SLCO1B1 基因变异对儿科高胆固醇血症中阿托瓦斯塔丁全身暴露的影响
Jonathan B Wagner1,2,3, Susan Abdel-Rahman2,3, Geetha Raghuveer1,3
1Ward Family Heart Center, Children's Mercy, Kansas City, MO 64108, USA.
Genes
|January 23, 2024
概括
在患有高胆固醇的儿童中,SLCO1B1基因变异显著影响阿托瓦斯塔丁水平. 增加的体重指数也会影响药物暴露,需要个性化剂量以防止毒性.
科学领域:
- 药物基因组学 药物基因组学
- 临床药理学 临床药理学
- 儿科内分泌学 儿科内分泌学
背景情况:
- 儿童的高胆固醇血症需要有效的治疗,通常是使用阿托瓦斯塔丁等他类药物.
- 众所周知,遗传变异,特别是SLCO1B1基因,会影响成年人的他类药理动力学.
- 了解儿童群体中这些遗传影响对于优化治疗至关重要.
研究的目的:
- 调查SLCO1B1 c.521T>C多态性 (rs4149056) 对儿科高胆固醇血中的阿托瓦斯塔丁度的影响.
- 确定导致儿童阿托瓦斯塔丁暴露的个体间变异的因素.
主要方法:
- 一项涉及单次口服阿托瓦斯塔丁剂量的药理动力学研究,针对不同SLCO1B1 c.521T>C基因型 (异合体,同合体和对照) 的儿科参与者 (8-21岁).
- 测量血阿托瓦斯塔丁度,并计算面积-低度-时间曲线 (AUC0-24).
- 多变量分析以评估SLCO1B1变体和体重指数对阿托瓦斯塔丁暴露的贡献.
主要成果:
- 与对照组 (c.521T/T) 相比,阿托瓦斯塔丁AUC0-24在患有c.521T/C (1.7倍) 和c.521C/C (2.8倍) 基因型的儿科参与者中显著更高.
- SLCO1B1 c.521T>C 变异是阿托瓦斯塔丁全身暴露的主要决定因素,解释了AUC0-24.0 变化的约65%.
- 增加的体重指数与c.521T/T和c.521T/C基因型组内较高的阿托瓦斯塔丁暴露有关,这与较低的阿托瓦斯塔丁乳度有关.
结论:
- SLCO1B1 c.521T>C多态性在患有高胆固醇血症的儿童中显著影响阿托瓦斯塔丁的药理学,类似于成年人.
- 阿托瓦斯塔丁暴露的个体间变异性是多因素的,遗传和人类学因素起着关键作用.
- 针对儿科患者的阿托瓦斯塔丁个性化剂量策略应考虑SLCO1B1基因型和体重指数,以减轻毒性风险.
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