Díaz-Molina Raúl, Cornejo-Bravo José M, Ramos-Ibarra Marco A, Estrada-Guzmán Julia D, Morales-Arango Ofelia, Reyes-Báez Rubén, Robinson-Navarro Octavio M, Soria-Rodríguez Carmen G
Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Mexicali, B.C. 21000, Mexico.
Mol Med Rep. 2008 Nov-Dec;1(6):875-9. doi: 10.3892/mmr_00000044.
Isoniazid (INH) is a drug extensively used as a prophylactic and therapeutic agent for human tuberculosis (TB). INH is metabolized by the enzymatic activity of N-acetyltransferase 2 (NAT2). Human NAT2, encoded by a highly polymorphic gene, is involved in the biotransformation of xenobiotics, including drugs and certain chemical carcinogens. Numerous studies have established the correlation between the acetylator phenotype and the NAT2 genotype in several populations; however, little is known regarding Latin-American populations and the pharmacogenetics of NAT2. Here, we report the molecular genotyping of the NAT2 gene, the acetylator phenotype, and the incidence of INH-related adverse reactions in a group of 25 Mexican individuals enrolled in a prophylactic protocol for TB. Using both the NAT2 genotyping and acetylation phenotyping approach, we found a ratio of 69.2 and 30.8% of slow and fast acetylators, respectively. Concordance of the NAT2 genotype and phenotype classification was 88% in the bimodal model. Regarding INH-related adverse reactions, only 2 individuals (8%) exhibited declared gastric intolerance. In our study group, we found an association between the NAT2 genotype and acetylator phenotype (OR=7.78, 95% CI, 0.87-87.98, Fisher's exact test, p<0.05), but did not find any genotype or phenotype association with the incidence of INH-related adverse reactions (Fisher's exact test, p>0.05).
异烟肼(INH)是一种广泛用于人类结核病(TB)预防和治疗的药物。INH通过N - 乙酰转移酶2(NAT2)的酶活性进行代谢。人类NAT2由一个高度多态性的基因编码,参与包括药物和某些化学致癌物在内的外源性物质的生物转化。许多研究已经在多个群体中建立了乙酰化表型与NAT2基因型之间的相关性;然而,对于拉丁裔群体以及NAT2的药物遗传学知之甚少。在此,我们报告了一组25名参与结核病预防方案的墨西哥个体中NAT2基因的分子基因分型、乙酰化表型以及INH相关不良反应的发生率。使用NAT2基因分型和乙酰化表型分型方法,我们分别发现慢乙酰化者和快乙酰化者的比例为69.2%和30.8%。在双峰模型中,NAT2基因型和表型分类的一致性为88%。关于INH相关不良反应,只有2名个体(8%)表现出明确的胃部不耐受。在我们的研究组中,我们发现NAT2基因型与乙酰化表型之间存在关联(OR = 7.78,95% CI,0.87 - 87.98,Fisher精确检验,p < 0.05),但未发现任何基因型或表型与INH相关不良反应的发生率存在关联(Fisher精确检验,p > 0.05)。