Khalaila Jawad M, Elami Amir, Caraco Yoseph
Clinical Pharmacology Unit, Division of Medicine, Hadassah University Hospital, Jerusalem, Israel.
Pharmacogenet Genomics. 2007 Oct;17(10):803-11. doi: 10.1097/FPC.0b013e3281eb8f07.
Single nucleotide polymorphisms at nucleotides 46, 79 and 491 of the beta2 adrenergic receptor (beta2AR) gene modify its pharmacological properties and may alter the response to agonists. The purpose of this study was to evaluate the role played by beta2AR polymorphisms on isoproterenol-induced relaxation of internal mammary arteries ex vivo.
Internal mammary leftover segments were collected from 96 patients undergoing coronary artery bypass operation. Vascular rings were allowed to reach equilibrium with physiological Krebs solution before precontraction with U46619. Using the organ bath technique, cumulative dose-response curve of isoproterenol was constructed and average EC50 calculated. beta2AR genotyping was performed using a PCR-RFLP analysis.
Arterial segments obtained from Gly16 homozygotes displayed reduced sensitivity to isoproterenol compared with carriers of Arg16 allele(s) [Mean (-log) EC50+/-SD, 6.42+/-0.24, 95% confidence interval (CI) 6.32-6.53 vs. 6.67+/-0.25, 95% CI 6.62-6.73, P<0.001]. Among Gly16 homozygotes, the presence of two Glu27 alleles restored vascular response to the level noted among Arg16 carriers (6.58+/-0.17, 95% CI 6.41-6.76). The least response to isoproterenol was noted in a single patient carrying the Gly16Gly-Gln27Glu-Thr164Ile combined genotype requiring almost six-fold higher isoproterenol concentration than carriers of the wild-type genotype to achieve half the maximal arterial dilatation (17.78 x 10(-7) vs. 3.01 x 10(-7) +/- 2.62 x 10(-7) mol/l).
Vascular dilatation by isoproterenol is determined by a complex interaction between polymorphisms at nucleotides 46, 79 and 491 of the beta2AR gene. Further studies are warranted to evaluate the effect of additional polymorphisms in the coding and noncoding regions on vascular reactivity.
β2肾上腺素能受体(β2AR)基因第46、79和491位核苷酸处的单核苷酸多态性改变其药理学特性,并可能改变对激动剂的反应。本研究的目的是评估β2AR多态性在异丙肾上腺素诱导的离体乳内动脉舒张中所起的作用。
从96例行冠状动脉搭桥手术的患者中收集乳内动脉剩余节段。在用U46619预收缩前,使血管环与生理Krebs溶液达到平衡。采用器官浴技术构建异丙肾上腺素的累积剂量-反应曲线,并计算平均半数有效浓度(EC50)。使用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)进行β2AR基因分型。
与携带Arg16等位基因的个体相比,从Gly16纯合子获得的动脉节段对异丙肾上腺素的敏感性降低[平均(-log)EC50±标准差,6.42±0.24,95%置信区间(CI)6.32-6.53 vs. 6.67±0.25,95%CI 6.62-6.73,P<0.001]。在Gly16纯合子中,两个Glu27等位基因的存在使血管反应恢复到Arg16携带者中的水平(6.58±0.17,95%CI 6.41-6.76)。在一名携带Gly16Gly-Gln27Glu-Thr164Ile联合基因型的患者中观察到对异丙肾上腺素的反应最小,该患者达到最大动脉扩张一半所需的异丙肾上腺素浓度几乎是野生型基因型携带者的六倍(17.78×10⁻⁷ vs. 3.01×10⁻⁷±2.62×10⁻⁷mol/L)。
异丙肾上腺素引起的血管舒张由β2AR基因第46、79和491位核苷酸处的多态性之间的复杂相互作用决定。有必要进一步研究评估编码区和非编码区其他多态性对血管反应性的影响。