NAT2乙化状态预测抗结核治疗期间的肝毒性:多民族队列的累积风险分析
Marco Schiuma1, Sofia Dinegro2, Vera Battini2
1Department of Infectious Disease, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.
International journal of molecular sciences
|May 7, 2025
概括
抗结核药物诱导的肝毒性 (ATDH) 风险在缓慢的乙化剂中较高,这是由于N-乙转移酶2 (NAT2) 活性降低. 早期识别NAT2表型可以提高结核病治疗的安全性和有效性.
科学领域:
- 药物遗传学 药物遗传学
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
背景情况:
- 抗结核药物诱导的肝毒性 (ATDH) 复杂化了结核治疗.
- N-乙转移酶2 (NAT2) 酶的乙化表型影响药物代谢和毒性.
- 缓慢的乙化剂增加了ATDH风险,而快速的乙化剂则面临更高的治疗失败率.
研究的目的:
- 调查NAT2乙化表型与ATDH发生之间的关联.
- 在多民族人群中评估NAT2表型对ATDH的预测价值.
- 为了确定NAT2表型对ATDH发病时间的影响.
主要方法:
- 结核病患者的回顾性观察研究 (2020年7月-2023年9月).
- 通过NAT2基因定型,将患者分类为缓慢或快速/中等乙化剂.
- 使用累积发病率分析和精细灰色竞争风险回归模型.
主要成果:
- 21.6%的患者发展了ATDH; 16.7%是缓慢的乙化剂,4.9%是快速/中间的乙化剂.
- 在缓慢的乙化剂中,ATDH的发病时间明显较早 (中位数为0.5个月与2个月).
- 缓慢的乙化剂显示,发展ATDH的风险高3.05倍 (SHR=3.05;p=0.02),即使经过对混因素进行调整.
结论:
- NAT2乙化表型显著影响ATDH的风险和时间.
- 早期识别NAT2乙化剂状态可以指导个性化剂量调整,以获得更安全的抗结核治疗.
- 药物遗传学在优化结核病治疗方面发挥着至关重要的作用,通过提高疗效和最大限度地降低毒性来优化结核病治疗.
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