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HLA-B*51:01 和 CYP2C9*3 是日本人中苯妥英钠诱导皮疹的危险因素:来自日本生物银行项目的数据分析。

HLA-B*51:01 and CYP2C9*3 Are Risk Factors for Phenytoin-Induced Eruption in the Japanese Population: Analysis of Data From the Biobank Japan Project.

机构信息

Laboratory for Pharmacogenomics, RIKEN Center for Integrative Medical Sciences, Yokohama City, Kanagawa, Japan.

Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama City, Kanagawa, Japan.

出版信息

Clin Pharmacol Ther. 2020 May;107(5):1170-1178. doi: 10.1002/cpt.1706. Epub 2019 Dec 6.

Abstract

CYP2C93 and HLA-B alleles are reportedly associated with phenytoin-induced eruption in some East Asian populations; however, this finding is not readily applicable to the Japanese population. Thus, we aimed to investigate the risk alleles using samples and data from BioBank Japan. A total of 747 patients (24 cases and 723 tolerant controls) were selected for analysis. Case-control association studies were conducted, using CYP2C93, CYP2C927, CYP2C192, CYP2C193, and HLA-B allele genotype data. CYP2C93 carrier status was significantly associated with phenytoin-induced eruption (P = 0.0022, odds ratio 7.05, 95% confidence interval, 2.44-20.4). HLA-B51:01 showed the most prominent association (P = 0.010, odds ratio 3.19, 95% confidence interval, 1.37-7.48). Including both of these features improved predictive performance, measured as area under the receiver operating characteristic curve, by 10%. CYP2C93 and HLA-B*51:01 allele carrier statuses are significantly associated with phenytoin-induced eruption; thus, checking this carrier status before prescription would decrease the incidence of phenytoin-induced eruption in clinical practice.

摘要

CYP2C93 和 HLA-B 等位基因据称与某些东亚人群的苯妥英钠诱导皮疹有关;然而,这一发现并不适用于日本人群。因此,我们旨在使用 BioBank Japan 的样本和数据来研究风险等位基因。共选择了 747 名患者(24 例和 723 例耐受对照)进行分析。使用 CYP2C93、CYP2C927、CYP2C192、CYP2C193 和 HLA-B 等位基因基因型数据进行病例对照关联研究。CYP2C93 携带者状态与苯妥英钠诱导皮疹显著相关(P=0.0022,优势比 7.05,95%置信区间 2.44-20.4)。HLA-B51:01 显示出最显著的相关性(P=0.010,优势比 3.19,95%置信区间 1.37-7.48)。同时包含这两个特征可将接受者操作特征曲线下的预测性能提高 10%。CYP2C93 和 HLA-B*51:01 等位基因携带者状态与苯妥英钠诱导皮疹显著相关;因此,在处方前检查这种携带者状态将降低苯妥英钠诱导皮疹的临床发生率。

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