Wang Shu-Mei, Li Miao, Wu Wan-Shui, Sun Lu-Lu, Yan Dan
Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, China.
J Clin Pharm Ther. 2020 Aug;45(4):646-651. doi: 10.1111/jcpt.13171. Epub 2020 May 13.
Reduced folate carrier 1 (RFC1), which is encoded by the human solute carrier family 19 member 1 (SLC19A1) gene, plays an essential role in the cellular uptake of methotrexate (MTX). RFC1 expression is regulated by genetic variations and epigenetic modifications. The aim of the present study was to investigate the methylation status of the SLC19A1 promoter in peripheral blood and its association with MTX levels and toxicities in children with acute lymphoblastic leukaemia (ALL).
Serum MTX concentrations were measured using a fluorescence polarization immunoassay. Methylation quantification for SLC19A1 promoter region #17 was performed by Sequenom MassARRAY in 52 paediatric ALL patients.
Overall, the investigated region of the SLC19A1 promoter was in a hypermethylated state. No significant associations were detected between the methylation levels of six CpG units in the SLC19A1 promoter region #17 and clinical parameters of patients with ALL, including sex, age, immunotype and risk stratification. The methylation level of CpG_10 showed a significant positive correlation with MTX 24 hours after the initiation of infusion. No significant differences in the methylation levels of six CpG units were observed between patients with and without MTX toxicities. Due to the small sample size of this study, there was a high chance of false-positive results. A large-scale study would be required to confirm these preliminary results.
Our preliminary results suggested the hypermethylated status of the SLC19A1 promoter in children with ALL. The methylation levels of the SLC19A1 promoter might affect MTX exposure. These findings have implications for the mechanisms underlying the variability of MTX responses in childhood ALL.
还原型叶酸载体1(RFC1)由人类溶质载体家族19成员1(SLC19A1)基因编码,在甲氨蝶呤(MTX)的细胞摄取中起重要作用。RFC1的表达受基因变异和表观遗传修饰调控。本研究旨在探讨急性淋巴细胞白血病(ALL)患儿外周血中SLC19A1启动子的甲基化状态及其与MTX水平和毒性的关系。
采用荧光偏振免疫分析法测定血清MTX浓度。通过Sequenom MassARRAY对52例儿童ALL患者的SLC19A1启动子区域#17进行甲基化定量分析。
总体而言,SLC19A1启动子的研究区域处于高甲基化状态。在SLC19A1启动子区域#17的六个CpG位点的甲基化水平与ALL患者的临床参数(包括性别、年龄、免疫类型和风险分层)之间未检测到显著相关性。CpG_10的甲基化水平与输注开始后24小时的MTX水平呈显著正相关。在有和没有MTX毒性的患者之间,六个CpG位点的甲基化水平没有显著差异。由于本研究样本量较小,存在较高的假阳性结果可能性。需要进行大规模研究来证实这些初步结果。
我们的初步结果提示ALL患儿中SLC19A1启动子处于高甲基化状态。SLC19A1启动子的甲基化水平可能影响MTX暴露。这些发现对儿童ALL中MTX反应变异性的潜在机制具有启示意义。