the results obtained in the present invention, it can be established that:

la presencia de al menos un alelo T del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block;

- la presencia de al menos un alelo C del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of at least one C allele of SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo C del SNP rs4821566, o de los alelos correspondientes de los S Ps de su bloque de ligamiento; the presence of at least one C allele of SNP rs4821566, or of alleles corresponding to the S Ps of its linkage block;

la presencia de al menos un alelo T del S P rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of S P rsl0891510, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo A del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of at least one A allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I

la presencia de al menos un alelo T del SNP rs2023239, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs2023239, or of the corresponding alleles of the SNPs of its linkage block;

es indicativa de una baja probabilidad de que dicho sujeto cese el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos. It is indicative of a low probability that said subject will cease tobacco consumption in response to a therapy based on an agonist drug of nicotinic cholinergic receptors.

El nucleótido concreto presente en el sitio polimórfico de dichos SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239 permite identificar el alelo correspondiente; así, el alelo T del SNP rs678188 corresponde al alelo en el que hay una T en el sitio polimórfico de dicho SNP; el alelo C del SNP rs9658498 corresponde al alelo en el que hay una C en el sitio polimórfico de dicho SNP; el alelo C del SNP rs4821566 corresponde al alelo en el que hay una C en el sitio polimórfico de dicho SNP; el alelo T del SNP rsl0891510 corresponde al alelo en el que hay una T en el sitio polimórfico de dicho SNP; el alelo A del SNP rsl 1932367 corresponde al alelo en el que hay una A en el sitio polimórfico de dicho SNP; el alelo T del SNP rs2023239 corresponde al alelo en el que hay una T en el sitio polimórfico de dicho SNP.  The specific nucleotide present at the polymorphic site of said SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 allows to identify the corresponding allele; thus, the T allele of SNP rs678188 corresponds to the allele in which there is a T in the polymorphic site of said SNP; the C allele of SNP rs9658498 corresponds to the allele in which there is a C in the polymorphic site of said SNP; the C allele of SNP rs4821566 corresponds to the allele in which there is a C in the polymorphic site of said SNP; the T allele of SNP rsl0891510 corresponds to the allele in which there is a T in the polymorphic site of said SNP; the A allele of SNP rsl 1932367 corresponds to the allele in which there is an A at the polymorphic site of said SNP; the T allele of SNP rs2023239 corresponds to the allele in which there is a T in the polymorphic site of said SNP.

De forma más concreta, en una realización más particular de esta alternativa: la presencia de ambos alelos T del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  More specifically, in a more particular embodiment of this alternative: the presence of both T alleles of the SNP rs678188, or of the corresponding alleles of the SNPs of their linkage block;

- la presencia de ambos alelos C del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of both C alleles of SNP rs9658498, or of the corresponding alleles of the SNPs of their linkage block;

la presencia de ambos alelos C del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both C alleles of SNP rs4821566, or of the corresponding alleles of the SNPs of their linkage block;

la presencia de ambos alelos T del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both T alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block;

la presencia de ambos alelos A del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o la presencia de ambos alelos T del S P rs2023239, o de los alelos correspondientes de los S Ps de su bloque de ligamiento; the presence of both A alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; I the presence of both T alleles of SP rs2023239, or of the corresponding alleles of the S Ps of its linkage block;

es indicativa de una baja probabilidad de que dicho sujeto cese el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos. It is indicative of a low probability that said subject will cease tobacco consumption in response to a therapy based on an agonist drug of nicotinic cholinergic receptors.

El término "baja" aplicado a la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, tal como aquí se utiliza, se refiere a que la frecuencia con la que se obtiene un resultado, en este caso, que un sujeto deje de consumir tabaco en respuesta a un tratamiento con un fármaco agonista de los receptores colinérgicos nicotínicos, es inferior al 50%.  The term "low" applied to the likelihood that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, as used herein, refers to the frequency with which it obtains a result, in this case, that a subject stops using tobacco in response to a treatment with a nicotinic cholinergic receptor agonist drug, is less than 50%.

Adicionalmente, ensayos realizados por los inventores han puesto de manifiesto que los SNPs analizados según el primer método de la invención pueden clasificarse en dos grupos:  Additionally, tests carried out by the inventors have shown that SNPs analyzed according to the first method of the invention can be classified into two groups:

- Grupo 1 : formado por los SNPs rs678188, rs9658498 y rs4821566; estos SNPs se relacionan con una alta probabilidad de que un sujeto en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos abandone el consumo de tabaco durante un periodo de, al menos, 3 meses contados desde el inicio de dicha terapia; y - Group 1: formed by SNPs rs678188, rs9658498 and rs4821566; these SNPs are related to a high probability that a subject in response to a therapy based on an agonist drug of nicotinic cholinergic receptors will quit smoking for a period of at least 3 months from the start of said therapy; Y

- Grupo 2: formado por los SNPs rsl0891510, rsl 1932367 y rs2023239; estos SNPs se relacionan con una alta probabilidad de que un sujeto en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos abandone el consumo de tabaco durante un periodo de, al menos, 12 meses contados desde el inicio de dicha terapia.  - Group 2: formed by SNPs rsl0891510, rsl 1932367 and rs2023239; These SNPs are related to a high probability that a subject in response to a therapy based on an agonist drug of nicotinic cholinergic receptors will quit smoking for a period of at least 12 months from the start of said therapy.

En una realización más concreta, el primer método de la invención contempla la posibilidad de analizar la presencia o ausencia en una muestra biológica de dicho sujeto al menos uno de los alelos de uno o más de los SNPs rs678188, rs9658498, rs4821566 o cualquier combinación de dichos SNPs, y/o de los correspondientes SNPs de su bloque de ligamiento, en donde  In a more concrete embodiment, the first method of the invention contemplates the possibility of analyzing the presence or absence in a biological sample of said subject at least one of the alleles of one or more of the SNPs rs678188, rs9658498, rs4821566 or any combination of said SNPs, and / or the corresponding SNPs of their linkage block, wherein

la presencia de al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; la presencia de al menos un alelo T del S P rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o the presence of at least one C allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block; the presence of at least one T allele of SP rs9658498, or the corresponding alleles of the SNPs of its linkage block; I

la presencia de al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block;

es indicativa de una alta probabilidad de que el sujeto bajo estudio abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos durante un periodo de, al menos, 3 meses desde el inicio del tratamiento con dicho fármaco agonista de los receptores colinérgicos nicotínicos. It is indicative of a high probability that the subject under study will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors for a period of at least 3 months from the start of treatment with said drug. agonist of nicotinic cholinergic receptors.

En otra realización concreta, el primer método de la invención contempla la posibilidad de analizar la presencia o ausencia en una muestra biológica de dicho sujeto al menos uno de los alelos de uno o más de los SNPs rs678188, rs9658498, rs4821566 o cualquier combinación de dichos SNPs, y/o de los correspondientes SNPs de su bloque de ligamiento, en donde  In another specific embodiment, the first method of the invention contemplates the possibility of analyzing the presence or absence in a biological sample of said subject at least one of the alleles of one or more of the SNPs rs678188, rs9658498, rs4821566 or any combination of said SNPs, and / or the corresponding SNPs of their linkage block, where

- la presencia de ambos alelos C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of both C alleles of the SNP rs678188, or of the corresponding alleles of the SNPs of their linkage block;

la presencia de ambos alelos T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of both T alleles of the SNP rs9658498, or of the corresponding alleles of the SNPs of their linkage block; I

la presencia de ambos alelos G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of the SNP rs4821566, or of the corresponding alleles of the SNPs of their linkage block;

es indicativa de una alta probabilidad de que el sujeto bajo estudio abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos durante un periodo de, al menos, 3 meses desde el inicio del tratamiento con dicho fármaco agonista de los receptores colinérgicos nicotínicos. It is indicative of a high probability that the subject under study will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors for a period of at least 3 months from the start of treatment with said drug. agonist of nicotinic cholinergic receptors.

Asimismo, en otra realización más concreta, el primer método de la invención contempla la posibilidad de analizar la presencia o ausencia en una muestra biológica de dicho sujeto al menos un alelo de uno o más de los SNPs rsl0891510, rsl 1932367 y rs2023239, o cualquier combinación de dichos SNPs, y/o de los correspondientes SNPs de su bloque de ligamiento, en donde  Also, in another more concrete embodiment, the first method of the invention contemplates the possibility of analyzing the presence or absence in a biological sample of said subject at least one allele of one or more of the SNPs rsl0891510, rsl 1932367 and rs2023239, or any combination of said SNPs, and / or the corresponding SNPs of their linkage block, wherein

la presencia de al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; la presencia de al menos un alelo G del S P rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o the presence of at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block; the presence of at least one G allele of SP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I

la presencia de al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento;  the presence of at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block;

es indicativa de una alta probabilidad de que el sujeto bajo estudio abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos durante un periodo de, al menos, 12 meses desde el inicio del tratamiento con dicho fármaco agonista de los receptores colinérgicos nicotínicos. It is indicative of a high probability that the subject under study will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors for a period of at least 12 months from the start of treatment with said drug. agonist of nicotinic cholinergic receptors.

Asimismo, en otra realización más concreta, el primer método de la invención contempla la posibilidad de analizar la presencia o ausencia en una muestra biológica de dicho sujeto al menos un alelo de uno o más de los SNPs rsl0891510, rsl 1932367 y rs2023239, o cualquier combinación de dichos SNPs, y/o de los correspondientes SNPs de su bloque de ligamiento, en donde  Also, in another more concrete embodiment, the first method of the invention contemplates the possibility of analyzing the presence or absence in a biological sample of said subject at least one allele of one or more of the SNPs rsl0891510, rsl 1932367 and rs2023239, or any combination of said SNPs, and / or the corresponding SNPs of their linkage block, wherein

- la presencia de ambos alelos G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of both G alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block;

la presencia de ambos alelos G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of both G alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; I

la presencia de ambos alelos C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento;  the presence of both C alleles of SNP rs2023239, or of the corresponding alleles of SNPs of their linkage block;

es indicativa de una alta probabilidad de que el sujeto bajo estudio abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos durante un periodo de, al menos, 12 meses desde el inicio del tratamiento con dicho fármaco agonista de los receptores colinérgicos nicotínicos. It is indicative of a high probability that the subject under study will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors for a period of at least 12 months from the start of treatment with said drug. agonist of nicotinic cholinergic receptors.

El primer método de la invención permite establecer la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos. Si dicha probabilidad es alta, por ejemplo, debido a la presencia de un alelo de éxito en al menos uno de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 o rs2023239 (Tabla 1), o de los alelos correspondientes de los SNPs de su bloque de ligamiento, entonces dicho sujeto puede ser un candidato apropiado a priori para recibir una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos con el fin de abandonar el consumo de tabaco, por ejemplo, vareniclina, citisina o dianiclina, entre otros. Al contrario, si dicha probabilidad es baja, entonces dicho sujeto no es un candidato apropiado a priori para recibir una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, y, por tanto, debería recibir una terapia alternativa para abandonar el consumo de tabaco. The first method of the invention makes it possible to establish the probability that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors. If said probability is high, for example, due to the presence of a successful allele in at least one of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 or rs2023239 (Table 1), or the corresponding alleles of the SNPs of its linkage block, then said subject may be an a priori appropriate candidate to receive a therapy based on a agonist drug of nicotinic cholinergic receptors in order to quit smoking, for example, varenicline, cytisine or dianicline, among others. On the contrary, if said probability is low, then said subject is not an appropriate a priori candidate to receive a therapy based on an agonist drug of nicotinic cholinergic receptors, and therefore should receive an alternative therapy to quit smoking .

Adicionalmente, los inventores han estudiado la posible influencia de variables clínicas, tales como estrés subjetivo, motivos para fumar y la dependencia según la escala de Fagerstróm, en los resultados de eficacia de dicha terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos con el fin de abandonar el consumo de tabaco, así como su papel como variables confusoras o modificadoras de la asociación estudiada, mediante el empleo de modelos de regresión logística múltiple. Los resultados obtenidos ponen de manifiesto que la combinación de los SNPs con las variables clínicas proporciona unos modelos mejores ya que la predicción es mejor para el modelo multivariado (genotipo + variables clínicas) que para el modelo univariado (genotipo); de hecho, la significación del p-w or para modelos anidados (genotipo vs genotipo + variables clínicas) señala que el modelo multivariado es mejor que el univariado en la predicción del resultado, tal como se menciona en el Ejemplo 1, Tablas 2-5 y Figuras 1-6.  Additionally, the inventors have studied the possible influence of clinical variables, such as subjective stress, reasons for smoking and dependence according to the Fagerstrom scale, on the results of efficacy of said therapy based on an agonist drug of nicotinic cholinergic receptors with the in order to abandon tobacco consumption, as well as its role as confusing or modifying variables of the association studied, through the use of multiple logistic regression models. The results obtained show that the combination of SNPs with clinical variables provides better models since the prediction is better for the multivariate model (genotype + clinical variables) than for the univariate model (genotype); in fact, the significance of pw or for nested models (genotype vs genotype + clinical variables) indicates that the multivariate model is better than the univariate in predicting the result, as mentioned in Example 1, Tables 2-5 and Figures 1-6.

Por tanto, en una realización particular, el primer método de la invención comprende, además, analizar al menos una variable clínica relacionada con el consumo de tabaco. Aunque prácticamente cualquier variable clínica relacionada con el consumo de tabaco puede ser analizada, en una realización particular, dicha variable clínica relacionada con el consumo de tabaco se selecciona del grupo formado por estrés subjetivo, motivos para fumar, dependencia según la escala de Fagerstróm, y cualquiera de sus combinaciones.  Therefore, in a particular embodiment, the first method of the invention further comprises analyzing at least one clinical variable related to tobacco consumption. Although virtually any clinical variable related to tobacco consumption can be analyzed, in a particular embodiment, said clinical variable related to tobacco consumption is selected from the group consisting of subjective stress, reasons for smoking, dependence according to the Fagerstrom scale, and Any of your combinations.

Este modelo probabilístico basado en la determinación de al menos uno de los alelos de uno o más de los SNPs identificados en la presente invención, o de los alelos correspondientes de los SNPs de su bloque de ligamiento, opcionalmente junto con una evaluación clínica estructurada, constituye una valiosa herramienta para predecir el éxito o fracaso, en base a una probabilidad alta o baja, del abandono del consumo de tabaco, por parte de un sujeto, en respuesta a un tratamiento con un fármaco agonista de los receptores colinérgicos nicotínicos, por ejemplo, vareniclina, citisina o dianiclina, o cualquier otro fármaco con un mecanismo de acción similar. A la vista de los resultados proporcionados por esta invención, el especialista (e.g., un médico) podrá optimizar la atención terapéutica al sujeto eligiendo, desde el primer momento, la terapia más adecuada en función de la probabilidad (alta o baja) de que el sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos y realizar un seguimiento cercano de los sujetos en tratamiento. Por tanto, los métodos y medios proporcionados por la presente invención pueden ayudar a los médicos a seleccionar la terapia para abandonar el consumo de tabaco más apropiada para un sujeto. Por otra parte, se pueden evitar los efectos secundarios asociados con el tratamiento con fármacos agonistas de los receptores colinérgicos nicotínicos en sujetos cuyo tratamiento con ese fármaco sea ineficaz. This probabilistic model based on the determination of at least one of the alleles of one or more of the SNPs identified in the present invention, or of the corresponding alleles of the SNPs of its linkage block, optionally together with a structured clinical evaluation, constitutes a valuable tool for predicting success or failure, based on a high or low probability, of smoking cessation by a subject, in response to treatment with an agonist drug of nicotinic cholinergic receptors, for example, varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action. In view of the results provided by this invention, the specialist (eg, a doctor) may optimize the therapeutic care of the subject by choosing, from the outset, the most appropriate therapy based on the probability (high or low) that the subject quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug and closely monitor the subjects under treatment. Therefore, the methods and means provided by the present invention can help physicians select the therapy to quit smoking more appropriate for a subject. On the other hand, side effects associated with treatment with nicotinic cholinergic receptor agonists in subjects whose treatment with that drug is ineffective can be avoided.

Método para predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos ("segundo método de la invención"). Method for predicting the efficacy of a therapy to quit smoking based on a nicotinic cholinergic receptor agonist drug ("second method of the invention").

En otro aspecto, la invención se relaciona con un método para predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto (en adelante, "segundo método de la invención"), que comprende determinar en una muestra biológica de dicho sujeto al menos un alelo de uno o más de los polimorfismos de un solo nucleótido (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o cualquier S P de sus correspondientes bloques de ligamiento, en donde In another aspect, the invention relates to a method for predicting the efficacy of a therapy for quitting tobacco use based on an agonist drug of nicotinic cholinergic receptors in a subject (hereinafter, "second method of the invention"), comprising determining in an biological sample of said subject at least one allele of one or more of the single nucleotide polymorphisms (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SP of their corresponding blocks ligation where

- la presencia de al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of at least one C allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; la presencia de al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los S Ps de su bloque de ligamiento; y/o the presence of at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block; the presence of at least one G allele of SNP rsl 1932367, or of the corresponding alleles of the S Ps of its linkage block; I

la presencia de al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento;  the presence of at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block;

es indicativa de que dicha terapia será eficaz. It is indicative that such therapy will be effective.

En una realización alternativa del segundo método de la invención, la invención también se relaciona con un método para predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto, que comprende determinar en una muestra biológica de dicho sujeto, al menos un alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o de cualquier SNP de sus correspondientes bloques de ligamiento, en donde  In an alternative embodiment of the second method of the invention, the invention also relates to a method of predicting the efficacy of a therapy for quitting tobacco use based on an agonist drug of nicotinic cholinergic receptors in a subject, which comprises determining in a biological sample of said subject, at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or of any SNP of its corresponding ligation blocks, wherein

la presencia de al menos un alelo T del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block;

- la presencia de al menos un alelo C del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of at least one C allele of SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo C del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one C allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo T del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo A del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of at least one A allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I

la presencia de al menos un alelo T del SNP rs2023239, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs2023239, or of the corresponding alleles of the SNPs of its linkage block;

es indicativa de dicha terapia será ineficaz. It is indicative of such therapy will be ineffective.

La expresión "predecir la eficacia de una terapia", tal como aquí se utiliza, en combinación con el abandono del consumo de tabaco, se refiere a la determinación del resultado obtenido por un sujeto en respuesta a una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos, por ejemplo, vareniclina, citisina y dianiclina, entre otros. La consideración de que dicha terapia será eficaz implica que esa terapia proporciona el efecto deseado, es decir, que el sujeto abandone el consumo de tabaco en respuesta a dicha terapia, durante un periodo de tiempo determinado, por ejemplo, durante un periodo de tiempo de, al menos, 3 meses. The term "predict the efficacy of a therapy", as used herein, in combination with smoking cessation, refers to the determination of the result obtained by a subject in response to a therapy to quit based tobacco use. in a nicotinic cholinergic receptor agonist drug, for example, varenicline, cytisine and dianicline, among others. The consideration that such therapy will be effective implies that such therapy provides the desired effect, that is, that the subject quits smoking in response to said therapy, for a period of time. of a certain time, for example, for a period of time of at least 3 months.

Las características de la muestra biológica, el sujeto, los S Ps (rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239) y sus correspondientes bloques de ligamiento, así como las de sus sitios polimórficos, ya han sido mencionadas previamente en relación con el primer método de la invención, al igual que los métodos para detrminar dichos SNPs e identificar los nucleótidos presentes en los sitios polimórficos de dichos SNPs; todo ello se incorpora en este método por referencia.  The characteristics of the biological sample, the subject, the S Ps (rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239) and their corresponding binding blocks, as well as those of their polymorphic sites, have already been mentioned previously in relation to the first method of the invention, as well as the methods for detrminating said SNPs and identifying the nucleotides present at the polymorphic sites of said SNPs; All this is incorporated into this method by reference.

De acuerdo con el segundo método de la invención, en una muestra biológica del sujeto bajo estudio se determina al menos un alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o de cualquier SNP de sus correspondientes bloques de ligamiento, y se correlacionan los resultados obtenidos con la predicción de la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto. Ejemplos ilustrativos, no limitativos, de fármacos agonistas de los receptores colinérgicos nicotínicos incluyen citisina, dianiclina y vareniclina. En una realización particular, dicho fármaco agonista de los receptores colinérgicos nicotínicos es vareniclina.  In accordance with the second method of the invention, at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of their subjects is determined in a biological sample of the subject under study corresponding ligation blocks, and the results obtained are correlated with the prediction of the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject. Illustrative, non-limiting examples of nicotinic cholinergic receptor agonist drugs include cytisine, dianicline and varenicline. In a particular embodiment, said nicotinic cholinergic receptor agonist drug is varenicline.

Una vez que se determina en una muestra biológica de dicho sujeto al menos uno de los alelos de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, y/o de cualquier SNP de sus correspondientes bloques de ligamiento, según el segundo método de la invención, es posible predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto. La predicción de que dicha terapia será eficaz o ineficaz en un sujeto se puede llevar a cabo en base a la presencia o ausencia de los alelos de éxito (es decir, en base a la presencia o ausencia de los nucleótidos presentes en los sitios polimórficos de dichos SNPs asociados con una predicción de que dicha terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será eficaz o ineficaz) de dichos SNPS en el genoma del sujeto bajo estudio. Dichos alelos de éxito (en este caso, alelos cuya presencia está asociada con una predicción de que la terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será eficaz) se mencionan en la Tabla 1. En una realización particular, del segundo método de la invención: Once it is determined in a biological sample of said subject at least one of the alleles of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or of any SNP of their corresponding binding blocks According to the second method of the invention, it is possible to predict the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject. The prediction that such therapy will be effective or ineffective in a subject can be carried out based on the presence or absence of the success alleles (i.e., based on the presence or absence of nucleotides present at the polymorphic sites of said SNPs associated with a prediction that said therapy based on a nicotinic cholinergic receptor agonist drug will be effective or ineffective) of said SNPS in the genome of the subject under study. Such alleles of success (in this case, alleles whose presence is associated with a prediction that therapy based on an agonist drug of nicotinic cholinergic receptors will be effective) are mentioned in Table 1. In a particular embodiment, of the second method of the invention:

la presencia de ambos alelos C del S P rs678188, o de los alelos correspondientes de los S Ps de su bloque de ligamiento;  the presence of both alleles C of S P rs678188, or of the corresponding alleles of the S Ps of its linkage block;

la presencia de ambos alelos T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both T alleles of the SNP rs9658498, or of the corresponding alleles of the SNPs of their linkage block;

la presencia de ambos alelos G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of the SNP rs4821566, or of the corresponding alleles of the SNPs of their linkage block;

la presencia de ambos alelos G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block;

- la presencia de ambos alelos G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  - the presence of both G alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; I

la presencia de ambos alelos C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento;  the presence of both C alleles of SNP rs2023239, or of the corresponding alleles of SNPs of their linkage block;

es indicativa de que dicha terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será eficaz. It is indicative that such therapy based on a nicotinic cholinergic receptor agonist drug will be effective.

Alternativamente, en otra realización particular de la realización alternativa del segundo método de la invención:  Alternatively, in another particular embodiment of the alternative embodiment of the second method of the invention:

la presencia de ambos alelos T del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both T alleles of the SNP rs678188, or of the corresponding alleles of the SNPs of their linkage block;

- la presencia de ambos alelos C del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of both C alleles of SNP rs9658498, or of the corresponding alleles of the SNPs of their linkage block;

la presencia de ambos alelos C del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both C alleles of SNP rs4821566, or of the corresponding alleles of the SNPs of their linkage block;

la presencia de ambos alelos T del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both T alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block;

la presencia de ambos alelos A del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of both A alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; I

la presencia de ambos alelos T del SNP rs2023239, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both T alleles of the SNP rs2023239, or of the corresponding alleles of the SNPs of their linkage block;

es indicativa de que dicha terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será ineficaz. En otra realización particular, el segundo método de la invención contempla la posibilidad de determinar al menos un alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566 o cualquier combinación de dichos SNPs, y/o de los correspondientes SNPs de su bloque de ligamiento, en donde It is indicative that such therapy based on a nicotinic cholinergic receptor agonist drug will be ineffective. In another particular embodiment, the second method of the invention contemplates the possibility of determining at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566 or any combination of said SNPs, and / or the corresponding SNPs of their block of ligation where

- la presencia de al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - the presence of at least one C allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block;

la presencia de al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of at least one T allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block; I

la presencia de al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block;

es indicativa de que dicha terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será eficaz en un sujeto durante un periodo de, al menos, 3 meses desde el inicio de dicha terapia. it is indicative that said therapy based on a nicotinic cholinergic receptor agonist drug will be effective in a subject for a period of at least 3 months from the start of said therapy.

Asimismo, en otra realización particular, el segundo método de la invención contempla la posibilidad de determinar al menos un alelo de uno o más de los SNPs rsl0891510, rsl 1932367, rs2023239, o cualquier combinación de dichos SNPs, y/o de los correspondientes SNPs de su bloque de ligamiento, en donde  Also, in another particular embodiment, the second method of the invention contemplates the possibility of determining at least one allele of one or more of the SNPs rsl0891510, rsl 1932367, rs2023239, or any combination of said SNPs, and / or the corresponding SNPs of its linkage block, where

la presencia de al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block;

- la presencia de al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  - the presence of at least one G allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I

la presencia de al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento;  the presence of at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block;

es indicativa de que dicha terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será eficaz en un sujeto durante un periodo de, al menos, 12 meses desde el inicio de dicha terapia. it is indicative that said therapy based on a nicotinic cholinergic receptor agonist drug will be effective in a subject for a period of at least 12 months from the start of said therapy.

En una realización particular, el segundo método de la invención comprende, además, analizar al menos una variable clínica relacionada con el consumo de tabaco. In a particular embodiment, the second method of the invention further comprises analyzing at least one clinical variable related to tobacco consumption.

Aunque prácticamente cualquier variable clínica relacionada con el consumo de tabaco puede ser analizada, en una realización particular, dicha variable clínica relacionada con el consumo de tabaco se selecciona del grupo formado por estrés subjetivo, motivos para fumar, dependencia según la escala de Fagerstróm, y cualquiera de sus combinaciones. La combinación de los SNPs con las variables clínicas proporciona, en general, unos modelos mejores. Although virtually any clinical variable related to tobacco consumption can be analyzed, in a particular embodiment, said clinical variable related to tobacco consumption is selected from the group consisting of subjective stress, reasons for smoking, dependence according to the Fagerstrom scale, and any of your combinations The combination of SNPs with clinical variables generally provides better models.

El segundo método de la invención permite predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto, de manera que si el resultado de dicha predicción es que la terapia será eficaz, entonces el sujeto puede ser tratado con un fármaco agonista de los receptores colinérgicos nicotínicos para abandonar el consumo de tabaco, mientras que, en caso contrario, si el resultado de dicha predicción fuera que la terapia será ineficaz, entonces el sujeto no debería ser tratado con un fármaco agonista de los receptores colinérgicos nicotínicos. Ejemplos ilustrativos, no limitativos, de fármacos agonistas de los receptores colinérgicos nicotínicos incluyen vareniclina, citisina o dianiclina, o cualquier otro fármaco con un mecanismo de acción similar.  The second method of the invention makes it possible to predict the efficacy of a therapy for abandoning tobacco consumption based on an agonist drug of nicotinic cholinergic receptors in a subject, so that if the result of said prediction is that the therapy will be effective, then the subject can be treated with a nicotinic cholinergic receptor agonist drug to quit smoking, while, otherwise, if the result of such prediction were that the therapy will be ineffective, then the subject should not be treated with a agonist drug of nicotinic cholinergic receptors. Illustrative, non-limiting examples of nicotinic cholinergic receptor agonist drugs include varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action.

Este modelo predictivo basado en la determinación de al menos uno de los alelos de uno o más de los SNPs identificados en la presente invención, o de los alelos correspondientes de los SNPs de su bloque de ligamiento, opcionalmente junto con una evaluación clínica estructurada, constituye una valiosa herramienta para predecir la eficacia o ineficacia de un tratamiento con un fármaco agonista de los receptores colinérgicos nicotínicos, por ejemplo, vareniclina, citisina o dianiclina, o cualquier otro fármaco con un mecanismo de acción similar. A la vista de los resultados proporcionados por esta invención, el especialista (e.g., un médico) podrá optimizar la atención terapéutica al sujeto eligiendo, desde el primer momento, la terapia más adecuada en función de la predicción de la eficacia o ineficacia de que el sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, y realizar un seguimiento cercano de los sujetos en tratamiento.  This predictive model based on the determination of at least one of the alleles of one or more of the SNPs identified in the present invention, or of the corresponding alleles of the SNPs of its linkage block, optionally together with a structured clinical evaluation, constitutes a valuable tool for predicting the efficacy or ineffectiveness of a treatment with an agonist drug of nicotinic cholinergic receptors, for example, varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action. In view of the results provided by this invention, the specialist (eg, a doctor) will be able to optimize the therapeutic attention to the subject by choosing, from the outset, the most appropriate therapy based on the prediction of the efficacy or ineffectiveness of the subject quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, and closely monitor the subjects under treatment.

Por tanto, los métodos y medios proporcionados por la presente invención pueden ayudar a los médicos a seleccionar la terapia para abandonar el consumo de tabaco más apropiada para un sujeto. Por otra parte, se pueden evitar los efectos secundarios asociados con el tratamiento con fármacos agonistas de los receptores colinérgicos nicotínicos en sujetos cuyo tratamiento con ese fármaco sea ineficaz. En una realización particular, dicho fármaco agonista de los receptores colinérgicos nicotínicos es vareniclina. Método para seleccionar un sujeto para una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos (en adelante, "tercer método de la invención"). Therefore, the methods and means provided by the present invention can help physicians select the therapy to quit smoking more appropriate for a subject. On the other hand, side effects associated with treatment with nicotinic cholinergic receptor agonists in subjects whose treatment with that drug is ineffective can be avoided. In a particular embodiment, said nicotinic cholinergic receptor agonist drug is varenicline. Method for selecting a subject for a therapy to quit smoking based on a nicotinic cholinergic receptor agonist drug (hereinafter, "third method of the invention").

En otro aspecto, la invención se relaciona con un método para seleccionar un sujeto para una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de receptores colinérgicos nicotínicos (en adelante, "tercer método de la invención"), que comprende determinar en una muestra biológica de dicho sujeto al menos un alelo de uno o más de los polimorfismos de un solo nucleótido (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o cualquier S P de sus correspondientes bloques de ligamiento, en donde dicho sujeto es seleccionado para dicha terapia si tiene In another aspect, the invention relates to a method for selecting a subject for a therapy to quit tobacco use based on a nicotinic cholinergic receptor agonist drug (hereinafter, "third method of the invention"), which comprises determining in a biological sample of said subject at least one allele of one or more of the single nucleotide polymorphisms (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SP of its corresponding ligation blocks, where said subject is selected for said therapy if he has

al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one C allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block;

al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los at least one T allele of SNP rs9658498, or of the corresponding alleles of the

SNPs de su bloque de ligamiento; SNPs of its linkage block;

al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one G allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block;

- al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block;

al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  at least one G allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I

al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento.  at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block.

En una realización particular del tercer método de la invención, se selecciona un sujeto para una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de receptores colinérgicos nicotínicos, cuando dicho sujeto tiene  In a particular embodiment of the third method of the invention, a subject is selected for a therapy to quit smoking based on a nicotinic cholinergic receptor agonist drug, when said subject has

ambos alelos C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  both C alleles of SNP rs678188, or of the corresponding alleles of SNPs of their linkage block;

ambos alelos T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; ambos alelos G del S P rs4821566, o de los alelos correspondientes de los S Ps de su bloque de ligamiento; both T alleles of the SNP rs9658498, or of the corresponding alleles of the SNPs of their linkage block; both alleles G of SP rs4821566, or of the corresponding alleles of the S Ps of their linkage block;

ambos alelos G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  both G alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block;

- ambos alelos G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  - both G alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; I

ambos alelos C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento.  both C alleles of SNP rs2023239, or of the corresponding alleles of SNPs of their linkage block.

Las características de la muestra biológica, el sujeto, los SNPs (rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239) y sus correspondientes bloques de ligamiento, así como las de sus sitios polimórficos, ya han sido mencionadas previamente en relación con el primer método de la invención, al igual que los métodos para detrminar dichos SNPs e identificar los nucleótidos presentes en los sitios polimórficos de dichos SNPs; todo ello se incorpora en este método por referencia.  The characteristics of the biological sample, the subject, the SNPs (rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239) and their corresponding ligation blocks, as well as those of their polymorphic sites, have already been mentioned previously in relation to the first method of the invention, as well as the methods for detrminating said SNPs and identifying the nucleotides present at the polymorphic sites of said SNPs; All this is incorporated into this method by reference.

De acuerdo con el tercer método de la invención, en una muestra biológica del sujeto bajo estudio se determina al menos un alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o de cualquier SNP de sus correspondientes bloques de ligamiento, y se correlacionan los resultados obtenidos con la posibilidad de seleccionar un sujeto para que reciba una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto. Ejemplos ilustrativos, no limitativos, de fármacos agonistas de los receptores colinérgicos nicotínicos incluyen citisina, dianiclina y vareniclina. En una realización particular, dicho fármaco agonista de los receptores colinérgicos nicotínicos es vareniclina.  In accordance with the third method of the invention, at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of its subjects is determined in a biological sample of the subject under study corresponding ligation blocks, and the results obtained are correlated with the possibility of selecting a subject to receive a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject. Illustrative, non-limiting examples of nicotinic cholinergic receptor agonist drugs include cytisine, dianicline and varenicline. In a particular embodiment, said nicotinic cholinergic receptor agonist drug is varenicline.

Una vez que se determina en una muestra biológica de dicho sujeto al menos uno de los alelos de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, y/o de cualquier SNP de sus correspondientes bloques de ligamiento, es posible, según el tercer método de la invención, seleccionar un sujeto para que reciba o no una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto. La selección del sujeto se puede llevar a cabo en base a la presencia o ausencia de los alelos de éxito (es decir, en base a la presencia o ausencia de los nucleótidos presentes en los sitios polimórficos de dichos S Ps asociados con una predicción de que dicha terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será eficaz) de dichos SNPS en el genoma del sujeto bajo estudio. Dichos alelos de éxito (en este caso, alelos cuya presencia está asociada con una predicción de que la terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será eficaz) se mencionan en la Tabla 1. Once it is determined in a biological sample of said subject at least one of the alleles of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or of any SNP of their corresponding binding blocks It is possible, according to the third method of the invention, to select a subject to receive or not a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject. The selection of the subject can be carried out based on the presence or absence of the alleles of success (ie, based on the presence or absence of the nucleotides present at the polymorphic sites of said S Ps associated with a prediction that said therapy based on a nicotinic cholinergic receptor agonist drug will be effective) of said SNPS in the genome of the subject under study. Such alleles of success (in this case, alleles whose presence is associated with a prediction that therapy based on an agonist drug of nicotinic cholinergic receptors will be effective) are mentioned in Table 1.

En una realización particular, el tercer método de la invención comprende, además, analizar al menos una variable clínica relacionada con el consumo de tabaco. Aunque prácticamente cualquier variable clínica relacionada con el consumo de tabaco puede ser analizada, en una realización particular, dicha variable clínica relacionada con el consumo de tabaco se selecciona del grupo formado por estrés subjetivo, motivos para fumar, dependencia según la escala de Fagerstróm, y cualquiera de sus combinaciones. La combinación de los SNPs con las variables clínicas proporciona, en general, unos modelos mejores.  In a particular embodiment, the third method of the invention further comprises analyzing at least one clinical variable related to tobacco consumption. Although virtually any clinical variable related to tobacco consumption can be analyzed, in a particular embodiment, said clinical variable related to tobacco consumption is selected from the group consisting of subjective stress, reasons for smoking, dependence according to the Fagerstrom scale, and Any of your combinations. The combination of SNPs with clinical variables generally provides better models.

El tercer método de la invención permite seleccionar un sujeto para que reciba una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos, de manera que si el sujeto es seleccionado entonces dicho sujeto puede ser tratado con un fármaco agonista de los receptores colinérgicos nicotínicos para abandonar el consumo de tabaco, mientras que, en caso contrario, si el sujeto no es seleccionado para dicha terapia entonces el sujeto no debería ser tratado con un fármaco agonista de los receptores colinérgicos nicotínicos.  The third method of the invention allows selecting a subject to receive a therapy to quit smoking based on an agonist drug of the nicotinic cholinergic receptors, so that if the subject is selected then said subject can be treated with an agonist drug. of nicotinic cholinergic receptors to quit smoking, while, otherwise, if the subject is not selected for such therapy then the subject should not be treated with a nicotinic cholinergic receptor agonist drug.

Este modelo selectivo basado en la determinación de al menos uno de los alelos de uno o más de los SNPs identificados en la presente invención, o de los alelos correspondientes de los SNPs de su bloque de ligamiento, opcionalmente junto con una evaluación clínica estructurada, constituye una valiosa herramienta para predecir la eficacia o ineficacia de un tratamiento con un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto. A la vista de los resultados proporcionados por esta invención, el especialista (e.g., un médico) podrá seleccionar al sujeto a ser sometido a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, y realizar un seguimiento cercano de los sujetos sometidos a dicha terapia. Ejemplos ilustrativos, no limitativos, de fármacos agonistas de los receptores colinérgicos nicotínicos incluyen vareniclina, citisina o dianiclina, o cualquier otro fármaco con un mecanismo de acción similar. This selective model based on the determination of at least one of the alleles of one or more of the SNPs identified in the present invention, or of the corresponding alleles of the SNPs of its linkage block, optionally together with a structured clinical evaluation, constitutes A valuable tool for predicting the efficacy or ineffectiveness of a treatment with an agonist drug of nicotinic cholinergic receptors in a subject. In view of the results provided by this invention, the specialist (eg, a physician) may select the subject to be subjected to a therapy based on an agonist drug of the nicotinic cholinergic receptors, and closely monitor the subjects subjected to such therapy. Illustrative, non-limiting examples of receptor agonist drugs Nicotinic cholinergics include varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action.

Método para seleccionar una terapia para abandonar el consumo de tabaco para un sujeto en necesidad de terapia (en adelante, "cuarto método de la invención"). Method for selecting a therapy to quit smoking for a subject in need of therapy (hereinafter, "fourth method of the invention").

En otro aspecto, la invención se relaciona con un método para seleccionar una terapia para un sujeto en necesidad de terapia para abandonar el consumo de tabaco (en adelante, "cuarto método de la invención"), que comprende determinar en una muestra biológica de dicho sujeto al menos un alelo de uno o más de los polimorfismos de un solo nucleótido (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o cualquier SNP de sus correspondientes bloques de ligamiento, en donde se selecciona una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de receptores colinérgicos nicotínicos si dicho sujeto tiene In another aspect, the invention relates to a method for selecting a therapy for a subject in need of therapy to quit smoking (hereinafter, "fourth method of the invention"), which comprises determining in a biological sample of said subject at least one allele of one or more of the single nucleotide polymorphisms (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of their corresponding linker blocks, wherein a therapy is selected for abandon tobacco use based on a nicotinic cholinergic receptor agonist drug if said subject has

- al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - at least one C allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block;

al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one T allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block;

al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one G allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block;

al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block;

al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  at least one G allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I

- al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento.  - at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block.

En una realización particular del cuarto método de la invención, se selecciona una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de receptores colinérgicos nicotínicos, cuando dicho sujeto tiene  In a particular embodiment of the fourth method of the invention, a therapy is selected to quit smoking based on a nicotinic cholinergic receptor agonist drug, when said subject has

- ambos alelos C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  - both C alleles of SNP rs678188, or of the corresponding alleles of SNPs of their linkage block;

ambos alelos T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; both T alleles of SNP rs9658498, or of the corresponding alleles of SNPs of its linkage block;

ambos alelos G del S P rs4821566, o de los alelos correspondientes de los S Ps de su bloque de ligamiento;  both alleles G of the S P rs4821566, or of the corresponding alleles of the S Ps of its linkage block;

ambos alelos G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  both G alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block;

ambos alelos G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  both G alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; I

ambos alelos C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento.  both C alleles of SNP rs2023239, or of the corresponding alleles of SNPs of their linkage block.

Las características de la muestra biológica, el sujeto, los SNPs (rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239) y sus correspondientes bloques de ligamiento, así como las de sus sitios polimórficos, ya han sido mencionadas previamente en relación con el primer método de la invención, al igual que los métodos para detrminar dichos SNPs e identificar los nucleótidos presentes en los sitios polimórficos de dichos SNPs; todo ello se incorpora en este método por referencia.  The characteristics of the biological sample, the subject, the SNPs (rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239) and their corresponding ligation blocks, as well as those of their polymorphic sites, have already been mentioned previously in relation to the first method of the invention, as well as the methods for detrminating said SNPs and identifying the nucleotides present at the polymorphic sites of said SNPs; All this is incorporated into this method by reference.

De acuerdo con el cuarto método de la invención, en una muestra biológica del sujeto bajo estudio se determina al menos un alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o de cualquier SNP de sus correspondientes bloques de ligamiento, y se correlacionan los resultados obtenidos con la posibilidad de seleccionar una terapia para un sujeto en necesidad de recibir terapia para abandonar el consumo de tabaco.  In accordance with the fourth method of the invention, at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of its subjects is determined in a biological sample of the subject under study corresponding ligation blocks, and the results obtained are correlated with the possibility of selecting a therapy for a subject in need of receiving therapy to quit smoking.

Una vez que se determina en una muestra biológica de dicho sujeto al menos uno de los alelos de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, y/o de cualquier SNP de sus correspondientes bloques de ligamiento, es posible, según el cuarto método de la invención, seleccionar (o no) una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto a aplicar al sujeto. La selección de dicha terapia se puede llevar a cabo en base a la presencia o ausencia de los alelos de éxito (es decir, en base a la presencia o ausencia de los nucleótidos presentes en los sitios polimórficos de dichos SNPs asociados con una predicción de que dicha terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será eficaz) de dichos SNPS en el genoma del sujeto bajo estudio. Dichos alelos de éxito (en este caso, alelos cuya presencia está asociada con una predicción de que la terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos será eficaz) se mencionan en la Tabla 1. Once it is determined in a biological sample of said subject at least one of the alleles of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, and / or of any SNP of their corresponding binding blocks It is possible, according to the fourth method of the invention, to select (or not) a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject to be applied to the subject. The selection of such therapy can be carried out based on the presence or absence of the success alleles (i.e., based on the presence or absence of nucleotides present at the polymorphic sites of said SNPs associated with a prediction that said therapy based on a nicotinic cholinergic receptor agonist drug will be effective) of said SNPS in the genome of the subject under study. Such alleles of success (in this case, alleles whose presence is associated with a prediction that therapy based on a nicotinic cholinergic receptor agonist drug will be effective) are mentioned in Table 1.

En una realización particular, el cuarto método de la invención comprende, además, analizar al menos una variable clínica relacionada con el consumo de tabaco. Aunque prácticamente cualquier variable clínica relacionada con el consumo de tabaco puede ser analizada, en una realización particular, dicha variable clínica relacionada con el consumo de tabaco se selecciona del grupo formado por estrés subjetivo, motivos para fumar, dependencia según la escala de Fagerstróm, y cualquiera de sus combinaciones. La combinación de los SNPs con las variables clínicas proporciona, en general, unos modelos mejores.  In a particular embodiment, the fourth method of the invention further comprises analyzing at least one clinical variable related to tobacco consumption. Although virtually any clinical variable related to tobacco consumption can be analyzed, in a particular embodiment, said clinical variable related to tobacco consumption is selected from the group consisting of subjective stress, reasons for smoking, dependence according to the Fagerstrom scale, and Any of your combinations. The combination of SNPs with clinical variables generally provides better models.

El cuarto método de la invención permite seleccionar una terapia para abandonar el consumo de tabaco a administrara a un sujeto basada en un fármaco agonista de los receptores colinérgicos nicotínicos, de manera que se selecciona esa terapia, de entre otras terapias para abandonar el consumo de tabaco, cuando el genotipo del sujeto a ser sometido a terapia presenta las características mencionadas previamente, mientras que, en caso contrario, si el sujeto no presenta esas características, entonces habría que seleccionar una terapia para dejar el consumo de tabaco que no estuviera basada en fármacos agonistas de los receptores colinérgicos nicotínicos.  The fourth method of the invention allows to select a therapy to abandon the consumption of tobacco to be administered to a subject based on an agonist drug of the nicotinic cholinergic receptors, so that such therapy is selected, among other therapies to quit smoking , when the genotype of the subject to be subjected to therapy has the previously mentioned characteristics, while, otherwise, if the subject does not have those characteristics, then one would have to select a therapy to quit the consumption of tobacco that was not based on drugs Nicotinic cholinergic receptor agonists.

Este modelo selectivo basado en la determinación de al menos uno de los alelos de uno o más de los SNPs identificados en la presente invención, o de los alelos correspondientes de los SNPs de su bloque de ligamiento, opcionalmente junto con una evaluación clínica estructurada, constituye una valiosa herramienta para predecir la eficacia o ineficacia de un tratamiento con un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto. A la vista de los resultados proporcionados por esta invención, el especialista (e.g., un médico) podrá seleccionar la terapia a administrar al sujeto, en concreto, una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos (u otra terapia basada en otros fármacos), y realizar un seguimiento cercano de la eficacia de dicha terapia seleccionada en los sujetos sometidos a dicha terapia. Ejemplos ilustrativos, no limitativos, de fármacos agonistas de los receptores colinérgicos nicotínicos incluyen vareniclina, citisina o dianiclina, o cualquier otro fármaco con un mecanismo de acción similar. Kits de la invención This selective model based on the determination of at least one of the alleles of one or more of the SNPs identified in the present invention, or of the corresponding alleles of the SNPs of its linkage block, optionally together with a structured clinical evaluation, constitutes A valuable tool for predicting the efficacy or ineffectiveness of a treatment with an agonist drug of nicotinic cholinergic receptors in a subject. In view of the results provided by this invention, the specialist (eg, a doctor) may select the therapy to be administered to the subject, in particular, a therapy based on an agonist drug of nicotinic cholinergic receptors (or other therapy based on others drugs), and closely monitor the efficacy of said selected therapy in subjects undergoing such therapy. Illustrative, non-limiting examples of nicotinic cholinergic receptor agonist drugs include varenicline, cytisine or dianicline, or any other drug with a similar mechanism of action. Kits of the invention

La invención también contempla la preparación de unos kits para su uso de acuerdo con los métodos de la presente invención. Por tanto, en otro aspecto, la invención se relaciona con un kit, en adelante "kit de la invención", que comprende al menos un reactivo para determinar la presencia de al menos un alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239, y/o de los correspondientes SNPs de su bloque de ligamiento, y/o al menos un reactivo para determinar el nucleótido presente en el sitio polimórfico de dichos SNPs. The invention also contemplates the preparation of kits for use in accordance with the methods of the present invention. Therefore, in another aspect, the invention relates to a kit, hereinafter "kit of the invention", comprising at least one reagent for determining the presence of at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239, and / or the corresponding SNPs of its linkage block, and / or at least one reagent for determining the nucleotide present at the polymorphic site of said SNPs.

En una realización particular, el kit de la invención comprende al menos un reactivo para determinar la presencia de un único SNP seleccionado del grupo formado por los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 y los correspondientes SNPs de sus bloques de ligamiento, y, al menos, un reactivo para determinar el nucleótido presente en el sitio polimórfico de dicho SNP.  In a particular embodiment, the kit of the invention comprises at least one reagent for determining the presence of a single SNP selected from the group consisting of SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and the corresponding SNPs of their blocks ligation, and at least one reagent to determine the nucleotide present in the polymorphic site of said SNP.

En otra realización particular, el kit de la invención comprende al menos un reactivo necesario para determinar la presencia de 1, 2, 3, 4, 5 cualesquiera, o incluso los 6, SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239, y/o en los correspondientes SNPs de sus bloques de ligamiento, y/o al menos un reactivo necesario para determinar el nucleótido presente en dichos SNPs.  In another particular embodiment, the kit of the invention comprises at least one reagent necessary to determine the presence of any 1, 2, 3, 4, 5, or even 6, SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 , and / or in the corresponding SNPs of their linkage blocks, and / or at least one reagent necessary to determine the nucleotide present in said SNPs.

Opcionalmente, el kit de la invención puede incluir, además, medios para extraer la muestra del sujeto y/o medios o reactivos para amplificar el ácido nucleico presente en dicha muestra.  Optionally, the kit of the invention may also include means for extracting the sample from the subject and / or means or reagents for amplifying the nucleic acid present in said sample.

Los kits de la invención incluyen uno o más reactivos para su uso de acuerdo con la presente invención en recipientes adecuados y materiales de embalaje, incluidos los tubos, viales, y técnicas de embalaje como el retractilado y moldeados por soplado. Materiales adecuados para su inclusión en un kit de acuerdo con la presente invención comprenden uno o más de los siguientes: pares de cebadores específicos para PCR (oligonucleótidos) que hibridan con dominios de la secuencia de ADN o cDNA que flanquean los SNPs de interés (SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 y los correspondientes SNPs de sus bloques de ligamiento); reactivos capaces de amplificar un dominio de una secuencia específica, ya sea en el ADNg o ADNc sin tener que realizar la PCR; reactivos necesarios para discriminar entre los distintos alelos en la secuencia de los dominios amplificados por PCR y PCR- no amplificación (por ejemplo, las endonucleasas de restricción, oligonucleótidos que hibridan preferentemente a un alelo del polimorfismo, incluidos los modificados para contener enzimas o grupos químicos fluorescentes que amplifican la señal de los oligonucleótidos y que hacen la discriminación de los alelos más robusta); reactivos necesarios para separar físicamente los productos derivados de los diferentes alelos (por ejemplo, agarosa o poliacrilamida y un tampón para ser utilizado en la electroforesis, columnas de HPLC, geles SSCP, geles formamida o un soporte de la matriz de MALDI- TOF), etc. The kits of the invention include one or more reagents for use in accordance with the present invention in suitable containers and packaging materials, including tubes, vials, and packaging techniques such as shrink wrapping and blow molding. Materials suitable for inclusion in a kit according to the present invention comprise one or more of the following: pairs of PCR-specific primers (oligonucleotides) that hybridize with domains of the DNA or cDNA sequence flanking the SNPs of interest (SNPs) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and the corresponding SNPs of their linkage blocks); reagents capable of amplifying a domain of a specific sequence, either in the CDNA or cDNA without having to perform the PCR; reagents necessary to discriminate between the different alleles in the sequence of the domains amplified by PCR and PCR-not amplification (for example, restriction endonucleases, oligonucleotides that preferentially hybridize to a polymorphism allele, including those modified to contain enzymes or chemical groups fluorescents that amplify the signal of the oligonucleotides and that make the discrimination of the alleles more robust); reagents necessary to physically separate products derived from the different alleles (for example, agarose or polyacrylamide and a buffer to be used in electrophoresis, HPLC columns, SSCP gels, formamide gels or a MALDI-TOF matrix support), etc.

Están específicamente contemplados kits que comprenden uno o más oligonucleótidos alelo-específicos o polimorfismo-específicos o parejas de oligonucleótidos, donde cada pareja de oligonucleótidos alelo-específicos o polimorfismo-específicos está dirigida a uno de los polimorfismo citados en este documento, es decir, los S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239 y/o los correspondientes SNPs de sus bloques de ligamiento. El técnico en la materia entenderá que en este contexto el término "dirigido a" significa un oligonucleótido o pareja de oligonucleótidos capaz de identificar el alelo presente en un SNP determinado.  Kits comprising one or more allele-specific oligonucleotides or polymorphism-specific or pairs of oligonucleotides are specifically contemplated, where each pair of allele-specific oligonucleotides or polymorphism-specific is directed to one of the polymorphism cited herein, i.e. S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 and / or the corresponding SNPs of their linkage blocks. The person skilled in the art will understand that in this context the term "directed to" means an oligonucleotide or oligonucleotide pair capable of identifying the allele present in a given SNP.

A modo ilustrativo, no limitativo, la presente invención contempla kits que comprenden un conjunto de sondas, comprendiendo una pluralidad de sondas de oligonucleótidos que interrogan para SNPs seleccionados del grupo formado por los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239 y/o los correspondientes SNPs de sus bloques de ligamiento, donde dichas sondas oligonucleotídicas suponen al menos el 50% de las sondas oligonucleotídicas del conjunto de sondas. Por tanto, dicho conjunto de sondas, comprendiendo una pluralidad de sondas oligonucleotídicas que interrogan para SNPs seleccionados entre dichos SNPs, donde dichas sondas oligonucleotídicas suponen al menos el 50% de las sondas oligonucleotídicas del conjunto de sondas, constituye una realización adicional de esta invención.  By way of illustration, not limitation, the present invention contemplates kits comprising a set of probes, comprising a plurality of oligonucleotide probes that interrogate SNPs selected from the group consisting of SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239 and / or the corresponding SNPs of their linkage blocks, wherein said oligonucleotide probes account for at least 50% of the oligonucleotide probes of the probe set. Therefore, said set of probes, comprising a plurality of oligonucleotide probes that interrogate for SNPs selected among said SNPs, wherein said oligonucleotide probes account for at least 50% of the oligonucleotide probes of the probe set, constitutes a further embodiment of this invention.

En una realización particular, el kit comprende una o más parejas de oligonucleótidos polimorfismo-específicos o alelo-específicos dirigidas a dos o más de los SNPs citados anteriormente, mientras que otra realización contempla uno o más oligonucleótidos o parejas de oligonucleótidos polimorfismo-específicos o alelo- específicos dirigidos a todos los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 y/o a los correspondientes SNPs de sus bloques de ligamiento. In a particular embodiment, the kit comprises one or more pairs of polymorphism-specific or allele-specific oligonucleotides directed to two or more of the SNPs cited above, while another embodiment contemplates one or more oligonucleotides or pairs of polymorphism-specific or allele-specific oligonucleotides targeting all SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and / or the corresponding SNPs of their ligation blocks

El kit de la invención permite predecir el éxito en el abandono del consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos. Por tanto, en otro aspecto, la invención se relaciona con el uso del kit de la invención para:  The kit of the invention allows prediction of success in smoking cessation in response to a therapy based on an agonist drug of nicotinic cholinergic receptors. Therefore, in another aspect, the invention relates to the use of the kit of the invention for:

determinar la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en en un fármaco agonista de los receptores colinérgicos nicotínicos; o para  determine the probability that a subject will quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug; or for

predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto; o para  predict the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject; or for

seleccionar un sujeto para una terapia para abandonar el consumo de tabaco basada en en un fármaco agonista de los receptores colinérgicos nicotínicos; o para  select a subject for a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors; or for

seleccionar una terapia a administrar a un sujeto en necesidad de terapia para abandonar el consumo.  select a therapy to be administered to a subject in need of therapy to abandon consumption.

Usos de la invención Uses of the invention

En otro aspecto, la invención se relaciona con el uso de al menos un SNP para: determinar la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en en un fármaco agonista de los receptores colinérgicos nicotínicos; o para In another aspect, the invention relates to the use of at least one SNP to: determine the likelihood that a subject will quit smoking in response to therapy based on an agonist drug of nicotinic cholinergic receptors; or for

predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto; o para  predict the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject; or for

- seleccionar un sujeto para una terapia para abandonar el consumo de tabaco basada en en un fármaco agonista de los receptores colinérgicos nicotínicos; o para seleccionar una terapia a administrar a un sujeto en necesidad de terapia para abandonar el consumo, - select a subject for a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors; or for select a therapy to be administered to a subject in need of therapy to abandon consumption,

en donde dicho S P se selecciona del grupo formado por los S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 y cualquier combinación de los mismos y/o cualquier SNP de sus correspondientes bloques de ligamiento. wherein said S P is selected from the group consisting of S Ps rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and any combination thereof and / or any SNP of their corresponding linkage blocks.

En una realización particular, dicho SNP se selecciona del grupo formado por los SNPs rs678188, rs9658498, rs4821566, o cualquier combinación de dichos SNPs, y/o de los correspondientes SNPs de su bloque de ligamiento.. En otra realización particular, dicho SNP se selecciona del grupo formado por los SNPs rsl0891510, rsl 1932367, rs2023239, o cualquier combinación de dichos SNPs, y/o de los correspondientes SNPs de su bloque de ligamiento.  In a particular embodiment, said SNP is selected from the group consisting of SNPs rs678188, rs9658498, rs4821566, or any combination of said SNPs, and / or the corresponding SNPs of its linkage block. In another particular embodiment, said SNP is it selects from the group formed by the SNPs rsl0891510, rsl 1932367, rs2023239, or any combination of said SNPs, and / or the corresponding SNPs of its linkage block.

En otro aspecto, la invención se relaciona con una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos para su empleo en el tratamiento de un sujeto en necesidad de terapia para abandonar el consumo de tabaco, en donde dicho sujeto se selecciona mediante el tercer método de la invención. En una realización particular, dicho fármaco agonista de los receptores colinérgicos nictoínico se selecciona entre vareniclina, citisina y dianiclina, preferentemente careniclina.  In another aspect, the invention relates to a therapy for abandoning tobacco use based on an agonist drug of nicotinic cholinergic receptors for use in the treatment of a subject in need of therapy to abandon tobacco use, wherein said subject is selected by the third method of the invention. In a particular embodiment, said nictoinic cholinergic receptor agonist drug is selected from varenicline, cytisine and dianicline, preferably carenicline.

El siguiente ejemplo sirve para ilustrar la invención y no debe ser considerado como limitativo del alcance de la misma.  The following example serves to illustrate the invention and should not be considered as limiting its scope.

EJEMPLO 1 EXAMPLE 1

Identificación de SNPs asociados con el éxito en el abandono del consumo de tabaco en sujetos tratados con vareniclina  Identification of SNPs associated with success in smoking cessation in subjects treated with varenicline

1. MATERIALES Y MÉTODOS 1. MATERIALS AND METHODS

Grupos y parámetros de estudio Groups and study parameters

En un estudio realizado sobre 807 pacientes de las Unidades de Tabaquismo de 22 Hospitales y Centros Sanitarios de España y Portugal se valoraron más de 300 SNPs relacionados con vías relevantes respecto a la eficacia de los 3 tratamientos farmacológicos de primera línea en deshabituación tabáquica: terapia de sustitución con nicotina (TSN), bupropión y vareniclina. La eficacia se valoró en términos de abstinencia de consumo tabáquico a 3 meses (eficacia a corto plazo) y a 12 meses (eficacia a largo plazo). Tras aplicar los chequeos habituales para corregir errores en la introducción de datos, el proceso de análisis se llevó a cabo. En primer lugar, se caracterizó el estado de los sujetos bien como "casos" o bien como "controles", en función de los resultados de eficacia obtenidos a los 3 meses y a los 12 meses de seguimiento tras la instauración del tratamiento de deshabituación tabáquica de elección. Como "casos" se consideraron aquellas personas que tuvieron éxito en el tratamiento de deshabituación tabáquica, y, de ese modo, los distintos modelos de análisis estadísticos proporcionarán información sobre la probabilidad de éxito asociada a la presencia de un determinado patrón genético a los distintos tiempos de evaluación del resultado. In a study conducted on 807 patients of the Smoking Units of 22 Hospitals and Health Centers in Spain and Portugal, more than 300 SNPs related to relevant pathways were evaluated regarding the efficacy of the 3 first-line pharmacological treatments in smoking cessation: therapy of replacement with nicotine (TSN), bupropion and varenicline. Efficacy was assessed in terms of withdrawal from smoking at 3 months (short-term effectiveness) and 12 months (long-term efficacy). After applying the usual checks to correct errors in the data entry, the analysis process was carried out. First, the status of the subjects was characterized either as "cases" or as "controls", depending on the efficacy results obtained at 3 months and at 12 months of follow-up after the establishment of smoking cessation treatment of choice. Those cases that were successful in the treatment of smoking cessation were considered as "cases", and, thus, the different statistical analysis models will provide information on the probability of success associated with the presence of a certain genetic pattern at different times of evaluation of the result.

Para valorar la posibilidad de sesgos de confusión como resultado del análisis de poblaciones mixtas, y también como control de errores de genotipado, se realizó el test de desequilibrio de Hardy-Weinberg tanto en los "casos" como en los "controles" correspondientes. El resultado de este test se valoró antes de analizar los resultados obtenidos en los diversos modelos de regresión logística que se han utilizado para valorar la asociación entre los S Ps específicos y los resultados de eficacia de los tratamientos prescritos. Se han utilizado los siguientes modelos de penetrancia en los modelos de regresión logística: dominante, recesivo, aditivo, sobredominante y log- aditivo. Los análisis estadísticos se realizaron tanto con la frecuencia alélica como con la frecuencia genotípica, siendo estos últimos los que aportan la mayor información sobre las asociaciones que se pretenden replicar. Todos los resultados se presentaron con odds-ratios, con sus correspondientes intervalos de confianza al 95%, y su valor de significación estadística.  To assess the possibility of confusion biases as a result of the analysis of mixed populations, and also as a control of genotyping errors, the Hardy-Weinberg imbalance test was performed both in the "cases" and in the corresponding "controls". The result of this test was assessed before analyzing the results obtained in the various logistic regression models that have been used to assess the association between the specific S Ps and the efficacy results of the prescribed treatments. The following penetrance models have been used in the logistic regression models: dominant, recessive, additive, super-dominant and logistic. Statistical analyzes were performed with both allelic frequency and genotypic frequency, the latter being the ones that provide the most information on the associations that are intended to be replicated. All results were presented with odds ratios, with their corresponding 95% confidence intervals, and their statistical significance value.

La posible influencia de variables clínicas, tales como estrés subjetivo, motivos para fumar, y dependencia según la escala de Fagerstróm, en los resultados de eficacia así como su papel como variables confusoras o modificadoras de la asociación estudiada, se valoró con modelos de regresión logística múltiple. Por último, el poder discriminante de los distintos indicadores genéticos (SNPs) y clínicos analizados respecto a los resultados de eficacia se valoró mediante curvas de operador-receptor y el análisis del área bajo la curva. El objetivo final de esta estrategia de análisis era el de poder llegar a estimar la probabilidad de éxito que pudiera tener un sujeto con un determinado perfil genotípico que comienza un tratamiento de deshabituación tabáquica (en particular, con veraniclina) y ajustar y monitorizar su tratamiento en base a esta información. The possible influence of clinical variables, such as subjective stress, reasons for smoking, and dependence according to the Fagerstrom scale, on the efficacy results as well as their role as confusing or modifying variables of the association studied, was assessed with logistic regression models. multiple. Finally, the discriminant power of the different genetic and clinical indicators (SNPs) analyzed with respect to efficacy results was assessed by operator-receiver curves and Analysis of the area under the curve. The final objective of this analysis strategy was to be able to estimate the probability of success that a subject with a certain genotypic profile could have that begins a smoking cessation treatment (in particular, with veranicline) and adjust and monitor their treatment in based on this information.

Genotipado Genotyping

Las muestras de ácidos nucleicos pueden ser genotipadas para determinar los alelos que están presentes en una región génica determinada de interés, por ejemplo, la posición de un SNP determinado, mediante métodos bien conocidos del estado de la técnica. Los SNPs candidatos fueron identificados mediante 3 estrategias diferentes, dirigidas principalmente a incluir SNPs con un potencial impacto funcional en la estructura proteica y/o expresión génica, así como a partir de la información de variaciones comunes a lo largo de un gen dado.  Nucleic acid samples can be genotyped to determine the alleles that are present in a particular gene region of interest, for example, the position of a particular SNP, by methods well known in the state of the art. Candidate SNPs were identified by 3 different strategies, mainly aimed at including SNPs with a potential functional impact on protein structure and / or gene expression, as well as from the information of common variations throughout a given gene.

Según una primera estrategia, se buscaron SNPs codificantes no-sinónimos According to a first strategy, non-synonyms coding SNPs were searched

(nsSNPs) y SNPs localizados en regiones potenciales (en sentido 5' corriente arriba, 5'- UTR, región codificante, sitios de splicing, primer intrón, 3'-UTR y corriente abajo 3'). Los SNPs se buscaron desde 20 kilobases (kb) en sentido corriente arriba 5' a partir del codón de inicio hasta 10 kb corriente abajo 3' a partir del codón de parada para un gen dado. Los SNPs incluidos en este grupo fueron aquellos con un posible efecto funcional, en concreto aquellos que alteran potenciales sitios de unión a factores de transcripción tales como los que se pueden predecir mediante el empleo del software Pupas View (Conde et al. 2005, Nucleic Acid Res 33 : W501-5) y SNPs localizados en secuencias conservadas entre especies, tal como han sido determinados mediante el uso de UCSC Genome Browser Datábase (http://genome.ucsc.edu/index.html). (nsSNPs) and SNPs located in potential regions (5 'upstream, 5'-UTR, coding region, splicing sites, first intron, 3'-UTR and downstream 3'). SNPs were searched from 20 kilobases (kb) upstream 5 'from the start codon to 10 kb downstream 3' from the stop codon for a given gene. The SNPs included in this group were those with a possible functional effect, specifically those that alter potential binding sites to transcription factors such as those that can be predicted through the use of Pupas View software (Conde et al. 2005, Nucleic Acid Res 33: W501-5) and SNPs located in conserved sequences between species, as determined by the use of UCSC Genome Browser Datábase (http://genome.ucsc.edu/index.html).

En una segunda estrategia, se seleccionaron varios SNPs diana. El principal objetivo de esta selección fue identificar un conjunto de SNPs dirigidos a casi todos los SNPs conocidos en un gen, incluyendo aquellos localizados en potenciales regiones reguladoras que no mostraron ninguna evidencia de funcionalidad. En este estudio, los SNPs diana fueron definidos como SNPs comunes con un r2 estimado superior a 0,8 (r2 > 0,8) con otros SNPs en sujetos con ancestro europeo (CEU) en la base de datos HapMap (Tagger, Haploview 3.2) (Barrett et al, 2005, Bioinformatics 21(2):263-265). Finalmente, en la tercera estrategia se consideraron S Ps descritos previamente en la literatura. In a second strategy, several target SNPs were selected. The main objective of this selection was to identify a set of SNPs targeting almost all known SNPs in a gene, including those located in potential regulatory regions that showed no evidence of functionality. In this study, the target SNPs were defined as common SNPs with an estimated R2 greater than 0.8 (r2> 0.8) with other SNPs in subjects with European ancestry (CEU) in the HapMap database (Tagger, Haploview 3.2 ) (Barrett et al, 2005, Bioinformatics 21 (2): 263-265). Finally, in the third strategy, S Ps previously described in the literature were considered.

En todos los casos, se seleccionaron solamente aquellos SNPs con una frecuencia descrita de alelo minoritario superior al 5% (MAF>0,05) en poblaciones caucásicas de HapMap-CEU y PERLEGEN-EUR-Panel North America (ENSEMBL genome browser v. 3.3-3.6; www.ensembl.org), con el objetivo de garantizar SNPs informativos. Todos los SNPs seleccionados fueron filtrados mediante los criterios de la tecnología Illumina (score > 0,6 ó GoldengateValidated Status, Illumina Inc., San Diego, USA). El genotipado de los SNPs fue llevado a cabo en el Centro Nacional de Genotipado (CeGen), España, usando el sistema Illumina Bead Array (Illumina Inc., San Diego; USA).  In all cases, only those SNPs with a described frequency of minor allele greater than 5% (MAF> 0.05) were selected in Caucasian populations of HapMap-CEU and PERLEGEN-EUR-Panel North America (ENSEMBL genome browser v. 3.3 -3.6; www.ensembl.org), with the objective of guaranteeing informative SNPs. All selected SNPs were filtered using the Illumina technology criteria (score> 0.6 or GoldengateValidated Status, Illumina Inc., San Diego, USA). The genotyping of SNPs was carried out at the National Genotyping Center (CeGen), Spain, using the Illumina Bead Array system (Illumina Inc., San Diego; USA).

La tecnología Illumina Bead Array está basada en partículas ("beads") de 3 μιη que autoagregan en micropocillos sobre uno de los sustratos: haces de fibra óptica o superficies planas de sílice. Cuando las partículas se ensamblan aleatoriamente sobre uno de estos 2 sustratos, se disponen con una separación uniforme de aproximadamente 5,7 mm. Cada partícula está recubierta por cientos de miles de copias de un oligonucleótido específico que actúa capturando las secuencias en uno de los ensayos de Illumina. De promedio, cada tipo de partícula está representada 30 veces por muestra, permitiendo un alto grado de precisión. Se seleccionó el ensayo de genotipado GoldenGate Genotyping assay. En esta aproximación, durante la fase líquida, oligonucleótidos específicos de alelo (ASO) se hibridan a ADNg, se extienden y ligan a un oligonucleótido específico de locus (LSO). La PCR se llevó a cabo utilizando cebadores universales. Los productos de la reacción multiplex se hibridaron para su detección y análisis a un Sentrix Array universal. Los resultados obtenidos en muestras de ADN de duplicados de sangre fueron concordantes con todos los SNPs genotipados por este método. El ADN fue cuantificado en el Centro Nacional de Genotipado (CeGen) mediante la técnica de PicoGreen y diluido a una concentración final de 50 ng/ml. Con esta técnica, la concentración de ADN se determinó mediante un marcador fluorescente (PicoGreen®, Molecular Probes) que se une a ADN bicatenario y posterior cuantificación en un fluorímetro. Illumina Bead Array technology is based on particles ("beads") of 3 μιη that self-aggregate in microwells on one of the substrates: fiber optic beams or flat silica surfaces. When the particles are randomly assembled on one of these 2 substrates, they are arranged with a uniform separation of approximately 5.7 mm. Each particle is coated by hundreds of thousands of copies of a specific oligonucleotide that acts by capturing the sequences in one of Illumina's assays. On average, each type of particle is represented 30 times per sample, allowing a high degree of accuracy. The GoldenGate Genotyping assay genotyping assay was selected. In this approach, during the liquid phase, allele-specific oligonucleotides (ASO) hybridize to gDNA, extend and bind to a locus-specific oligonucleotide (LSO). PCR was carried out using universal primers. The products of the multiplex reaction were hybridized for detection and analysis to a universal Sentrix Array. The results obtained in DNA samples of blood duplicates were consistent with all SNPs genotyped by this method. The DNA was quantified at the National Genotyping Center (CeGen) using the PicoGreen technique and diluted to a final concentration of 50 ng / ml. With this technique, the DNA concentration was determined by a fluorescent marker (PicoGreen ® , Molecular Probes) that binds to double stranded DNA and subsequent quantification in a fluorimeter.

2. RESULTADOS Con el objetivo de determinar el perfil farmacogen ético asociado a la eficacia de un tratamiento farmacológico para dejar de fumar, se evaluaron los resultados obtenidos en términos de abstinencia de consumo tabáquico a 3 meses (eficacia a corto plazo) y a 12 meses (eficacia a largo plazo). El éxito del tratamiento se entiende como la abstinencia del consumo de tabaco en un estudio prospectivo con 3 grupos de sujetos que demandaron una intervención de profesionales sanitarios y fueron tratados con TSN, bupropión y vareniclina. 2. RESULTS In order to determine the ethical pharmacogen profile associated with the efficacy of a drug treatment for smoking cessation, the results obtained in terms of withdrawal from smoking at 3 months (short-term efficacy) and 12 months (long-term efficacy) were evaluated. term). The success of the treatment is understood as the withdrawal of tobacco use in a prospective study with 3 groups of subjects who demanded an intervention of health professionals and were treated with TSN, bupropion and varenicline.

Se trata de un estudio observacional que contó con la intervención de 21 unidades de tabaquismo de los servicios públicos de salud de España y Portugal. Un total de 807 sujetos fueron invitados a participar en el estudio de los cuales 798 pacientes aportaron sus datos sociodemográficos y clínicos realizando un test de 144 ítem. Además aportaron una muestra biológica para su posterior genotipado. Un total de 483 individuos fueron tratados con vareniclina. La información tanto de variables fenotípicas como genotípicas fue recogida para 479 pacientes tratados con vareniclina antes de la instauración del tratamiento farmacológico. This is an observational study that included the intervention of 21 smoking units of public health services in Spain and Portugal. A total of 807 subjects were invited to participate in the study of which 798 patients provided their sociodemographic and clinical data by conducting a 144-item test. They also provided a biological sample for subsequent genotyping. A total of 483 individuals were treated with varenicline. Information on both phenotypic and genotypic variables was collected for 479 patients treated with varenicline before the initiation of pharmacological treatment.

La descripción general de la muestra se presenta en la Tabla 2.  The general description of the sample is presented in Table 2.

Tabla 2. Características de la muestra evaluada y en tratamiento con vareniclina Table 2. Characteristics of the sample evaluated and treated with varenicline

Variables Media (DE) N (%)  Variables Mean (SD) N (%)

Género:  Gender:

Varones 241 (49.9) Mujeres 242 (483) Men 241 (49.9) Women 242 (483)

Edad (años) 46.2 (10.8) Age (years) 46.2 (10.8)

Consumo cigarrillos/día 23.9 (10.9)  Cigarette consumption / day 23.9 (10.9)

Edad comienzo consumo tabaco (años) 15.5 (3.6)  Age beginning tobacco consumption (years) 15.5 (3.6)

Edad comienzo consumo diario (años) 18.1 (4.5)  Age start daily consumption (years) 18.1 (4.5)

Número intentos de dejar de fumar 2.8 (7.1)  Number attempts to quit smoking 2.8 (7.1)

Método utilizado en los intentos previos:  Method used in previous attempts:

TSN 115 (31.1) TSN 115 (31.1)

Bupropion/vareniclina 36 (9.7) Sin fármacos 219 (5.2)Bupropion / Varenicline 36 (9.7) Without drugs 219 (5.2)

Meses desde el último intento de dejar de fumar 41.5 (86.4) Months since the last attempt to quit smoking 41.5 (86.4)

Tiempo máximo de abstinencia alcanzado (meses) 29.0 (80.1)  Maximum withdrawal time reached (months) 29.0 (80.1)

DE: desviación estándar; TSN: terapia de sustitución con nicotina  DE: standard deviation; TSN: nicotine replacement therapy

Los resultados clínicos fueron relacionados con la eficacia de los tratamientos farmacológicos. La eficacia fue evaluada a los 3 y 12 meses posteriores al inicio del tratamiento, de acuerdo a los criterios de abstinencia previamente establecidos tales como la medición del monóxido de carbono, entrevistas clínicas e información propia del paciente. The clinical results were related to the efficacy of pharmacological treatments. The efficacy was evaluated 3 and 12 months after the start of treatment, according to previously established withdrawal criteria such as carbon monoxide measurement, clinical interviews and patient information.

Se seleccionaron 80 genes candidatos en base a su relevancia biológica y a la búsqueda bibliográfica así como en base a las apuestas de los genes candidatos de los investigadores. En las muestras se analizaron 384 SNPs, inserción/deleción y repeticiones en tándem. Para cada gen la selección del SNP se basó en los siguientes criterios: 80 candidate genes were selected based on their biological relevance and literature search as well as based on the bets of the candidate candidate genes. In the samples, 384 SNPs, insertion / deletion and tandem repeats were analyzed. For each gene the selection of the SNP was based on the following criteria:

1. SNPs diana, r2>0,98 con otros SNPs en individuos HapMap de ancestro europeo (CEU) (The International HapMap Project, 2003) 1. Target SNPs, R2> 0.98 with other SNPs in European ancestor HapMap individuals (CEU) (The International HapMap Project, 2003)

(Tagger, Haploview 3.2). (Tagger, Haploview 3.2).

2. SNPs localizados en regiones que pueden tener influencia con la función del gen (corriente arriba, 5'UTR, región codificante, sitios de splicing, intrón 1, 3'UTR y corriente abajo).  2. SNPs located in regions that may influence the function of the gene (upstream, 5'UTR, coding region, splicing sites, intron 1, 3'UTR and downstream).

3. SNPs previamente asociados con la dependencia y cesación del consumo de tabaco.  3. SNPs previously associated with dependence and cessation of tobacco consumption.

Los resultados obtenidos pusieron de manifiesto la asociación entre SNPs y la eficacia del tratamiento para dejar de fumar únicamente de aquellos genes que muestran un valor de p menor de 0,01. Los resultados genéticos se presentan con sus correspondientes OR (odds ratio), su precisión (95% intervalos de confianza) y el correspondiente valor de p. Con todo ello se obtuvieron los 6 SNPs asociados con eficacia de vareniclina que se muestran en las Tablas 3-6.  The results obtained showed the association between SNPs and the efficacy of smoking cessation treatment only for those genes that show a p-value of less than 0.01. The genetic results are presented with their corresponding OR (odds ratio), their accuracy (95% confidence intervals) and the corresponding p-value. With all this, the 6 SNPs associated with varenicline efficacy are shown, which are shown in Tables 3-6.

Los resultados que se muestran a continuación presentan el ajuste de dos modelos de predicción. El primero es un modelo univariado que sólo incluye el genotipo como variable explicativa, mientras que el segundo incluye además variables clínicas (estrés subjetivo, motivos para fumar, y dependencia según la escala de Fagerstróm). Se ha contrastado el poder explicativo de ambos modelos mediante el test de cociente de verosimilitudes para modelos anidados. Un />-valor significativo señala la necesidad de explicar el resultado mediante el modelo multivariado, mientras que un p- valor no significativo implica que el modelo univariado (genotipo) sería suficiente para explicar el resultado. The results shown below present the adjustment of two prediction models. The first is a univariate model that only includes the genotype as an explanatory variable, while the second also includes clinical variables (subjective stress, reasons for smoking, and dependence according to the Fagerstrom scale). The explanatory power of both models has been checked using the likelihood ratio test for nested models. A significant value indicates the need to explain the result through the multivariate model, while a non-significant p-value implies that the univariate model (genotype) would be sufficient to explain the result.

Tabla 3 Table 3

Resultados univariados (genotipo) y multivariados (genotipo y variables clínicas) de la eficacia de un tratamiento con vareniclina para la deshabituación tabáquica - Abstinencia a 3 meses rs678188 (Chr 10; PARD3)  Univariate (genotype) and multivariate (genotype and clinical variables) results of the efficacy of a varenicline treatment for smoking cessation - 3-month withdrawal rs678188 (Chr 10; PARD3)

Resultado Genotipo P-valor AIC AUC  Result Genotype P-value AIC AUC

T/T C/T C/C  T / T C / T C / C

1 109 165 69  1 109 165 69

0 61 55 16  0 61 55 16

OR 1,00 1,68 2,41 0,0073 557,6  OR 1.00 1.68 2.41 0.0073 557.6

OR lineal 1,59 0,0018 555,7 0,5849  Linear OR 1.59 0.0018 555.7 0.5849

Resultado Alelos OR (IC 95%) P-valor Result OR alleles (95% CI) P-value

T C  T C

1 383 303  1 383 303

0 177 87  0 177 87

Total 560 390 1,61 (1, 19 - 2, 17) 0,002  Total 560 390 1.61 (1, 19 - 2, 17) 0.002

Genotipo Resultados univariados Resultados multivariados P-valor Genotype Univariate results Multivariate results P-value

(modelos anidados) (nested models)

OR (IC 95%) -valor AUC OR (IC 95%) -valor AUCOR (95% CI) -value AUC OR (95% CI) -value AUC

T/T 1,0 1,0 T / T 1.0 1.0

C/T 1,68 (1,08 a 0,020 1,67 (1,06 a 0,028  C / T 1.68 (1.08 to 0.020 1.67 (1.06 to 0.028

2,60) 2,63)  2.60) 2.63)

C/C 2,57 (1,36 a 0,004 0.5886 2,47 (1,26 a 0,008 0,6633 0,0002 4,88) 4,83) C / C 2.57 (1.36 to 0.004 0.5886 2.47 (1.26 to 0.008 0.6633 0.0002 4.88) 4.83)

Comentarios Los genotipos C/T y C/C están asociados a una mayor abstinencia a los 3 meses, siendo el alelo C el factor más importante en la explicación del éxito de la abstinencia. La predicción es mejor para el modelo multivariado (66% en base al área bajo la curva) que para el univariado. La significación del «-valor para modelos anidados (genotipo versus genotipo más variables clínicas) señala que el modelo multivariado es significativamente mejor que el univariado en la predicción del resultado. Comments The C / T and C / C genotypes are associated with greater withdrawal at 3 months, with the C allele being the most important factor in explaining the success of withdrawal. The prediction is better for the multivariate model (66% based on the area under the curve) than for the univariate. The significance of «-value for nested models (genotype versus genotype plus clinical variables) indicates that the multivariate model is significantly better than the univariate in predicting the outcome.

La Figura 1 muestra las curvas ROC correspondientes a los modelos univariado (gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rs678188. rs9658498 (Chr 12; NOS 1)  Figure 1 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to the SNP rs678188. rs9658498 (Chr 12; US 1)

Resultado Genotipo P-valor AIC AUC  Result Genotype P-value AIC AUC

T/T C/T C/C  T / T C / T C / C

1 154 151 37  1 154 151 37

0 52 49 32  0 52 49 32

OR 1,00 1,04 0,39 0,0019 556,8  OR 1.00 1.04 0.39 0.0019 556.8

OR lineal 0,68 0,0081 560,3 0,5628  Linear OR 0.68 0.0081 560.3 0.5628

Resultado Alelos OR (IC 95%) P-valor Result OR alleles (95% CI) P-value

T C  T C

1 459 225  1 459 225

0 153 113  0 153 113

Total 612 338 0,66 (0,50 - 0,89) 0,006  Total 612 338 0.66 (0.50 - 0.89) 0.006

Genotipo Resultados univariados Resultados multivariados P-valor Genotype Univariate results Multivariate results P-value

(modelos anidados) (nested models)

OR (IC 95%) -valor AUC OR (IC -valor AUC OR (95% CI) -value AUC OR (IC -value AUC

95%)  95%)

T/T 1,0 1,0  T / T 1.0 1.0

C/T 1,06 (0,67 a 0,793 1, 13 (0,71 a 0,598  C / T 1.06 (0.67 to 0.793 1, 13 (0.71 to 0.598

1,67) 1,81)  1.67) 1.81)

C/C 0,39 (0,22 a 0,001 0,5718 0,39 (0,22 a 0,002 0,6682 0,0001  C / C 0.39 (0.22 to 0.001 0.5718 0.39 (0.22 to 0.002 0.6682 0.0001

0,69) 0,72) Comentarios Los genotipos C/T y T/T están asociados a una mayor abstinencia a los 3 meses, siendo el alelo C el factor más importante en la explicación del fracaso en la abstinencia. La predicción es mejor para el modelo multivariado (66% en base al área bajo la curva) que para el univariado. La significación del «-valor para modelos anidados (genotipo versus genotipo más variables clínicas) señala que el modelo multivariado es significativamente mejor que el univariado en la predicción del resultado. 0.69) 0.72) Comments The C / T and T / T genotypes are associated with greater withdrawal at 3 months, with the C allele being the most important factor in explaining withdrawal failure. The prediction is better for the multivariate model (66% based on the area under the curve) than for the univariate. The significance of «-value for nested models (genotype versus genotype plus clinical variables) indicates that the multivariate model is significantly better than the univariate in predicting the outcome.

La Figura 2 muestra las curvas ROC correspondientes a los modelos univariado (gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rs9658498. rs4821566 (Chr 22; CSF2RB)  Figure 2 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to the SNP rs9658498. rs4821566 (Chr 22; CSF2RB)

Resultado Genotipo P-valor AIC AUC  Result Genotype P-value AIC AUC

C/C C/G G/G  C / C C / G G / G

1 84 169 91  1 84 169 91

0 48 62 24  0 48 62 24

OR 1,00 1,56 2, 17 0,0226 565,6  OR 1.00 1.56 2, 17 0.0226 565.6

OR lineal 1,48 0,0061 563,7 0,5742  Linear OR 1.48 0.0061 563.7 0.5742

Resultado Alelos OR (IC 95%) P-valor Result OR alleles (95% CI) P-value

C G  C G

1 337 351  1 337 351

0 158 110  0 158 110

Total 495 461 1,50 (1, 12 - 1,99) 0,006  Total 495 461 1.50 (1, 12 - 1.99) 0.006

Figure imgf000059_0001
Figure imgf000059_0001

Comentarios Los genotipos G/G y C/G están asociados a una mayor abstinencia a los 3 meses. Siendo el alelo G el factor más importante en la explicación del éxito en la abstinencia La predicción es mejor para el modelo multivariado (66% en

Figure imgf000060_0001
Comments G / G and C / G genotypes are associated with greater withdrawal at 3 months. The G allele being the most important factor in explaining success in withdrawal. Prediction is better for the multivariate model (66% in
Figure imgf000060_0001

En abstinencia a 3 meses, los SNP rs678188 y rs4821566 están asociados significativamente a la respuesta y en ambos se observó una relación dosis-respuesta. De estos SNP, se observó una mayor significación estadística para el SNP rs678188 (p = 0.0049). Por otro lado, los autores de la presente invención han evaluado la capacidad de predicción de la respuesta al tratamiento a 3 meses del conjunto de SNP formado por rs678188, rs9658498 y rs4821566 respecto al valor predictivo de cada uno de dichos SNP por separado observando que, cuando dichos SNP son considerados en conjunto, se mejora la fiabilidad de la predicción de respuesta al tratamiento (AUC = 0,6582) con respecto a la de cada uno de dichos SNP por separado (AUC (rs678188) = 0,5886; AUC (rs9658498) = 0,5718; AUC (rs4821566) = 0,5747). Por lo tanto, los SNP rs678188, rs9658498 y rs4821566 tienen un valor predictivo de eficacia a tres meses de un tratamiento farmacológico para dejar de fumar basado en vareniclina cuando son analizados en conjunto. In 3 month withdrawal, the SNP rs678188 and rs4821566 are significantly associated with the response and in both cases a dose-response relationship was observed. Of these SNPs, a higher statistical significance was observed for the SNP rs678188 (p = 0.0049). On the other hand, the authors of the present invention have evaluated the ability to predict the response to the 3-month treatment of the set of SNPs formed by rs678188, rs9658498 and rs4821566 with respect to the predictive value of each of these SNPs separately observing that, when said SNPs are taken together, the reliability of the prediction of treatment response (AUC = 0.68582) is improved with respect to that of each of said SNPs separately (AUC (rs678188) = 0.5886; AUC ( rs9658498) = 0.5718; AUC (rs4821566) = 0.5747). Therefore, SNPs rs678188, rs9658498 and rs4821566 have a predictive value of efficacy at three months of a pharmacological treatment for smoking cessation based on varenicline when analyzed together.

Tabla 4 Table 4

Resultados univariados (genotipo) y multivariados (genotipo y variables clínicas) de la eficacia de un tratamiento con vareniclina para la deshabituación tabáquica - Abstinencia a 12 meses rsl0891510 (Chr 11; NCAM1)  Univariate (genotype) and multivariate (genotype and clinical variables) results of the efficacy of a varenicline treatment for smoking cessation - 12-month withdrawal rsl0891510 (Chr 11; NCAM1)

Resultado Genotipo P-valor AIC AUC  Result Genotype P-value AIC AUC

G/G G/T T7T  G / G G / T T7T

1 72 114 36  1 72 114 36

0 65 115 68  0 65 115 68

OR 1,00 0,89 0,48 0,0115 647,2  OR 1.00 0.89 0.48 0.0115 647.2

OR lineal 0,71 0,0080 647, 1 0,5639  Linear OR 0.71 0.0080 647, 1 0.5639

Resultado Alelos OR (IC 95%) P-valor G T Result OR alleles (95% CI) P-value GT

1 258 186  1 258 186

0 245 251  0 245 251

Total 503 437 0,70 (0,54 - 0,91) 0,008  Total 503 437 0.70 (0.54 - 0.91) 0.008

Figure imgf000061_0001
Figure imgf000061_0001

Comentarios El genotipo G/G está asociado a la abstinencia a los 12 meses. Siendo el alelo Comments The G / G genotype is associated with withdrawal at 12 months. Being the allele

T el factor más importante en la explicación del fracaso en la abstinencia. La predicción es mejor para el modelo multivariado (64% en base al área bajo la curva) que para el univariado. La significación del «-valor para modelos anidados (genotipo versus genotipo más variables clínicas) señala que el modelo multivariado es significativamente mejor que el univariado en la predicción del resultado.  T the most important factor in the explanation of failure in withdrawal. The prediction is better for the multivariate model (64% based on the area under the curve) than for the univariate. The significance of «-value for nested models (genotype versus genotype plus clinical variables) indicates that the multivariate model is significantly better than the univariate in predicting the outcome.

La Figura 4 muestra las curvas ROC correspondientes a los modelos univariado (gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rsl0891510. rsl 1932367 (Chr 4; GRID2)  Figure 4 shows the ROC curves corresponding to the univariate (upper graphic) and multivariate (lower graphic) models in relation to SNP rsl0891510. rsl 1932367 (Chr 4; GRID2)

Resultado Genotipo P-valor AIC AUC  Result Genotype P-value AIC AUC

G/G A/G A A  G / G A / G A A

1 125 84 13  1 125 84 13

0 109 120 21  0 109 120 21

OR 1,00 0,61 0,54 0,0211 650,9  OR 1.00 0.61 0.54 0.0211 650.9

OR lineal 0,67 0,0077 649,6 0,5654  Linear OR 0.67 0.0077 649.6 0.5654

Resultado Alelos OR (IC 95%) P-valor Result OR alleles (95% CI) P-value

334 110 338 162 334 110 338 162

Total 672 272 0,68 (0,52 - 0,91) 0,010  Total 672 272 0.68 (0.52 - 0.91) 0.010

Figure imgf000062_0001
Figure imgf000062_0001

Comentarios El genotipo G/G está asociado a la abstinencia a los 12 meses, siendo el alelo Comments The genotype G / G is associated with withdrawal at 12 months, the allele being

A el factor más importante en la explicación del fracaso en la abstinencia. La predicción es mejor para el modelo multivariado (64% en base al área bajo la curva) que para el univariado. La significación del «-valor para modelos anidados (genotipo versus genotipo más variables clínicas) señala que el modelo multivariado es significativamente mejor que el univariado en la predicción del resultado.  To the most important factor in the explanation of failure in withdrawal. The prediction is better for the multivariate model (64% based on the area under the curve) than for the univariate. The significance of «-value for nested models (genotype versus genotype plus clinical variables) indicates that the multivariate model is significantly better than the univariate in predicting the outcome.

La Figura 5 muestra las curvas ROC correspondientes a los modelos univariado (gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rsl 1932367. rs2023239 (Chr 6; CNR1)  Figure 5 shows the ROC curves corresponding to the univariate (upper graph) and multivariate (lower graph) models in relation to SNP rsl 1932367. rs2023239 (Chr 6; CNR1)

Resultado Genotipo P-valor AIC AUC  Result Genotype P-value AIC AUC

T/T C/T c/c  T / T C / T c / c

1 126 83 13  1 126 83 13

0 175 65 10  0 175 65 10

OR 1,00 1,77 1,81 0,0115 649,7  OR 1.00 1.77 1.81 0.0115 649.7

OR lineal 1,57 0,0049 648,7 0,5664  Linear OR 1.57 0.0049 648.7 0.5664

Resultado Alelos OR (IC 95%) P-valor Result OR alleles (95% CI) P-value

T C  T C

1 335 109  1 335 109

0 415 85  0 415 85

Total 750 194 1,59 (1,16 - 2, 18) 0,004 Genotipo Resultados univariados Resultados multivariados P-valor Total 750 194 1.59 (1.16 - 2, 18) 0.004 Genotype Univariate results Multivariate results P-value

(modelos anidados) (nested models)

OR (IC 95%) -valor AUC OR (IC P- AUC OR (95% CI) -value AUC OR (IC P- AUC

95%) valor  95%) value

T/T 1,0 1,0  T / T 1.0 1.0

C/T 1,76 (1, 18 a 0,005 1,85 (1,22 a  C / T 1.76 (1.18 to 0.005 1.85 (1.22 a

2,62) 2,81)  2.62) 2.81)

c/c 1,79 (0,76 a 0, 180 0,5657 1,73 (0,71 a 0,228 0,6577 0,0002  c / c 1.79 (0.76 to 0. 180 0.5657 1.73 (0.71 to 0.228 0.6577 0.0002

4,22) 4,20)  4.22) 4.20)

Comentarios Los genotipos C/T y C/C están asociados a una mayor abstinencia a los 12 meses, siendo el alelo C el factor más importante en la explicación del éxito en la abstinencia. La predicción es mejor para el modelo multivariado (66% en base al área bajo la curva) que para el univariado. La significación del «-valor para modelos anidados (genotipo versus genotipo más variables clínicas) señala que el modelo multivariado es significativamente mejor que el univariado en la predicción del resultado. Comments The C / T and C / C genotypes are associated with greater abstinence at 12 months, with the C allele being the most important factor in explaining success in withdrawal. The prediction is better for the multivariate model (66% based on the area under the curve) than for the univariate. The significance of «-value for nested models (genotype versus genotype plus clinical variables) indicates that the multivariate model is significantly better than the univariate in predicting the outcome.

La Figura 6 muestra las curvas ROC correspondientes a los modelos univariado (gráfica superior) y multivariado (gráfica inferior) en relación con el SNP rs2023239.  Figure 6 shows the ROC curves corresponding to the univariate (upper graph) and multivariate (lower graph) models in relation to SNP rs2023239.

Asimismo, los autores de la presente invención han evaluado la capacidad de predicción de la respuesta al tratamiento a 12 meses del conjunto de SNP formado por rsl0891510, rsl 1932367 y rs2023239 respecto al valor predictivo de cada uno de dichos SNP por separado observando que, cuando dichos SNP son considerados en conjunto, también se mejora la fiabilidad de la predicción de respuesta al tratamiento (AUC = 0,6305) con respecto a la de cada uno de dichos SNP por separado (AUC (rsl0891510) = 0,5655; AUC (rsl 1932367) = 0,5637; AUC (rs2023239) = 0,5657). Estos resultados ponen de manifiesto que los SNP rsl0891510, rsl 1932367 y rs2023239 tienen un valor predictivo de eficacia a 12 meses de un tratamiento farmacológico para dejar de fumar basado en vareniclina cuando son analizados en conjunto. Likewise, the authors of the present invention have evaluated the prediction capacity of the 12-month treatment response of the SNP set formed by rsl0891510, rsl 1932367 and rs2023239 with respect to the predictive value of each of these SNPs separately, observing that when said SNPs are considered together, the reliability of the prediction of treatment response (AUC = 0.6305) is also improved with respect to that of each of said SNPs separately (AUC (rsl0891510) = 0.5655; AUC ( rsl 1932367) = 0.5637; AUC (rs2023239) = 0.5657). These results show that the SNP rsl0891510, rsl 1932367 and rs2023239 have a predictive value of efficacy at 12 months of a pharmacological treatment to stop smoking based on varenicline when analyzed together.

Tabla 5 Table 5

Vareniclina - Abstinencia a 3 meses  Varenicline - 3 month withdrawal

Gen ID SNP Ligado MAF Función Gene ID SNP Linked MAF Function

PARD3 rs678188 rs624056C/T C 0,442 IP (10pll.21) (p-0,0073)C rs626385 C/T T 0,376 IP-CG PARD3 rs678188 rs624056C / TC 0.442 IP (10pll. 21) (p-0.0073) C rs626385 C / TT 0.376 IP-CG

rsl765160 A/G G 0,449 INF rs 1274478 A/G A0,338 INF-CG rs678188 C/T C0,407 INF-CG rs7959232 A/G G 0,394 IP rs904658 G/T G 0,389 INF rs 10774910 C/T T 0,381 INF  rsl765160 A / G G 0.449 INF rs 1274478 A / G A0.338 INF-CG rs678188 C / T C0.407 INF-CG rs7959232 A / G G 0.394 IP rs904658 G / T G 0.399 INF rs 10774910 C / T T 0.381 INF

NOSl  NOSl

rs9658498 rs3741476 C/T C 0,397 INF  rs9658498 rs3741476 C / T C 0.397 INF

(12q24.2- (12q24.2-

(p-0,0019)T (p-0.0019) T

q24.31) rs 12830203 C/T T 0,347 INF-CG rs2291908A/G G 0,363 INF-CG rs2293046 A/G A 0,336 IP-CG rs9658498 C/T C 0,389 INF-CG rs4821565 C/T 0,5 AARRP rs9607391 A/T T 0,486 AA F rs2413435 G/T 0,5 IGRT rs4239882 A/G G 0,492 AART rs4821561 C/T T 0,473 IGRT-CG rs2049908 A/G G 0,471 IGRT-CG rs4821560 G/T G 0,473 IGRT rsl 807546 A/C C 0,492 IGRT rs9607397 C/T T 0,48 AART rs2413436A/G G 0,473 IG F  q24.31) rs 12830203 C / TT 0.347 INF-CG rs2291908A / GG 0.363 INF-CG rs2293046 A / GA 0.336 IP-CG rs9658498 C / TC 0.399 INF-CG rs4821565 C / T 0.5 AARRP rs9607391 A / TT 0.486 AA F rs2413435 G / T 0.5 IGRT rs4239882 A / GG 0.492 AART rs4821561 C / TT 0.473 IGRT-CG rs2049908 A / GG 0.471 IGRT-CG rs4821560 G / TG 0.473 IGRT rsl 807546 A / CC 0.492 IGRT rs9 03977777/73977 48 AART rs2413436A / GG 0.473 IG F

CSF2RB rs4821566 rs9607390 C/T T 0,439 AA F  CSF2RB rs4821566 rs9607390 C / T T 0.439 AA F

(22ql3.1) (p-0,0226)G rs9607396 A/C A 0,453 AART  (22ql3.1) (p-0.0226) G rs9607396 A / C A 0.453 AART

rs2075941C/T T 0,492 INF rsl 0222238G/T G 0,469 AART-CG rsl0222232A/G A 0,491 AART rs4821567 G 0,478 AART rs4820262C/T T 0,492 AART rs4820261A/G G 0,483 AART-CG rs5756407C/T C0,478 AART rs4821568 C 0,478 AART rs2899276 C/T C 0,473 IGRT rs4821566 C/G G 0,482 AANI  rs2075941C / TT 0.492 INF rsl 0222238G / TG 0.469 AART-CG rsl0222232A / GA 0.491 AART rs4821567 G 0.478 AART rs4820262C / TT 0.492 AART rs4820261A / GG 0.483 AART-CG rs575648768 A7 IGRT rs4821566 C / GG 0.482 AANI

AAIGRT: Aguas arriba intergénico regulador transcripcional; AANF: Aguas arriba no funcional; AARR: Aguas arriba región reguladora; AARRP: Aguas arriba regulador de región de promotor; AART: Aguas arriba regulador transcripcional; ABNF: Aguas abajo no funcional; ABRT: Aguas abajo regulador transcripcional; CG: Sitio CpG; ERES: Exónico regulador ensamblaje sinónimo; IGNF: Intergénico no funcional; IGRT: Intergénico regulador transcripcional; INF Intrónico no funcional; IP: Intrónico potenciador; IRT: Intrónico regulador transcripcional; ISI: Intrónico sin información; ND: Dato no disponible. Tabla 6 AAIGRT: Upstream intergenic transcriptional regulator; AANF: Upstream non-functional; AARR: Upstream regulatory region; AARRP: Upstream promoter region regulator; AART: Upstream transcriptional regulator; ABNF: Downstream non-functional; ABRT: Downstream transcriptional regulator; CG: CpG Site; YOU ARE: Exonic regulator assembly synonym; IGNF: Non-functional intergenic; IGRT: Intergenic transcriptional regulator; Intronic non-functional INF; IP: Intronic enhancer; IRT: Intronic transcriptional regulator; ISI: Intronic without information; ND: Data not available. Table 6

Vareniclina - Abstinencia a 12 meses  Varenicline - 12 month withdrawal

Gen ID SNP Ligado MAF Función  Gene ID SNP Linked MAF Function

rs4936263 A/G G 0,46 IGRT-CG rsl0891518 C/T T 0,458 IGRT-CG rs4936263 A / G G 0.46 IGRT-CG rsl0891518 C / T T 0.458 IGRT-CG

NCAM1 rsl0891510 NCAM1 rsl0891510

rs4937993 A/G A 0,491 IGRT-CG (llq23.1) (p-0,0115)G  rs4937993 A / G A 0.491 IGRT-CG (llq23.1) (p-0.0115) G

rs7932647 A/G A 0,458 IGRT rsl0891510 G/T T 0,491 IGRT rs6848888 C/T T 0,363 IRT rs4519763 C/T C 0,363 IRT-CG rs7932647 A / G A 0.458 IGRT rsl0891510 G / T T 0.491 IGRT rs6848888 C / T T 0.363 IRT rs4519763 C / T C 0.363 IRT-CG

GRID2 rsl 1932367 GRID2 rsl 1932367

rs7671794 A/G A 0,363 IRT-CG (4q22) (p-0,0211)G  rs7671794 A / G A 0.363 IRT-CG (4q22) (p-0.0211) G

rsl 1097378 G/T T 0,381 IRT rsl 1932367 A/G A 0,385 INF-CG rs9450898 C/T T 0, 158 INF rs6928813 A/G G 0, 159 INF-CG rsl 1097378 G / T T 0.381 IRT rsl 1932367 A / G A 0.385 INF-CG rs9450898 C / T T 0.158 INF rs6928813 A / G G 0. 159 INF-CG

CNR1 rs2023239 CNR1 rs2023239

rs9444584 C/T T 0,2 IRT-CG (6ql4-ql5) (p-0,0115)C  rs9444584 C / T T 0.2 IRT-CG (6ql4-ql5) (p-0.0115) C

rs6928499 C/T C 0, 175 INF rs2023239 C/T C 0,167 INF-CG rs6928499 C / T C 0, 175 INF rs2023239 C / T C 0.167 INF-CG

AAIGRT: Aguas arriba intergénico regulador transcripcional; AANI: Aguas arriba no información; AANF Aguas arriba no funcional; AARR: Aguas arriba región reguladora; AARRP: Aguas arriba regulador de región de promotor; AART: Aguas arriba regulador transcripcional; ABNF: Aguas abajo no funcional; ABRT: Aguas abajo regulador transcripcional; CG: Sitio CpG; ERES: Exónico regulador ensamblaje sinónimo; IGNF: Intergénico no funcional; IGRT: Intergénico regulador transcripcional; INF Intrónico no funcional; IP: Intrónico potenciador; IRT: Intrónico regulador transcripcional; ISI: Intrónico sin información; ND: Dato no disponible. AAIGRT: Upstream intergenic transcriptional regulator; AANI: Upstream no information; AANF Upstream non-functional; AARR: Upstream regulatory region; AARRP: Upstream promoter region regulator; AART: Upstream transcriptional regulator; ABNF: Downstream non-functional; ABRT: Downstream transcriptional regulator; CG: CpG Site; YOU ARE: Exonic regulator assembly synonym; IGNF: Non-functional intergenic; IGRT: Intergenic transcriptional regulator; Intronic non-functional INF; IP: Intronic enhancer; IRT: Intronic transcriptional regulator; ISI: Intronic without information; ND: Data not available.

TRADUCCIÓN AL CASTELLANO DE TÉRMINOS EN INGLÉS QUE APARECEN EN LA LISTA DE SECUENCIAS TRANSLATION TO ENGLISH OF ENGLISH TERMS THAT APPEAR ON THE LIST OF SEQUENCES

El término "SEQUENCE LISTING" significa "LISTA DE SECUENCIAS".  The term "SEQUENCE LISTING" means "LIST OF SEQUENCES".

Claims

REIVINDICACIONES Un método para determinar la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos, que comprende determinar en una muestra biológica de dicho sujeto, al menos un alelo de uno o más de los polimorfismos de un solo nucleótido (S P) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o de cualquier SNP de sus correspondientes bloques de ligamiento, en donde la presencia de al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; A method for determining the probability that a subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors, which comprises determining in a biological sample of said subject, at least one allele of one or more of single nucleotide polymorphisms (SP) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or of any SNP of its corresponding linkage blocks, where the presence of at least one C allele of the SNP rs678188, or of the corresponding alleles of the SNPs of their linkage block; la presencia de al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo G del SNP rs 10891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rs 10891510, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of at least one G allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I la presencia de al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento; es indicativa de una alta probabilidad de que dicho sujeto abandone el consumo de tabaco en respuesta a dicha terapia; o alternativamente, en donde la presencia de al menos un alelo T del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block; it is indicative of a high probability that said subject will quit smoking in response to said therapy; or alternatively, where the presence of at least one T allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo C del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; la presencia de al menos un alelo C del S P rs4821566, o de los alelos correspondientes de los S Ps de su bloque de ligamiento; the presence of at least one C allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block; the presence of at least one C allele of SP rs4821566, or of the corresponding alleles of the S Ps of its linkage block; la presencia de al menos un alelo T del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block; - la presencia de al menos un alelo A del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  - the presence of at least one A allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I la presencia de al menos un alelo T del SNP rs2023239, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; es indicativa de una baja probabilidad de que dicho sujeto cese el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos.  the presence of at least one T allele of the SNP rs2023239, or of the corresponding alleles of the SNPs of its linkage block; It is indicative of a low probability that said subject will cease tobacco consumption in response to a therapy based on an agonist drug of nicotinic cholinergic receptors. Método según la reivindicación 1, en el que: la presencia de ambos alelos C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; Method according to claim 1, wherein: the presence of both C alleles of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block; la presencia de ambos alelos T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both T alleles of the SNP rs9658498, or of the corresponding alleles of the SNPs of their linkage block; la presencia de ambos alelos G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of the SNP rs4821566, or of the corresponding alleles of the SNPs of their linkage block; la presencia de ambos alelos G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block; la presencia de ambos alelos G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of both G alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; I la presencia de ambos alelos C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento; es indicativa de una alta probabilidad de que dicho sujeto abandone el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos; o alternativamente, en el que la presencia de ambos alelos T del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; the presence of both C alleles of SNP rs2023239, or of the corresponding alleles of SNPs of their linkage block; it is indicative of a high probability that said subject will quit smoking in response to a therapy based on an agonist drug of nicotinic cholinergic receptors; or alternatively, in which the presence of both T alleles of the SNP rs678188, or of the corresponding alleles of the SNPs of their linkage block; la presencia de ambos alelos C del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both C alleles of the SNP rs9658498, or of the corresponding alleles of the SNPs of their linkage block; la presencia de ambos alelos C del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both C alleles of SNP rs4821566, or of the corresponding alleles of the SNPs of their linkage block; la presencia de ambos alelos T del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both T alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block; la presencia de ambos alelos A del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of both A alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; I la presencia de ambos alelos T del SNP rs2023239, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; es indicativa de una baja probabilidad de que dicho sujeto cese el consumo de tabaco en respuesta a una terapia basada en un fármaco agonista de los receptores colinérgicos nicotínicos.  the presence of both T alleles of the SNP rs2023239, or of the corresponding alleles of the SNPs of their linkage block; It is indicative of a low probability that said subject will cease tobacco consumption in response to a therapy based on an agonist drug of nicotinic cholinergic receptors. Un método para predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto, que comprende determinar en una muestra biológica de dicho sujeto al menos un alelo de uno o más de los polimorfismos de un solo nucleótido (SNPs) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o cualquier SNP de sus correspondientes bloques de ligamiento, en donde la presencia de al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; A method for predicting the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject, which comprises determining in an biological sample of said subject at least one allele of one or more of the polymorphisms single nucleotide (SNPs) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of its corresponding ligation blocks, where the presence of at least one C allele of the SNP rs678188, or the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; the presence of at least one G allele of SNP rs4821566, or of alleles corresponding of the SNPs of its linkage block; la presencia de al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of at least one G allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I la presencia de al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento; es indicativa de que dicha terapia será eficaz; o alternativamente, en donde la presencia de al menos un alelo T del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block; It is indicative that such therapy will be effective; or alternatively, where the presence of at least one T allele of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo C del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one C allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo C del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one C allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo T del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of at least one T allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block; la presencia de al menos un alelo A del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  the presence of at least one A allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I la presencia de al menos un alelo T del SNP rs2023239, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; es indicativa de que dicha terapia será ineficaz.  the presence of at least one T allele of the SNP rs2023239, or of the corresponding alleles of the SNPs of its linkage block; It is indicative that such therapy will be ineffective. Método según la reivindicación 3, en el que: la presencia de ambos alelos C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; Method according to claim 3, wherein: the presence of both C alleles of the SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block; la presencia de ambos alelos T del SNP rs9658498, o de los alelos correspondientes de los S Ps de su bloque de ligamiento; the presence of both T alleles of the SNP rs9658498, or of the alleles corresponding to the S Ps of its linkage block; la presencia de ambos alelos G del S P rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of S P rs4821566, or of the corresponding alleles of the SNPs of their linkage block; la presencia de ambos alelos G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block; la presencia de ambos alelos G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o la presencia de ambos alelos C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento; es indicativa de que dicha terapia será eficaz; o alternativamente, en el que - la presencia de ambos alelos T del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both G alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; and / or the presence of both C alleles of SNP rs2023239, or the corresponding alleles of SNPs of their linkage block; It is indicative that such therapy will be effective; or alternatively, in which - the presence of both T alleles of the SNP rs678188, or of the corresponding alleles of the SNPs of their linkage block; la presencia de ambos alelos C del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both C alleles of the SNP rs9658498, or of the corresponding alleles of the SNPs of their linkage block; la presencia de ambos alelos C del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both C alleles of SNP rs4821566, or of the corresponding alleles of the SNPs of their linkage block; la presencia de ambos alelos T del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  the presence of both T alleles of SNP rsl0891510, or of the corresponding alleles of SNPs of their linkage block; la presencia de ambos alelos A del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o - la presencia de ambos alelos T del SNP rs2023239, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; es indicativa de que dicha terapia será ineficaz. 5. Un método para seleccionar un sujeto para una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de receptores colinérgicos nicotínicos, que comprende determinar en una muestra biológica de dicho sujeto al menos un alelo de uno o más de los polimorfismos de un solo nucleótido (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o cualquier SNP de sus correspondientes bloques de ligamiento, en donde dicho sujeto es seleccionado para dicha terapia si tiene al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; the presence of both A alleles of SNP rsl 1932367, or of the corresponding alleles of SNPs of their linkage block; and / or - the presence of both T alleles of SNP rs2023239, or of the corresponding alleles of SNPs of their linkage block; It is indicative that such therapy will be ineffective. 5. A method of selecting a subject for a therapy to quit smoking based on a nicotinic cholinergic receptor agonist drug, which comprises determining in a biological sample of said subject at least one allele of one or more of the single nucleotide polymorphisms (S Ps) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of its corresponding ligation blocks, wherein said subject is selected for said therapy if you have at least one C allele of the SNP rs678188, or of the corresponding alleles of the SNPs of your linkage block; al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one T allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block; al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one G allele of the SNP rs4821566, or of the corresponding alleles of the SNPs of its linkage block; al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block; al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o  at least one G allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; I al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento.  at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block. Un método para seleccionar una terapia para un sujeto en necesidad de terapia para abandonar el consumo de tabaco, que comprende determinar en una muestra biológica de dicho sujeto al menos un alelo de uno o más de los polimorfismos de un solo nucleótido (SNPs) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 y rs2023239, o cualquier SNP de sus correspondientes bloques de ligamiento, en donde se selecciona una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de receptores colinérgicos nicotínicos si dicho sujeto tiene al menos un alelo C del SNP rs678188, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; A method for selecting a therapy for a subject in need of therapy to quit smoking, which comprises determining in a biological sample of said subject at least one allele of one or more of the single nucleotide polymorphisms (SNPs) rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367 and rs2023239, or any SNP of their corresponding ligation blocks, where a therapy is selected to abandon tobacco use based on an agonist drug of nicotinic cholinergic receptors if said subject has at least one allele C of SNP rs678188, or of the corresponding alleles of the SNPs of its linkage block; al menos un alelo T del SNP rs9658498, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one T allele of the SNP rs9658498, or of the corresponding alleles of the SNPs of its linkage block; al menos un alelo G del SNP rs4821566, o de los alelos correspondientes de los S Ps de su bloque de ligamiento; at least one G allele of SNP rs4821566, or of the corresponding alleles of the S Ps of its linkage block; al menos un alelo G del SNP rsl0891510, o de los alelos correspondientes de los SNPs de su bloque de ligamiento;  at least one G allele of the SNP rsl0891510, or of the corresponding alleles of the SNPs of its linkage block; al menos un alelo G del SNP rsl 1932367, o de los alelos correspondientes de los SNPs de su bloque de ligamiento; y/o al menos un alelo C del SNP rs2023239, o de los alelos correspondientes de SNPs de su bloque de ligamiento.  at least one G allele of the SNP rsl 1932367, or of the corresponding alleles of the SNPs of its linkage block; and / or at least one C allele of SNP rs2023239, or of the corresponding alleles of SNPs of its linkage block. 7. Método según cualquiera de las reivindicaciones 1 a 6, en el que dicho SNP se selecciona del grupo formado por los SNPs rs678188, rs9658498, rs4821566 y cualquier combinación de dichos SNPs y/o correspondientes SNPs de sus bloques de ligamiento, o, alternativamente, del grupo formado por los SNPs rsl0891510, rsl 1932367, rs2023239 y cualquier combinación de dichos SNPs y/o de los correspondientes SNPs de sus bloques de ligamiento. Method according to any one of claims 1 to 6, wherein said SNP is selected from the group consisting of SNPs rs678188, rs9658498, rs4821566 and any combination of said SNPs and / or corresponding SNPs of their linkage blocks, or, alternatively , of the group formed by SNPs rsl0891510, rsl 1932367, rs2023239 and any combination of said SNPs and / or the corresponding SNPs of their linkage blocks. 8. Método según cualquiera de las reivindicaciones 1 a 7, en el que dicho sujeto es un consumidor activo de tabaco, preferentemente, un fumador activo. A method according to any one of claims 1 to 7, wherein said subject is an active tobacco consumer, preferably, an active smoker. 9. Método según cualquiera de las reivindicaciones 1 a 8, que comprende, además, analizar al menos una variable clínica relacionada con el consumo de tabaco. 9. Method according to any of claims 1 to 8, further comprising analyzing at least one clinical variable related to tobacco consumption. 10. Método según la reivindicación 9, en el que dicha variable clínica relacionada con el consumo de tabaco se selecciona del grupo formado por estrés subjetivo, motivos para fumar, dependencia según la escala de Fagerstróm, y cualquiera de sus combinaciones. 10. The method according to claim 9, wherein said clinical variable related to tobacco consumption is selected from the group consisting of subjective stress, reasons for smoking, dependence according to the Fagerstrom scale, and any combination thereof. 11. Un kit que comprende al menos un reactivo necesario para determinar la presencia de al menos un alelo de uno o más de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 y/o de los alelos correspondientes de los SNPs de sus bloques de ligamiento, y/o, al menos, un reactivo para determinar el nucleótido presente en el sitio polimórfico de dichos uno o más SNPs, en donde dichos al menos un reactivo necesario para determinar la presencia de al menos un alelo de uno o más de dichos SNPs y/o de los alelos correspondientes de los SNPs de sus bloques de ligamiento, y/o, al menos, un reactivo para determinar el nucleótido presente en el sitio polimórfico de dichos uno o más SNPs comprende: 11. A kit comprising at least one reagent necessary to determine the presence of at least one allele of one or more of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and / or the corresponding alleles of the SNPs of their ligation blocks, and / or at least one reagent for determining the nucleotide present at the polymorphic site of said one or more SNPs, wherein said at least one reagent necessary for determining the presence of at least one allele of one or more of said SNPs and / or the corresponding alleles of the SNPs of their linkage blocks, and / or at least one reagent to determine the nucleotide present in the polymorphic site of said one or more SNPs comprises: - una o más parejas de oligonucleótidos alelo-específicos o polimorfismo- específicos, donde cada pareja de oligonucleótidos alelo-específicos o polimorfismo-específicos está dirigida a uno de los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 y/o los correspondientes SNPs de sus bloques de ligamiento, o - one or more pairs of allele-specific or polymorphism-specific oligonucleotides, where each pair of allele-specific or polymorphism-specific oligonucleotides is directed to one of the SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and / or corresponding SNPs of their linkage blocks, or - un conjunto de sondas, en donde dicho conjunto de sondas comprende una pluralidad de sondas de oligonucleótidos que interrogan para los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, s2023239 y/o sus correspondientres SNPs de sus bloques de ligamiento, en donde dichas sondas de oligonucleótidos suponen al menos el 50% de las sondas de oligonucleótidos de dicho conjunto de sondas.  - a set of probes, wherein said set of probes comprises a plurality of oligonucleotide probes that interrogate for SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, s2023239 and / or their corresponding SNPs of their ligation blocks, where said oligonucleotide probes account for at least 50% of the oligonucleotide probes of said set of probes. 12. Uso de un kit según la reivindicación 11, para: 12. Use of a kit according to claim 11, for: determinar la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en en un fármaco agonista de los receptores colinérgicos nicotínicos; o para  determine the probability that a subject will quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug; or for predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto; o para  predict the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject; or for - seleccionar un sujeto para una terapia para abandonar el consumo de tabaco basada en en un fármaco agonista de los receptores colinérgicos nicotínicos; o para  - select a subject for a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors; or for seleccionar una terapia a administrar a un sujeto en necesidad de terapia para abandonar el consumo,  select a therapy to be administered to a subject in need of therapy to abandon consumption, 13. Uso de un polimorfismo de un solo nucleótido (SNP) para: determinar la probabilidad de que un sujeto abandone el consumo de tabaco en respuesta a una terapia basada en en un fármaco agonista de los receptores colinérgicos nicotínicos; o para 13. Use of a single nucleotide polymorphism (SNP) to: determine the probability that a subject will quit smoking in response to a therapy based on a nicotinic cholinergic receptor agonist drug; or for predecir la eficacia de una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos en un sujeto; o para  predict the efficacy of a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors in a subject; or for seleccionar un sujeto para una terapia para abandonar el consumo de tabaco basada en en un fármaco agonista de los receptores colinérgicos nicotínicos; o para  select a subject for a therapy to quit smoking based on an agonist drug of nicotinic cholinergic receptors; or for - seleccionar una terapia a administrar a un sujeto en necesidad de terapia para abandonar el consumo;  - select a therapy to be administered to a subject in need of therapy to abandon consumption; en donde dicho SNP se selecciona del grupo formado por los SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 y cualquier combinación de los mismos y/o cualquier SNP de sus correspondientes bloques de ligamiento.  wherein said SNP is selected from the group consisting of SNPs rs678188, rs9658498, rs4821566, rsl0891510, rsl 1932367, rs2023239 and any combination thereof and / or any SNP of their corresponding linkage blocks. 14. Una terapia para abandonar el consumo de tabaco basada en un fármaco agonista de los receptores colinérgicos nicotínicos para su empleo en el tratamiento de un sujeto, en donde dicho sujeto se selecciona mediante el método de la reivindicación 5. 14. A therapy to quit tobacco use based on an agonist drug of nicotinic cholinergic receptors for use in the treatment of a subject, wherein said subject is selected by the method of claim 5. 15. Método según cualquiera de las reivindicaciones 1 a 10, kit según la reivindicación 11, uso de un kit según la reivindicación 12, uso de un SNP según la reivindicación 13, o terapia según la reivindicación 14, en donde dicho fármaco agonista de los receptores colinérgicos nicotínicos se selecciona del grupo formado por vareniclina, citisina y dianiclina. 15. Method according to any of claims 1 to 10, kit according to claim 11, use of a kit according to claim 12, use of a SNP according to claim 13, or therapy according to claim 14, wherein said agonist drug of the Nicotinic cholinergic receptors are selected from the group consisting of varenicline, cytisine and dianicline.
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