载体基因和他类药物诱导的肝毒性
Seo-A Choi1, Jung Sun Kim1, Yoon-A Park1
1College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, Korea.
Cardiovascular drugs and therapy
|May 29, 2024
概括
达丁类药物诱导的肝损伤与SLCO1B1.1.等药物载体的遗传变异有关. 特定的SLCO1B1 (有机阴离子载体聚1B1) 和ABCG2 (乳腺癌抗性蛋白) 多态性显著增加肝毒性风险,有助于个性化他类药物治疗.
科学领域:
- 药物基因组学 药物基因组学
- 药物代谢和运输 药物代谢和运输
- 肝病学 肝病学是一种肝病学.
背景情况:
- 肝毒性是停止使用他类药物的常见原因.
- 关键的药物载体,包括有机阴离子载体聚1B1 (SLCO1B1),多抗药蛋白1 (ABCB1) 和乳腺癌抗药蛋白 (ABCG2),影响他的药理动力学.
- 这些载体在他类药物相关的肝毒性中的确切作用需要进一步阐明.
研究的目的:
- 综合分析SLCO1B1,ABCB1和ABCG2基因中肝毒性和多态性之间的关联.
- 为了确定预测他类药物诱导的肝损伤风险的遗传标记.
主要方法:
- 对851名患者前性采集的样本进行了回顾性分析.
- 在SLCO1B1中选择了10个单核酸多态,在ABCB1中选择了9个,在ABCG2中选择了12个.
- 开发两个多变量模型:仅临床因素 (模型I) 和临床和遗传因素 (模型II) 组合,并确定可归因风险.
主要成果:
- 肝毒性发生在7.8%的患者中 (66/851).
- 模型I确定了脂友性他类药物,心房动和糖尿病为危险因素.
- 模型II显示了与脂友性他类药物,心房动,SLCO1B1rs11045818A等位基因,SLCO1B1rs4149035T等位基因以及ABCG2rs2622629TT基因型的显著关联.
- 在SLCO1B1 rs11045818 A基因组中,可归因风险最高 (93.2%).
- 与模型I (AUC0.62) 相比,模型II显示出更好的预测准确性 (AUC0.71).
结论:
- 药物载体基因的遗传多态性,特别是SLCO1B1,与他类药物诱导的肝毒性显著相关.
- 这些发现支持基于基因分析的他类药物治疗中个性化药物的潜力.
- 通过基因查识别高风险个体可以帮助减轻药物不良反应.
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