Inoue Kazuyuki, Suzuki Eri, Yazawa Rei, Yamamoto Yoshiaki, Takahashi Toshiki, Takahashi Yukitoshi, Imai Katsumi, Koyama Seiichi, Inoue Yushi, Tsuji Daiki, Hayashi Hideki, Itoh Kunihiko
*Department of Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka; and †Department of Clinical Research, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, National Epilepsy Center, Shizuoka, Japan.
Ther Drug Monit. 2014 Jun;36(3):406-9. doi: 10.1097/FTD.0000000000000012.
Valproic acid (VPA) is widely used to treat various types of epilepsy. Interindividual variability in VPA pharmacokinetics may arise from genetic polymorphisms of VPA-metabolizing enzymes. This study aimed to examine the relationships between plasma VPA concentrations and the -161C>T single nucleotide polymorphism in uridine diphosphate glucuronosyltransferase (UGT) 2B7 genes in pediatric epilepsy patients.
This study included 78 pediatric epilepsy patients carrying the cytochrome P450 (CYP) 2C9*1/1 genotype and who were not treated with the enzyme inducers (phenytoin, phenobarbital, and carbamazepine), lamotrigine, and/or topiramate. CYP2C93 and UGT2B7 -161C>T polymorphisms were identified using methods based on polymerase chain reaction-restriction fragment length polymorphism. Blood samples were drawn from each patient under steady-state conditions, and plasma VPA concentrations were measured.
Significant differences in adjusted plasma VPA concentrations were observed between carriers of CC, CT, and TT genotypes in the UGT2B7 -161C>T polymorphism (P = 0.039). Patients with the CC genotype had lower adjusted plasma VPA concentrations than those with CT or TT genotype (P = 0.028).
These data suggest that the UGT2B7 -161C>T polymorphism in pediatric epilepsy patients carrying the CYP2C9*1/*1 genotype affects VPA concentration.
丙戊酸(VPA)广泛用于治疗各种类型的癫痫。VPA药代动力学的个体间差异可能源于VPA代谢酶的基因多态性。本研究旨在探讨小儿癫痫患者血浆VPA浓度与尿苷二磷酸葡萄糖醛酸转移酶(UGT)2B7基因-161C>T单核苷酸多态性之间的关系。
本研究纳入78例携带细胞色素P450(CYP)2C9*1/1基因型且未接受酶诱导剂(苯妥英、苯巴比妥和卡马西平)、拉莫三嗪和/或托吡酯治疗的小儿癫痫患者。采用基于聚合酶链反应-限制性片段长度多态性的方法鉴定CYP2C93和UGT2B7 -161C>T多态性。在稳态条件下采集每位患者的血样,并测定血浆VPA浓度。
在UGT2B7 -161C>T多态性中,CC、CT和TT基因型携带者的校正血浆VPA浓度存在显著差异(P = 0.039)。CC基因型患者的校正血浆VPA浓度低于CT或TT基因型患者(P = 0.028)。
这些数据表明,携带CYP2C9*1/*1基因型的小儿癫痫患者中,UGT2B7 -161C>T多态性会影响VPA浓度。