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系统评价和药物遗传学研究在慢性肾脏病患者的荟萃分析。

A Systematic Review and Meta-Analysis of Pharmacogenetic Studies in Patients with Chronic Kidney Disease.

机构信息

Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece.

Protypo Bioiatriko Laboratory, 41110 Larissa, Greece.

出版信息

Int J Mol Sci. 2021 Apr 25;22(9):4480. doi: 10.3390/ijms22094480.

Abstract

Chronic kidney disease (CKD) is an important global public health problem due to its high prevalence and morbidity. Although the treatment of nephrology patients has changed considerably, ineffectiveness and side effects of medications represent a major issue. In an effort to elucidate the contribution of genetic variants located in several genes in the response to treatment of patients with CKD, we performed a systematic review and meta-analysis of all available pharmacogenetics studies. The association between genotype distribution and response to medication was examined using the dominant, recessive, and additive inheritance models. Subgroup analysis based on ethnicity was also performed. In total, 29 studies were included in the meta-analysis, which examined the association of 11 genes (16 polymorphisms) with the response to treatment regarding CKD. Among the 29 studies, 18 studies included patients with renal transplantation, 8 involved patients with nephrotic syndrome, and 3 studies included patients with lupus nephritis. The present meta-analysis provides strong evidence for the contribution of variants harbored in the , , , , and genes that creates some genetic predisposition that reduces effectiveness or is associated with adverse events of medications used in CKD.

摘要

慢性肾脏病(CKD)是一个重要的全球性公共卫生问题,因为其高患病率和发病率。尽管肾脏病患者的治疗已经发生了很大的变化,但药物的无效性和副作用仍然是一个主要问题。为了阐明位于几个基因中的遗传变异在 CKD 患者治疗反应中的作用,我们对所有可用的药物遗传学研究进行了系统评价和荟萃分析。使用显性、隐性和加性遗传模型来检查基因型分布与药物反应之间的关联。还根据种族进行了亚组分析。共有 29 项研究被纳入荟萃分析,这些研究检查了 11 个基因(16 个多态性)与 CKD 治疗反应之间的关联。在这 29 项研究中,18 项研究包括肾移植患者,8 项涉及肾病综合征患者,3 项研究包括狼疮性肾炎患者。本荟萃分析提供了有力的证据,证明了位于 、 、 、 和 基因中的变异导致了一些遗传易感性,从而降低了药物在 CKD 中的有效性或与不良反应相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e55/8123337/fa215c9f71a6/ijms-22-04480-g001.jpg

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