Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Med Sci Monit. 2013 May 27;19:394-408. doi: 10.12659/MSM.883922.
Platelet reactivity in patients on acetylsalicylic acid (ASA) therapy can be influenced by physiological or pathological conditions affecting ASA pharmacokinetics or pharmacodynamics. The mechanism of such variability in the therapeutic response to ASA, particularly in diabetic patients, is poorly understood. The rate of elimination of ASA and its metabolite, salicylic acid (SA), is likely a major factor determining drug efficacy. The objective of this study was to investigate the effect of genetic polymorphisms in the selected candidate genes within the ASA metabolic pathway on the platelet reactivity and concentration of ASA and thromboxane A(2) (TxA(2)) metabolites in a population of patients with type 2 diabetes mellitus (T2DM).
The study cohort consisted of 287 Caucasians with T2DM who had been taking ASA tablets at the dose of 75 mg per day for at least 3 months. Platelet reactivity analyses were performed using VerifyNow Aspirin and PFA-100 assays. The measured ASA metabolite included salicylic acid (ASA), and TxA(2) metabolites included serum TxB(2) and urinary 11-dh-TxB(2). Genotyping for the selected 18 single-nucleotide polymorphisms (SNPs) within 5 genes of the ASA metabolic pathway was performed using a Sequenom iPLEX platform.
No statistically significant association was observed between the investigated SNPs genotypes, platelet reactivity, and measured metabolites in the investigated cohort of patients.
The results of our study failed to confirm that the selected variants in the genes within the ASA metabolic pathway might contribute to platelet reactivity in a diabetic population treated with ASA.
接受乙酰水杨酸(ASA)治疗的患者的血小板反应性可能受到影响 ASA 药代动力学或药效学的生理或病理状况。对于 ASA 治疗反应的这种可变性的机制,特别是在糖尿病患者中,了解甚少。ASA 及其代谢物水杨酸(SA)的消除率可能是决定药物疗效的主要因素。本研究的目的是研究 ASA 代谢途径中选定候选基因内的遗传多态性对 2 型糖尿病(T2DM)患者群体血小板反应性以及 ASA 和血栓烷 A2(TxA2)代谢物浓度的影响。
研究队列包括 287 名接受 ASA 片剂治疗的白种人 T2DM 患者,剂量为每天 75 毫克,至少服用 3 个月。使用 VerifyNow Aspirin 和 PFA-100 测定法进行血小板反应性分析。测量的 ASA 代谢物包括水杨酸(ASA),TxA2 代谢物包括血清 TxB2 和尿 11-dh-TxB2。使用 Sequenom iPLEX 平台对 ASA 代谢途径中 5 个基因内的 18 个单核苷酸多态性(SNP)进行了基因分型。
在所研究的患者队列中,未观察到所研究的 SNP 基因型与血小板反应性和测量的代谢物之间存在统计学显著关联。
我们的研究结果未能证实 ASA 代谢途径中基因内的所选变体可能导致接受 ASA 治疗的糖尿病患者的血小板反应性。