Kala N, Babu S P K K, Manjeu J, Aadivalavan A, Khan R
Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, India.
J Clin Pharm Ther. 2018 Feb;43(1):110-113. doi: 10.1111/jcpt.12587. Epub 2017 Jun 27.
Studies indicate that there is an increased serum concentration of amlodipine (a calcium channel blocker used to treat hypertension and angina) in patients having mutant multidrug resistance 1 (MDR1) gene. Hence, genetic factors may play a very significant role in amlodipine-induced complications including gingival enlargement.
Three patients with amlodipine-induced gingival enlargement showed improvement following drug substitution of amlodipine with enalapril (an angiotensin-converting enzyme inhibitor) and non-invasive periodontal therapy. Using allele-specific polymerase chain reaction, single nucleotide polymorphism of MDR1 gene of heterozygous mutant type (CT genotype) was identified in all three cases.
Drug-induced complications can potentially be a result of genetic factors, in combination with various local and systemic factors. Identifying genetic polymorphisms early might help predict adverse reactions and determine prognosis.
研究表明,携带突变多药耐药1(MDR1)基因的患者血清中氨氯地平(一种用于治疗高血压和心绞痛的钙通道阻滞剂)浓度会升高。因此,遗传因素可能在包括牙龈增生在内的氨氯地平诱导的并发症中起非常重要的作用。
三名氨氯地平诱导牙龈增生的患者在将氨氯地平替换为依那普利(一种血管紧张素转换酶抑制剂)并进行非侵入性牙周治疗后病情有所改善。通过等位基因特异性聚合酶链反应,在所有三例中均鉴定出杂合突变型(CT基因型)MDR1基因的单核苷酸多态性。
药物诱导的并发症可能是遗传因素与各种局部和全身因素共同作用的结果。早期识别基因多态性可能有助于预测不良反应并确定预后。