Cuevas Alejandro, Fernández César, Ferrada Luis, Zambrano Tomás, Rosales Alexy, Saavedra Nicolás, Salazar Luis A
Center of Molecular Biology & Pharmacogenetics, Department of Basic Sciences, Scientific and Technological Bioresources Nucleus, University of La Frontera (BIOREN-UFRO), Temuco, Chile.
Preclinical Sciences Department, Faculty of Medicine, University of La Frontera, Temuco, Chile.
Basic Clin Pharmacol Toxicol. 2016 Apr;118(4):292-7. doi: 10.1111/bcpt.12493. Epub 2015 Oct 23.
Lipid-lowering response to statin therapy shows large interindividual variability. At a genome-wide significance level, single nucleotide polymorphisms (SNPs) in PCSK9 and HMGCR have been implicated in this differential response. However, the influence of these variants is uncertain in the Chilean population. Hence, we aimed to evaluate the contribution of PCSK9 rs7552841 and HMGCR rs17671591 SNPs as genetic determinants of atorvastatin response in Chilean hypercholesterolaemic individuals. One hundred and one hypercholesterolaemic patients received atorvastatin 10 mg/day for 4 weeks. Plasma lipid profile (TC, HDL-C, LDL-C and TG) was determined before and after statin treatment, and SNPs were identified by allelic discrimination using TaqMan(®) SNP Genotyping Assays. Adjusted univariate and multivariate analyses' models were used for statistical analyses, and a p-value <0.05 was considered significant. From baseline (week 0) to the study end-point (week 4), significant reductions were observed in plasma TC, LDL-C and TG (p < 0.001), while HDL-C levels were increased (p < 0.001). Multivariate analysis showed no association between lipid levels and atorvastatin therapy for the PCSK9 variant. However, the HMGCR rs17671591 T allele contributed to basal HDL-C concentration variability along with a higher increase in this lipid fraction after statin medication. In addition, this allele determined greater plasma LDL-C reductions after therapy with atorvastatin. Our data suggest that the HMGCR rs17671591 polymorphism can constitute a genetic marker of lower plasma LDL-C and enhanced HDL-C concentration after atorvastatin therapy in the Chilean population.
他汀类药物治疗的降脂反应存在较大的个体间差异。在全基因组显著性水平上,前蛋白转化酶枯草溶菌素9(PCSK9)和3-羟基-3-甲基戊二酰辅酶A还原酶(HMGCR)中的单核苷酸多态性(SNP)与这种差异反应有关。然而,在智利人群中,这些变异的影响尚不确定。因此,我们旨在评估PCSK9 rs7552841和HMGCR rs17671591单核苷酸多态性作为智利高胆固醇血症个体阿托伐他汀反应的遗传决定因素的作用。101例高胆固醇血症患者接受每日10毫克阿托伐他汀治疗,为期4周。在他汀类药物治疗前后测定血浆脂质谱(总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯),并使用TaqMan®SNP基因分型检测通过等位基因鉴别来鉴定单核苷酸多态性。采用调整后的单变量和多变量分析模型进行统计分析,p值<0.05被认为具有显著性。从基线(第0周)到研究终点(第4周),血浆总胆固醇、低密度脂蛋白胆固醇和甘油三酯显著降低(p<0.001),而高密度脂蛋白胆固醇水平升高(p<0.001)。多变量分析显示,PCSK9变异的脂质水平与阿托伐他汀治疗之间无关联。然而,HMGCR rs17671591 T等位基因导致基础高密度脂蛋白胆固醇浓度的变异性,同时他汀类药物治疗后该脂质成分有更高的升高。此外,该等位基因决定了阿托伐他汀治疗后血浆低密度脂蛋白胆固醇的更大降低。我们的数据表明,在智利人群中,HMGCR rs17671591多态性可能构成阿托伐他汀治疗后血浆低密度脂蛋白胆固醇降低和高密度脂蛋白胆固醇浓度升高的遗传标志物。