孕激素受体多态性与 17α-羟孕酮己酸酯的临床反应。
Progesterone receptor polymorphisms and clinical response to 17-alpha-hydroxyprogesterone caproate.
机构信息
Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network, Bethesda, MD, USA.
出版信息
Am J Obstet Gynecol. 2011 Aug;205(2):135.e1-9. doi: 10.1016/j.ajog.2011.03.048. Epub 2011 Apr 8.
Abstract
OBJECTIVE
Seventeen-alpha-hydroxyprogesterone caproate (17-OHPC) reduces recurrent preterm birth (PTB). We hypothesized that single nucleotide polymorphisms in the human progesterone receptor (PGR) affect response to 17-OHPC in the prevention of recurrent PTB.
STUDY DESIGN
We conducted secondary analysis of a study of 17-OHPC vs placebo for recurrent PTB prevention. Twenty PGR gene single nucleotide polymorphisms were studied. Multivariable logistic regression assessed for an interaction between PGR genotype and treatment status in modulating the risk of recurrent PTB.
RESULTS
A total of 380 women were included; 253 (66.6%) received 17-OHPC and 127 (33.4%) received placebo. In all, 61.1% of women were African American. Multivariable logistic regression demonstrated significant treatment-genotype interactions (either a beneficial or harmful treatment response) for African Americans delivering<37 weeks' gestation for rs471767 and rs578029, and for Hispanics/Caucasians delivering<37 weeks' gestation for rs500760 and <32 weeks' gestation for rs578029, rs503362, and rs666553.
CONCLUSION
The clinical efficacy and safety of 17-OHPC for recurrent PTB prevention may be altered by PGR gene polymorphisms.
摘要
目的
己酸羟孕酮（17-OHPC）可减少早产复发（PTB）。我们假设，人类孕激素受体（PGR）的单核苷酸多态性会影响 17-OHPC 预防复发性 PTB 的效果。
研究设计
我们对一项关于 17-OHPC 与安慰剂预防复发性 PTB 的研究进行了二次分析。研究了 20 个 PGR 基因单核苷酸多态性。多变量逻辑回归评估了 PGR 基因型与治疗状态之间的相互作用，以调节复发性 PTB 的风险。
结果
共纳入 380 名女性；253 名（66.6%）接受 17-OHPC 治疗，127 名（33.4%）接受安慰剂治疗。共有 61.1%的女性为非裔美国人。多变量逻辑回归显示，对于非裔美国人在<37 孕周分娩的 rs471767 和 rs578029，以及对于西班牙裔/白种人在<37 孕周分娩的 rs500760 和<32 孕周分娩的 rs578029、rs503362 和 rs666553，存在显著的治疗-基因型相互作用（有益或有害的治疗反应）。
结论
PGR 基因多态性可能改变 17-OHPC 预防复发性 PTB 的临床疗效和安全性。
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