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[现代医学实践中UGT1A1基因突变的基因诊断。]

[The genetic diagnostics of mutations UGT1A1 in practice of modern medicine.].

作者信息

Volkov A N, Khabieva S M, Smirnova E Yu, Larionov A V

机构信息

The Federal State Budget Educational Institution of Higher Education "The Kemerovo State Medical University" of Minzdrav of Russia, 650029, Kemerovo, Russia.

The Federal State Budget Educational Institution of Higher Education "The Kemerovo State University", 650043, Kemerovo, Russia.

出版信息

Klin Lab Diagn. 2018;63(3):186-192. doi: 10.18821/0869-2084-2018-63-3-186-192.

Abstract

The detection of mutations of the gene of UDF-glucuronyltransferase A1 (UGT1A1) has an important practical value. The carriers of mutant genotypes, mainly *28/*28, are characterized by a reduced function of glucuronidation and excretion of a number of endogenous and exogenous toxins. A precise association of particular forms of benign hyperbilirubinemia (especially Gilbert's syndrome) with mutations in promoter and exonic areas of UGT1A1 is established. On the other hand, carriers of various genotypes of UGT1A1 differ significantly in metabolism characteristics of a number of common medications (irinotecan, belinostat, etc.), that requires a dosage of these medications considering individual genetic status of patient. The analysis of modern technical solutions for genetic diagnostics of UGT1A1 mutations is carried out. The particular attention is paid to discussion of national developments for genetic typing of UGT1A1. The conclusion is made concerning small assortment of corresponding test-systems of Russian production. In some cases, there is no data about their main analytical and diagnostic characteristics. When developing design of diagnosticums, various methodological approaches are applied that allow to potential consumers to choose depending on financial technical capabilities of laboratory, amount of implemented analyses, qualification of personnel. To support UGT1A1 research instrumentally, laboratory equipment of national manufacturers can be sufficient that would permit to organize entire analytical cycle on the basis of import substitution principle.

摘要

尿苷二磷酸葡萄糖醛酸基转移酶A1(UGT1A1)基因突变的检测具有重要的实用价值。突变基因型的携带者,主要是*28/*28,其特征是多种内源性和外源性毒素的葡萄糖醛酸化和排泄功能降低。UGT1A1启动子和外显子区域的突变与特定形式的良性高胆红素血症(尤其是吉尔伯特综合征)之间的确切关联已得到证实。另一方面,UGT1A1不同基因型的携带者在多种常用药物(伊立替康、贝利司他等)的代谢特征上有显著差异,这就需要根据患者的个体基因状况来确定这些药物的剂量。对UGT1A1突变基因诊断的现代技术解决方案进行了分析。特别关注了UGT1A1基因分型的国内研究进展。针对俄罗斯生产的相应检测系统种类较少得出了结论。在某些情况下,没有关于其主要分析和诊断特征的数据。在开发诊断产品设计时,应用了各种方法学方法,以便潜在消费者能够根据实验室的财务技术能力、实施分析的数量、人员资质进行选择。为了在仪器方面支持UGT1A1研究,国内制造商的实验室设备可能就足够了,这将允许在进口替代原则的基础上组织整个分析周期。

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