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CYP2C19基因多态性对奥美拉唑在中国人群中药代动力学和药效学的影响。

Effects of CYP2C19 genetic polymorphism on the pharmacokinetics and pharmacodynamics of omeprazole in Chinese people.

作者信息

Hu Xiang-Peng, Xu Jian-Ming, Hu Yong-Mei, Mei Qiao, Xu Xin-Hua

机构信息

Center of Endoscopic Diagnosis and Therapy, First Affiliated Hospital of Wenzhou Medical College, Wenzhou [corrected] China.

出版信息

J Clin Pharm Ther. 2007 Oct;32(5):517-24. doi: 10.1111/j.1365-2710.2007.00851.x.

Abstract

BACKGROUND

To investigate whether the pharmacodynamics and pharmacokinetics of omeprazole (OPZ) are dependent of the CYP2C19 genotype status in Chinese people.

METHODS

Eighteen healthy subjects were voluntary to participate in the study, whose CYP2C19 genotype status were determined by polymerase chain reaction-restriction fragment length polymorphism method. There were six homozygous extensive metabolizers, six heterozygous extensive metabolizers and six poor metabolizers (PMs). All subjects were Helicobacter pylori-negative, determined by serology method and (13)C-urea breath test. After d1 and d8 orally received OPZ 20 mg once daily in the morning, intragastric pH values were monitored for 24 h by Digitrapper pH. Meanwhile, blood samples were collected at various time-points until 24 h after administration. The serum concentrations of OPZ were measured by liquid chromatography.

RESULTS

After single or repeated doses, the PMs showed a significantly higher mean area under the serum concentration-time curves (AUC) values than that observed in the homozygous extensive metabolizers or the heterozygous extensive metabolizers, with a relative ratio of 1.0 : 1.1 : 4.2 and 1.0 : 1.3 : 3.3 (homozygous extensive metabolizers:heterozygous extensive metabolizers:poor metabolizers), respectively. After a single dose of OPZ, significant differences in intragastric pH median, pH > 3 holding time and pH > 4 holding time were observed among the three groups. After repeated doses, the PMs showed a significantly higher intragastric pH values than that observed in the homozygous extensive metabolizers or the heterozygous extensive metabolizers.

CONCLUSION

The pharmacodynamic effects of OPZ and its pharmacokinetics depend on the CYP2C19 genotype status in Chinese people.

摘要

背景

研究奥美拉唑(OPZ)的药效学和药代动力学是否依赖于中国人的CYP2C19基因分型状态。

方法

18名健康受试者自愿参与本研究,其CYP2C19基因分型状态采用聚合酶链反应-限制性片段长度多态性方法测定。其中有6名纯合子广泛代谢者、6名杂合子广泛代谢者和6名慢代谢者(PMs)。所有受试者经血清学方法和(13)C-尿素呼气试验确定幽门螺杆菌阴性。在第1天和第8天,所有受试者于早晨每日口服一次OPZ 20 mg后,采用Digitrapper pH监测胃内pH值24小时。同时,在给药后直至24小时的不同时间点采集血样。采用液相色谱法测定血清中OPZ的浓度。

结果

单次或重复给药后,慢代谢者血清浓度-时间曲线下平均面积(AUC)值显著高于纯合子广泛代谢者或杂合子广泛代谢者,纯合子广泛代谢者:杂合子广泛代谢者:慢代谢者的相对比值分别为1.0 : 1.1 : 4.2和1.0 : 1.3 : 3.3。单次服用OPZ后,三组之间胃内pH中位数、pH>3持续时间和pH>4持续时间存在显著差异。重复给药后,慢代谢者的胃内pH值显著高于纯合子广泛代谢者或杂合子广泛代谢者。

结论

OPZ的药效学作用及其药代动力学依赖于中国人的CYP2C19基因分型状态。

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