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CYP2C9和COX - 2基因多态性对非甾体抗炎药治疗强直性脊柱炎临床疗效的影响

Influence of CYP2C9 and COX-2 Genetic Polymorphisms on Clinical Efficacy of Non-Steroidal Anti-Inflammatory Drugs in Treatment of Ankylosing Spondylitis.

作者信息

Wang Yu, Yi Xiao-Dong, Lu Hai-Lin

机构信息

Department of Orthopaedics, Peking University First Hospital, Beijing, China (mainland).

出版信息

Med Sci Monit. 2017 Apr 12;23:1775-1782. doi: 10.12659/msm.900271.

Abstract

BACKGROUND The aim of this study was to evaluate the relationships of CYP2C9 and COX-2 genetic polymorphisms with therapeutic efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) in treatment of ankylosing spondylitis (AS). MATERIAL AND METHODS We enrolled 130 AS inpatients and outpatients in the Arthritis and Rheumatism Department of Peking University First Hospital and 106 healthy people getting routine check-ups between September 2013 and July 2014. CYP2C9 and COX-2 genetic polymorphisms were detected by PCR-RFLP. All AS patients underwent medical treatment and 12-week follow-up treatment. Score differences of BASDAI, ASAS20, ASAS50, and ASAS70 for AS patients with different genotypes before and after treatment were compared. RESULTS In terms of COX-2-1290A/G and -1195G/A gene polymorphism genotype and allele frequency, the case group and control group were obviously different (all P<0.05), but CYP2C9*3 polymorphism genotype and allele frequency were not statistically different between the 2 groups (P>0.05). AS patients had improved BASDAI, ASAS20, ASAS50, and ASAS70 scores after they received NSAID treatment (all P<0.05). Furthermore, the efficacy of NSAID in treatment of AS and COX-2 gene -1290A/G and -1195G/A polymorphism were associated (all P<0.05), but it is not associated with CYP2C9 *3 polymorphism (all P>0.05). CONCLUSIONS COX-2-1290A/G and -1195G/A polymorphism may increase AS risk and they both can be considered as biological indicators for prediction of efficacy of NSAIDs in treatment of AS.

摘要

背景 本研究旨在评估CYP2C9和COX-2基因多态性与非甾体抗炎药(NSAIDs)治疗强直性脊柱炎(AS)疗效之间的关系。材料与方法 我们纳入了2013年9月至2014年7月期间北京大学第一医院风湿免疫科的130例AS住院患者和门诊患者以及106例进行常规体检的健康人。采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)检测CYP2C9和COX-2基因多态性。所有AS患者均接受药物治疗及12周的随访治疗。比较不同基因型AS患者治疗前后巴斯强直性脊柱炎疾病活动指数(BASDAI)、AS病情活动度改善20%(ASAS20)、AS病情活动度改善50%(ASAS50)和AS病情活动度改善70%(ASAS70)评分的差异。结果 就COX-2 -1290A/G和-1195G/A基因多态性的基因型及等位基因频率而言,病例组与对照组存在明显差异(均P<0.05),但两组间CYP2C9*3多态性的基因型及等位基因频率无统计学差异(P>0.05)。AS患者接受NSAIDs治疗后BASDAI、ASAS20、ASAS50和ASAS70评分均有所改善(均P<0.05)。此外,NSAIDs治疗AS的疗效与COX-2基因-1290A/G和-1195G/A多态性相关(均P<0.05),但与CYP2C9 *3多态性无关(均P>0.05)。结论 COX-2 -1290A/G和-1195G/A多态性可能增加AS发病风险,二者均可被视为预测NSAIDs治疗AS疗效的生物学指标。

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