Fischer Simon, Lakatos Peter Laszlo, Lakatos Laszlo, Kovacs Agota, Molnar Tamas, Altorjay Istvan, Papp Maria, Szilvasi Aniko, Tulassay Zsolt, Osztovits Janos, Papp Janos, Demeter Pal, Schwab Richard, Tordai Attila, Andrikovics Hajnalka
1st Department of Medicine, Semmelweis University, Budapest, Hungary.
Scand J Gastroenterol. 2007 Jun;42(6):726-33. doi: 10.1080/00365520601101559.
MDR1 (ABCB1), a member of the ATP-binding cassette (ABC) transporters, is an attractive candidate gene for the pathogenesis of inflammatory bowel diseases (IBD) and perhaps for response to therapy. Since limited data are available on MDR1 and ABCG2 polymorphisms in East European IBD patients, the aim of this study was to investigate ABCG2 and MDR1 variants and responses to medical therapy and/or disease phenotype in Hungarian patients.
A total of 414 unrelated IBD patients (Crohn's disease (CD): 265, age: 35.2+/-12.1 years, duration: 8.7+/-7.6 years and ulcerative colitis (UC): 149, age: 44.4+/-15.4 years, duration: 10.7+/-8.9 years) and 149 healthy subjects were investigated. ABCG2 G34A, C421A and MDR1 C3435T, G2677T/A single nucleotide polymorphisms (SNPs) were detected using real-time polymerase chain reaction (PCR). Detailed clinical phenotypes were determined by reviewing the medical charts.
The frequency of the ABCG2 and MDR1 SNPs was not significantly different among IBD, CD, UC patients and controls. There was no difference in risk for steroid resistance in CD patients carrying variant ABCG2 (19.6% versus non-carriers 18.4%, p=NS) or MDR1 3435T (CC: 22.2% versus CT/TT: 17.6%) alleles. In addition, carriage of the variant allele was not associated with disease phenotype, presence of extra-intestinal manifestations, smoking, response to infliximab therapy or the need for surgery. In UC, the carriage of variant ABCG2 alleles seemed to be preventive for arthritis (15.5% versus 31.7%, OR: 0.39, 95% CI: 0.16-0.98).
MDR1 and ABCG2 SNPs were not associated with disease susceptibility or disease phenotype in Hungarian patients, and variant alleles did not predict the response to medical therapy or the need for surgery. Further studies are needed to clarify the association between the presence of ABCG2 variants and arthritis in UC.
多药耐药基因1(MDR1,即ABCB1)是ATP结合盒(ABC)转运蛋白家族的成员之一,是炎性肠病(IBD)发病机制以及可能的治疗反应中一个有吸引力的候选基因。由于关于东欧IBD患者中MDR1和ABCG2基因多态性的数据有限,本研究旨在调查匈牙利患者中ABCG2和MDR1基因变异以及药物治疗反应和/或疾病表型。
共调查了414例无亲缘关系的IBD患者(克罗恩病(CD):265例,年龄:35.2±12.1岁,病程:8.7±7.6年;溃疡性结肠炎(UC):149例,年龄:44.4±15.4岁,病程:10.7±8.9年)以及149名健康受试者。采用实时聚合酶链反应(PCR)检测ABCG2基因G34A、C421A以及MDR1基因C3435T、G2677T/A单核苷酸多态性(SNP)。通过查阅病历确定详细的临床表型。
IBD患者、CD患者、UC患者以及对照组中ABCG2和MDR1基因SNP的频率无显著差异。携带ABCG2基因变异(19.6%对比非携带者18.4%,p=无统计学意义)或MDR1基因3435T(CC:22.2%对比CT/TT:17.6%)等位基因的CD患者在类固醇抵抗风险方面无差异。此外,变异等位基因的携带与疾病表型、肠外表现的存在、吸烟、英夫利昔单抗治疗反应或手术需求均无关。在UC中,携带ABCG2基因变异等位基因似乎对关节炎有预防作用(15.5%对比31.7%,比值比:0.39,95%可信区间:0.16 - 0.98)。
在匈牙利患者中,MDR1和ABCG2基因SNP与疾病易感性或疾病表型无关,变异等位基因也不能预测药物治疗反应或手术需求。需要进一步研究以阐明UC中ABCG2基因变异的存在与关节炎之间的关联。