Hong Xiumei, Zhang Shanchun, Mao Guangyun, Jiang Shanqun, Zhang Yan, Yu Yunxian, Tang Genfu, Xing Houxun, Xu Xiping
Life Science School, University of Science and Technology of China, Huangshan Road, Hefei City, Anhui Province, China.
Eur J Clin Pharmacol. 2005 Oct;61(9):627-34. doi: 10.1007/s00228-005-0976-8. Epub 2005 Oct 19.
There is considerable variability in the individual pharmaceutical dosages required to achieve optimal therapeutic effects, which may be due to environmental or genetic factors. The objective of this study was to test the presence of the CYP2C9*3 allelic variant in the Chinese population and to investigate the association of this variant with both metabolism and therapeutic efficacy of irbesartan on essential hypertension.
In this study, we enrolled 711 subjects from Taihu County and 376 subjects from Dongzhi County in Anhui Province, China. All subjects received a single oral dose of 150 mg irbesartan daily for 28 days. The plasma concentration of irbesartan at 24 h after dosing on the 27th day and at 6 h after dosing on the 28th day was detected using fluorescence-high-performance liquid chromatography. CYP2C9 genotypes were determined using polymerase chain reaction-restriction fragment length polymorphism.
No CYP2C92 allele was found in 235 Chinese samples and was removed from further study. The mean frequency of the CYP2C93 allele was 3.65%, while no CYP2C93/3 genotype was detected. Multiple linear regression analyses revealed that the CYP2C93 allele carriers had significantly higher irbesartan concentrations in plasma at 6 h (Taihu: P < 0.0001; Dongzhi: P = 0.03) and 24 h (Taihu: P < 0.0001; Dongzhi: P = 0.00013) after dosing. No significant association was found between the CYP2C93 allelic variant and the therapeutic effect of irbesartan on essential hypertension.
Our study suggests that the CYP2C9*3 plays an important role in the metabolism of irbesartan and/or is in linkage disequilibrium with another potential CYP2C9 allele, both of which possibly modify the pharmacokinetics of irbesartan.
实现最佳治疗效果所需的个体药物剂量存在很大差异,这可能是环境或遗传因素所致。本研究的目的是检测中国人群中CYP2C9*3等位基因变异的存在情况,并研究该变异与厄贝沙坦治疗原发性高血压的代谢及疗效之间的关联。
本研究纳入了来自中国安徽省太湖县的711名受试者和东至县的376名受试者。所有受试者每天口服150 mg厄贝沙坦单剂量,共28天。在第27天给药后24小时和第28天给药后6小时,采用荧光高效液相色谱法检测厄贝沙坦的血浆浓度。使用聚合酶链反应-限制性片段长度多态性方法测定CYP2C9基因型。
在235份中国样本中未发现CYP2C92等位基因,因此将其排除在进一步研究之外。CYP2C93等位基因的平均频率为3.65%,未检测到CYP2C93/3基因型。多元线性回归分析显示,CYP2C93等位基因携带者在给药后6小时(太湖:P<0.0001;东至:P=0.03)和24小时(太湖:P<0.0001;东至:P=0.00013)时血浆中厄贝沙坦浓度显著更高。未发现CYP2C93等位基因变异与厄贝沙坦治疗原发性高血压的疗效之间存在显著关联。
我们的研究表明,CYP2C9*3在厄贝沙坦的代谢中起重要作用和/或与另一个潜在的CYP2C9等位基因处于连锁不平衡状态,这两者都可能改变厄贝沙坦的药代动力学。