Substance addiction is a complex brain disease, characterized as compulsive substance seeking, abstinence, and repeated relapse for substance use (Chisholm et al., 2021; Huang, Chen, Lane, Ho, & Chung, 2021). Opioid, one of the most abused prescription medicines for pain management and illicit drugs of addiction, causes the most harm in substance misuse-related deaths, killing tens of thousands people per year alone in America (Browne, Godino, Salery, & Nestler, 2020). In China, more than 730 thousand people have exposed to illicit opioid, mainly heroin in 2020. Mounting evidence has suggested that genetic underpinnings and environmental factors contribute to the development of substance addiction (Gerra et al., 2021). Twin studies reveal that the heritability of opioid addiction is about 70% (Goldman, Oroszi, & Ducci, 2005). Genome-wide association studies have proposed a large amount of risk gene variants for opioid addiction (Song et al., 2020; Zhou et al., 2020). However, the underlying mechanism of the association of risk gene variants and opioid addiction remains unknown.
Prolonged use of addictive substances could lead to adaptive alterations in neural plasticity in discrete brain regions including the mesocorticolimbic dopamine system which processes the reward and motivation effects (Hyman, Malenka, & Nestler, 2006), resulting in the transition to addicted states (Stewart, Fulton, & Maze, 2021). DNA methylation, one of the epigenetic components, represents a mechanism that affects the plasticity process and then the development of substance addiction by involving environmental stimuli and regulating gene expression patterns (Stewart et al., 2021). DNA methylation, especially in the promoter region of the gene where is rich with CpG sites and transcriptional factors binding sites, is an important mechanism that regulates gene expression (Pathak, Miller, Morris, Stewart, & Greenberg, 2018). Genetic variants can be associated with the methylation and expression level of the gene. These variants are known as the methylation quantitative trait locus (mQTL) (Villicaña & Bell, 2021) or expression quantitative trait locus (eQTL) (Degtyareva, Antontseva, & Merkulova, 2021). Previous studies have revealed that the mQTLs and eQTLs are enriched in risk genetic variants in many neuropsychiatric diseases such as schizophrenia (Perzel Mandell et al., 2021; Zhao et al., 2018), depression (Ciuculete et al., 2020; X. Wang et al., 2020), and substance addiction (Lin et al., 2020; H. Zhang et al., 2014). Thus, risk genetic variants that correlated with the methylation or expression of the gene may be important mechanism underlying the association with susceptibility and traits of substance addiction.
Tyrosine hydroxylase (TH) is a key rate-limiting enzyme in dopamine and norepinephrine biosynthesis (Boundy et al., 1998; Walters, Kuo, & Blendy, 2003). By regulating the level of the above neurotransmitters with essential roles in neuronal activity, TH has been shown involved in many neuropsychiatric disorders including opioid addiction (Jalali Mashayekhi, Rasti, Khoshdel, & Owji, 2018; Vaillancourt et al., 2021). Repeated morphine administration increased the TH expression in hippocampus (Fang et al., 2017) and locus coeruleus (Jalali Mashayekhi et al., 2018), which are important brain regions in mesocorticolimbic dopamine system. Aldehyde dehydrogenase 2 (ALDH2) inhibitor could prevent the reinstatement of cocaine and alcohol intake by suppressing the activated (phosphorylated) tyrosine hydroxylase signaling (Diamond & Yao, 2015). Hence, TH gene has long been an interesting candidate for the genetic association studies for opioid addiction. However, few studies have elucidated the underlying mechanism in it.
In the present study, we first determined the association between TH gene variants and susceptibility of heroin addiction. Then, the association of TH gene variants and traits of heroin addiction were analyzed. To reveal the potential mechanism of the association between risk SNPs in the TH gene and heroin addiction, we detected and compared the methylation level in the promoter region of the TH gene. Association analysis between the risk SNPs and the methylation level of CpG sites with differential methylation between patients with heroin addiction and healthy controls were performed. Finally, the risk SNPs were screened in the genotype-tissue expression (GTEx) database to demonstrate whether they were eQTLs in human brain regions.