Kootstra-Ros Jenny E, Smallegoor Windy, van der Weide Jan
Department of Clinical Chemistry, St Jansdal Hospital, PO Box 138, 3840 AC Harderwijk, The Netherlands.
Ann Clin Biochem. 2005 May;42(Pt 3):216-9. doi: 10.1258/0004563053857798.
The atypical antipsychotic drug clozapine is metabolized by CYP1A2. The activity of CYP1A2 is highly variable and is among others dependent on smoking habits. Certain genotypes of CYP1A2 have been associated with increased inducibility/activity of CYP1A2. However, the relevance of genotyping for these mutations in a clinical setting has not yet been demonstrated.
In this study, the CYP1A2 *1F, *1C and *1D genotypes of 58 schizophrenic patients on clozapine treatment were correlated with clozapine serum concentrations corrected for dose and weight or concentration/dosage ratios.
The allele frequency of *1F and *1D was 67% and 6%, respectively. With an allele frequency of 1%, the occurrence of *1C was very low. Multivariate analysis of variance did not reveal any significant correlations between CYP1A2 genotypes and clozapine clearance in these subjects, although a possible effect of the *1D allele cannot be excluded in this study.
Although this study was performed using samples from a limited number of patients, routine genotyping of CYP1A2 *1F, *1C or *1D polymorphisms for their effect on metabolic capacity is, at least in Caucasians, not yet indicated.
非典型抗精神病药物氯氮平由CYP1A2代谢。CYP1A2的活性高度可变,且在其他因素中取决于吸烟习惯。CYP1A2的某些基因型与CYP1A2诱导性/活性增加有关。然而,在临床环境中对这些突变进行基因分型的相关性尚未得到证实。
在本研究中,对58例接受氯氮平治疗的精神分裂症患者的CYP1A2 *1F、1C和1D基因型与经剂量和体重校正的氯氮平血清浓度或浓度/剂量比进行相关性分析。
1F和1D的等位基因频率分别为67%和6%。1C的出现频率很低,为1%。多变量方差分析未显示这些受试者的CYP1A2基因型与氯氮平清除率之间存在任何显著相关性,尽管本研究不能排除1D等位基因的可能影响。
尽管本研究使用的是有限数量患者的样本,但至少在白种人中,尚未表明对CYP1A2 *1F、1C或1D多态性进行常规基因分型以了解其对代谢能力的影响是必要的。