College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, South Korea.
College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, South Korea.
Travel Med Infect Dis. 2022 Jul-Aug;48:102333. doi: 10.1016/j.tmaid.2022.102333. Epub 2022 Apr 20.
To elucidate the relationship between CYP2D6 polymorphisms and Plasmodium vivax recurrence in patients receiving primaquine-based treatment through systematic review and meta-analysis.
We searched the PubMed, EMBASE, Cochrane Library, and Web of Science databases for eligible studies published up to August of 2021. We included studies investigating the associations between CYP2D6 polymorphisms and P. vivax recurrence. We evaluated the pooled odds ratio (OR) and 95% confidence interval (CI).
Data from nine studies, including 970 patients, were analyzed. We found that CYP2D6 poor metabolizers (PMs), intermediate metabolizers (IMs), or normal metabolizers slow (NM-Ss) were associated with a 1.8-fold (95% CI, 1.34-2.45; P = 0.0001) higher recurrence of P. vivax than normal metabolizers fast (NM-Fs), extensive metabolizers (EMs), or ultrarapid metabolizer (UMs). Subgroup analysis showed that studies on both Brazilian and Southeast or East Asian individuals had similar results to the main results. Sensitivity analysis by sequentially excluding individual studies also showed robust results (OR range: 1.63-2.01).
This meta-analysis confirmed that CYP2D6 PMs, IMs, or NM-Ss increased the risk of P. vivax recurrence compared to NM-Fs, EMs, or UMs. The results of this study could be used to predict P. vivax recurrence and suggest CYP2D6 genotype-based primaquine dosing.
通过系统评价和荟萃分析阐明 CYP2D6 多态性与接受伯氨喹治疗的患者间日疟复发之间的关系。
我们检索了 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 数据库，以获取截至 2021 年 8 月发表的合格研究。我们纳入了研究 CYP2D6 多态性与间日疟复发之间关联的研究。我们评估了合并的比值比（OR）和 95%置信区间（CI）。
对 9 项研究，共 970 名患者的数据进行了分析。我们发现 CYP2D6 弱代谢者（PMs）、中间代谢者（IMs）或正常代谢者慢代谢者（NM-Ss）与间日疟复发的风险增加 1.8 倍（95%CI，1.34-2.45；P = 0.0001），而 NM-Fs、广泛代谢者（EMs）或超快代谢者（UMs）则较低。亚组分析显示，对巴西人和东南亚或东亚个体的研究结果与主要结果相似。通过依次排除个别研究的敏感性分析也显示了稳健的结果（OR 范围：1.63-2.01）。
本荟萃分析证实，与 NM-Fs、EMs 或 UMs 相比，CYP2D6 PMs、IMs 或 NM-Ss 增加了间日疟复发的风险。本研究的结果可用于预测间日疟复发，并提示基于 CYP2D6 基因型的伯氨喹剂量。
