Mihara K, Suzuki A, Kondo T, Yasui N, Furukori H, Nagashima U, Otani K, Kaneko S, Inoue Y
Department of Neuropsychiatry, Hirosaki University School of Medicine, Japan.
Clin Pharmacol Ther. 1999 Mar;65(3):291-4. doi: 10.1016/S0009-9236(99)70108-6.
The CYP2D6*10 (*10) allele that causes decreased CYP2D6 activity is present in Asians with a high frequency of about 50%. In this study we studied the effects of the *10 allele on the steady-state plasma concentrations (Css) of haloperidol and reduced haloperidol.
The subjects were 67 Japanese inpatients with schizophrenia who had only the wild-type or *10 alleles. Thirty-four patients were homozygous for the wild-type allele, and 26 were heterozygous and 7 were homozygous for the *10 allele. All patients had been receiving 12 mg/day haloperidol for at least 2 weeks. Plasma concentrations of haloperidol and reduced haloperidol were measured by HPLC.
The mean +/- SD values of haloperidol Css in the patients with 0, 1, and 2 *10 alleles were 22.8+/-11.0, 30.1+/-10.6, and 31.2+/-21.2 nmol/L, respectively, and those values for reduced haloperidol were 6.1+/-2.9, 9.5+/-3.7, and 9.9+/-6.2 nmol/L, respectively. The mean haloperidol Css was significantly (P < .05) higher in the patients with 1 *10 allele than in those with no *10 alleles. The mean Css of reduced haloperidol was significantly (P < .05) higher in the patients with 1 and 2 *10 alleles than in those with no *10 alleles.
This study suggests that the *10 allele plays an important role in controlling the Css of both haloperidol and reduced haloperidol, especially in Asian subjects.
导致细胞色素P450 2D6(CYP2D6)活性降低的CYP2D6*10(10)等位基因在亚洲人中的出现频率较高,约为50%。在本研究中,我们研究了10等位基因对氟哌啶醇及其还原代谢产物稳态血药浓度(Css)的影响。
研究对象为67例仅携带野生型或10等位基因的日本精神分裂症住院患者。34例患者为野生型等位基因纯合子,26例为杂合子,7例为10等位基因纯合子。所有患者均接受12mg/天的氟哌啶醇治疗至少2周。采用高效液相色谱法测定氟哌啶醇及其还原代谢产物的血药浓度。
携带0、1和2个10等位基因的患者,其氟哌啶醇Css的均值±标准差分别为22.8±11.小、30.1±10.6和31.2±21.2nmol/L,其还原代谢产物的相应值分别为6.1±2.9、9.5±3.7和9.9±6.2nmol/L。携带1个10等位基因的患者,其氟哌啶醇Css均值显著高于(P<0.05)无10等位基因的患者。携带1个和2个10等位基因的患者,其还原代谢产物的Css均值显著高于(P<0.05)无*10等位基因的患者。
本研究提示,*10等位基因在控制氟哌啶醇及其还原代谢产物的Css方面起重要作用,尤其在亚洲人群中。