CYP2D6 表型与韩国患者间日疟原虫感染复发的关系。

Association between CYP2D6 phenotype and recurrence of Plasmodium vivax infection in south Korean patients.

机构信息

Division of Infectious Diseases, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.

Department of Infectious Diseases, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.

出版信息

Malar J. 2022 Oct 10;21(1):289. doi: 10.1186/s12936-022-04311-6.

DOI:10.1186/s12936-022-04311-6

PMID:36217154

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9552356/

Abstract

BACKGROUND

Primaquine is activated by CYP2D6 in the hepatocytes. In Korea, primaquine is the only hypnozoitocidal agent used for patients with vivax malaria. Thus, patients with poor CYP2D6 activity could have an increased risk of primaquine failure and subsequent relapse. The study sought to identify the association between CYP2D6 phenotype and recurrence of malaria in Korean patients.

METHODS

A total of 102 patients with vivax malaria were prospectively enrolled from eight institutions in Korea. An additional 38 blood samples from patients with recurred vivax malaria were provided by the Korea Disease Control and Prevention Agency. Malaria recurrence was defined as more than one episode of vivax malaria in the same or consecutive years. CYP2D6 star alleles, phenotypes, and activity scores were examined.

RESULTS

Genotyping for CYP2D6 was successful in 101 of the prospectively enrolled patients and 38 samples from the Korea Disease Control and Prevention Agency, of which 91 were included in the no-recurrence group and 48 were included in the recurrence group. Reduced CYP2D6 activity (intermediate metabolizer) phenotype was more common in the recurrence group than in the no-recurrence group (OR, 2.33 (95% CI, 1.14-4.77); p = 0.02). Patients with lower CYP2D6 activity had a higher probability of recurrence (p = 0.029).

CONCLUSION

This study suggests that CYP2D6 polymorphism may affect primaquine efficacy and thus Plasmodium vivax recurrence in Korea.

摘要

背景

伯氨喹啉在肝细胞中由 CYP2D6 激活。在韩国，伯氨喹啉是唯一用于治疗间日疟原虫的抗休眠药。因此，CYP2D6 活性差的患者可能会增加伯氨喹啉失效和随后复发的风险。本研究旨在确定 CYP2D6 表型与韩国患者疟疾复发之间的关系。

方法

从韩国的 8 个机构前瞻性招募了 102 例间日疟原虫患者。韩国疾病控制与预防局提供了另外 38 份来自复发性间日疟原虫患者的血液样本。疟疾复发定义为同一年内或连续年内出现两次或以上间日疟原虫感染。检测 CYP2D6 星等位基因、表型和活性评分。

结果

成功对 101 例前瞻性招募患者和 38 例韩国疾病控制与预防局样本进行了 CYP2D6 基因分型，其中 91 例纳入无复发组，48 例纳入复发组。复发组中，低 CYP2D6 活性（中间代谢型）表型较无复发组更为常见（OR，2.33（95%CI，1.14-4.77）；p=0.02）。CYP2D6 活性较低的患者复发的可能性更高（p=0.029）。