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中国结核病患者中细胞色素P450和谷胱甘肽S-转移酶的基因多态性与抗结核药物性肝毒性的关系

Genetic polymorphisms of cytochrome P450 and glutathione S-transferase associated with antituberculosis drug-induced hepatotoxicity in Chinese tuberculosis patients.

作者信息

Wang T, Yu H T, Wang W, Pan Y Y, He L X, Wang Z Y

机构信息

Tuberculosis Research Institute, 309 Hospital of the People's Liberation Army, Beijing, China.

出版信息

J Int Med Res. 2010 May-Jun;38(3):977-86. doi: 10.1177/147323001003800324.

Abstract

This study was designed to investigate the association of genetic polymorphisms of cytochrome P450 subtype 2E1 (CYP2E1) and glutathione S-transferase mu 1 (GSTM1) with susceptibility to antituberculosis drug-induced hepatotoxicity (ADIH) in Chinese tuberculosis patients. All patients were treated with a combination of isoniazid, rifampicin, pyrazinamide and ethambutol. Genomic DNA from 104 patients with ADIH and 111 without ADIH was analysed for the frequency of CYP2E1 RsaI and GSTM1 RsaI genotypes by polymerase chain reaction and restriction fragment length polymorphism. The association of polymorphisms with susceptibility to ADIH was calculated using the chi(2)-test and logistic regression analysis. The CYP2E1 RsaI polymorphisms were significantly associated with ADIH and the c1/c1 genotype was an independent risk factor for ADIH. Compared with the GSTM1 RsaI present genotype, the GSTM1 RsaI null genotype tended to increase susceptibility to ADIH, but the association with ADIH was not significant. The results indicate that CYP2E1 RsaI genotype c1/c1 is a potential risk factor for ADIH in the Chinese population. The tendency of the GSTM1 RsaI null genotype to increase susceptibility to ADIH needs further study.

摘要

本研究旨在探讨中国结核病患者中细胞色素P450 2E1亚型(CYP2E1)和谷胱甘肽S-转移酶μ1(GSTM1)基因多态性与抗结核药物性肝毒性(ADIH)易感性的关系。所有患者均接受异烟肼、利福平、吡嗪酰胺和乙胺丁醇联合治疗。采用聚合酶链反应和限制性片段长度多态性分析104例ADIH患者和111例无ADIH患者的基因组DNA中CYP2E1 RsaI和GSTM1 RsaI基因型频率。使用卡方检验和逻辑回归分析计算多态性与ADIH易感性的关联。CYP2E1 RsaI多态性与ADIH显著相关,c1/c1基因型是ADIH的独立危险因素。与GSTM1 RsaI存在基因型相比,GSTM1 RsaI缺失基因型倾向于增加ADIH易感性,但与ADIH的关联不显著。结果表明,CYP2E1 RsaI基因型c1/c1是中国人群ADIH的潜在危险因素。GSTM1 RsaI缺失基因型增加ADIH易感性的倾向需要进一步研究。

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