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通过药物基因组学研究与分析实现高血压个性化的临床用药指导

Clinical medication guidance for hypertension personalization through pharmacogenomic research and analysis.

作者信息

Ren Qian, Wang Shoulei, Ren Yansong, Liu Chang

机构信息

State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.

Tianjin Institutes of Health Science, Tianjin, China.

出版信息

Glob Med Genet. 2025 May 6;12(3):100056. doi: 10.1016/j.gmg.2025.100056. eCollection 2025 Sep.

Abstract

OBJECTIVE

We investigated the distribution of polymorphisms in five hypertension-related drug-target genes including cytochrome P450 2C9*3 (CYP2C9 *3), angiotensin II receptor type 1() (1166 A>C), cytochrome P450 2D6 * 10 (CYP2D6 *10), β1-adrenergic receptors () (1165 G>C), and angiotensin converting enzyme () in patients with hypertension in Beijing. The study aimed to provide a theoretical basis that will guide the application of personalized hypertensive therapy in this population and develop more targeted prevention and treatment strategies for hypertension and other chronic disease in different regions.

MATERIALS AND METHODS

We retrospectively analyzed 317 patients with hypertension from Beijing who were admitted to Peking University People's Hospital from October 2021 to January 2024. The polymorphisms of five genes associated with Class A and B antihypertensive drugs were detected through real-time fluorescence PCR. In addition, we explored the distribution of different genotypes in the patient population while considering gender and comorbidities.

RESULTS

We obtained a significant difference in ADRB1(1165 G>C) between males and females, and the allele mutation frequency of was found to be higher in the Beijing population.

CONCLUSION

Most hypertensive patients in the Beijing region carry a high frequency of CYP2D6 * 10, ADRB1(1165 G>C), and genes, implying that they might be more sensitive to β-blockers, potentially benefitting more from ACEI drugs. The high allele frequencies of CYP2D6 * 10, ADRB1(1165 G>C), and in Beijing hypertensive patients indicate enhanced sensitivity to β-blockers and good therapeutic response to ACE inhibitors. Therefore, clinicians need to account for these factors when prescribing the aforementioned medications.

摘要

目的

我们研究了北京高血压患者中五个高血压相关药物靶点基因的多态性分布,包括细胞色素P450 2C9*3(CYP2C9 *3)、血管紧张素II 1型受体(1166 A>C)、细胞色素P450 2D6 *10(CYP2D6 *10)、β1肾上腺素能受体(1165 G>C)和血管紧张素转换酶。该研究旨在提供理论依据,以指导该人群中个性化高血压治疗的应用,并为不同地区的高血压及其他慢性病制定更具针对性的预防和治疗策略。

材料与方法

我们回顾性分析了2021年10月至2024年1月北京大学人民医院收治的317例北京高血压患者。通过实时荧光PCR检测与A类和B类降压药物相关的五个基因的多态性。此外,我们在考虑性别和合并症的同时,探索了不同基因型在患者群体中的分布。

结果

我们发现男性和女性之间ADRB1(1165 G>C)存在显著差异,且在北京人群中该基因的等位基因突变频率较高。

结论

北京地区大多数高血压患者携带CYP2D6 *10、ADRB1(1165 G>C)和相关基因的频率较高,这意味着他们可能对β受体阻滞剂更敏感,可能从ACEI药物中获益更多。北京高血压患者中CYP2D6 *10、ADRB1(1165 G>C)和的高等位基因频率表明对β受体阻滞剂的敏感性增强,对ACE抑制剂有良好的治疗反应。因此,临床医生在开具上述药物时需要考虑这些因素。

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