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尿苷二磷酸葡萄糖醛酸基转移酶2B7 -161C>T基因多态性对小儿癫痫患者丙戊酸浓度的影响。

Influence of uridine diphosphate glucuronosyltransferase 2B7 -161C>T polymorphism on the concentration of valproic acid in pediatric epilepsy patients.

作者信息

Inoue Kazuyuki, Suzuki Eri, Yazawa Rei, Yamamoto Yoshiaki, Takahashi Toshiki, Takahashi Yukitoshi, Imai Katsumi, Koyama Seiichi, Inoue Yushi, Tsuji Daiki, Hayashi Hideki, Itoh Kunihiko

机构信息

*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.

出版信息

Ther Drug Monit. 2014 Jun;36(3):406-9. doi: 10.1097/FTD.0000000000000012.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

These data suggest that the UGT2B7 -161C>T polymorphism in pediatric epilepsy patients carrying the CYP2C9*1/*1 genotype affects VPA concentration.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

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