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MTHFR 和 ABCB1 多态性与中国儿童急性淋巴细胞白血病、淋巴瘤或骨肉瘤患者甲氨蝶呤诱导的黏膜炎相关:一项回顾性队列研究。

Association of MTHFR and ABCB1 polymorphisms with MTX-induced mucositis in Chinese paediatric patients with acute lymphoblastic leukaemia, lymphoma or osteosarcoma-A retrospective cohort study.

机构信息

Department of Pharmacy, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China.

Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

J Clin Pharm Ther. 2021 Dec;46(6):1557-1563. doi: 10.1111/jcpt.13505. Epub 2021 Aug 4.

Abstract

WHAT IS KNOWN AND OBJECTIVE

MTX pharmacology and toxicity involve several metabolizing enzymes and transporters whose functions have been suggested to be altered by genetic polymorphisms. The current study is to investigate the relationship between the genetic variation and MTX-induced adverse drug effects.

METHODS

A total of 80 paediatric patients (aged 1-14 years) were enrolled in this study. Toxicity was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 scoring system. Genotyping was performed by MassARRAY Assay method. Data were analysed using Spss statistical package version 17.0 and Plink v1.07 software. The HWE was tested by a chi-square test. The Fisher's exact test (chi-squaretest) was used to compare the distributions of genotypes between cases and controls. OR and 95%CI were applied to evaluate the association of genetic variants with the presence of mucositis using unconditional logistic regression.

RESULTS AND DISCUSSION

Mucosal inflammatory injuries were found in 28 children. SNPs of rs1128503 (p = 0.0022, OR = 3.04, 95%CI = 1.39-6.64) and rs1045642 (p = 0.0052, OR = 2.38, 95%CI = 1.15-5.00) located in the gene of ABCB1 and SNPs of rs1801133 (p = 0.040, OR = 2.50, 95%CI = 1.06-5.88) located in the gene of MTHFR show marked impacts on the risk of developing mucositis.

WHAT IS NEW AND CONCLUSION

SNPs of ABCB1 rs1128503, rs1045642 and MTHFR rs1801133 can be risk predictor for MTX-induced mucositis in Chinese paediatric patients diagnosed with acute lymphoblastic leukaemia, lymphoma or osteosarcoma.

摘要

已知和目的

MTX 的药理学和毒性涉及几种代谢酶和转运蛋白,其功能被认为会因遗传多态性而改变。本研究旨在探讨遗传变异与 MTX 诱导的药物不良反应之间的关系。

方法

本研究共纳入 80 例儿科患者(年龄 1-14 岁)。毒性评估采用国家癌症研究所不良事件通用术语标准 4.0 评分系统。采用 MassARRAY assay 方法进行基因分型。数据采用 Spss 统计软件包 17.0 和 Plink v1.07 软件进行分析。采用卡方检验(chi-squaretest)检验 HWE。采用 Fisher 确切检验(chi-squaretest)比较病例组和对照组基因型分布。采用非条件逻辑回归评估遗传变异与黏膜炎发生的关系。

结果与讨论

28 例儿童出现黏膜炎症损伤。位于 ABCB1 基因的 rs1128503(p=0.0022,OR=3.04,95%CI=1.39-6.64)和 rs1045642(p=0.0052,OR=2.38,95%CI=1.15-5.00),以及位于 MTHFR 基因的 rs1801133(p=0.040,OR=2.50,95%CI=1.06-5.88)的 SNP 显著影响发生黏膜炎的风险。

新发现和结论

ABCB1 rs1128503、rs1045642 和 MTHFR rs1801133 的 SNP 可作为中国急性淋巴细胞白血病、淋巴瘤或骨肉瘤患儿 MTX 诱导黏膜炎的风险预测因子。

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