Fex G, Larsson K, Andersson A, Berggren-Söderlund M
Department of Clinical Chemistry, University Hospital of Lund, Sweden.
Arch Toxicol. 1995;69(8):572-4. doi: 10.1007/s002040050215.
All-trans retinoic acid deficiency resulting from ethanol's interference with the synthesis of all-trans retinoic acid from retinol was recently suggested to cause the malformations of the fetal alcohol syndrome. Phenytoin, carbamazepine and valproate, might be teratogenic because they lower the concentration of all-trans retinoic acid in serum, by inducing the enzyme systems in the liver responsible for the metabolism of the all-trans retinoic acid, or by other mechanisms. Here we show, that in patients given therapeutic doses of phenytoin, carbamazepine and valproate, serum all-trans and 13-cis retinoic acid concentrations are indeed significantly lowered. We propose that drugs with this ability should be considered as potential teratogens.
最近有人提出，乙醇干扰视黄醇合成全反式维甲酸导致的全反式维甲酸缺乏会引起胎儿酒精综合征的畸形。苯妥英、卡马西平和丙戊酸盐可能具有致畸性，因为它们通过诱导肝脏中负责全反式维甲酸代谢的酶系统或通过其他机制降低血清中全反式维甲酸的浓度。在此我们表明，给予苯妥英、卡马西平和丙戊酸治疗剂量的患者，血清全反式和13-顺式维甲酸浓度确实显著降低。我们建议，具有这种能力的药物应被视为潜在的致畸剂。
