Frequency of pharmacogenomic variants affecting safety and efficacy of immunomodulators and biologics in a South Asian population from Sri Lanka.

IF 3.8 3区 医学 Q2 GENETICS & HEREDITY Human Genomics Pub Date : 2024-09-27 DOI:10.1186/s40246-024-00674-w
Priyanga Ranasinghe, Chiranthi Liyanage, Nirmala Sirisena, Sandamini Liyanage, C D Nelanka Priyadarshani, D P Bhagya Hendalage, Vajira H W Dissanayake
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Abstract

Background: Immunomodulators are important for management of autoimmune diseases and hematological malignancies. Significant inter-individual variation in drug response/reactions exists due to genetic polymorphisms. We describe frequency of identified genetic polymorphisms among Sri Lankans.

Methods: Sri Lankan data were obtained from an anonymized database of 670 participants. Data on variants and global distribution of Minor Allele frequency (MAF) of other populations (South Asian, Ashkenazi-Jewish, East-Asian, European-Finnish, European-non-Finnish, Latino-American, African/African-American) were obtained from pharmGKB online database.

Results: SLC19A1 (rs1051266) variant had a MAF (95% CI) of 63.3% (60.7-65.9). Other common variants included FCGR3A (rs396991), MTHFR (rs1801133), ITPA (rs1127354), CYP2C9*3 (rs1057910) and NUD15*3 (rs116855232), with MAFs of 35.3% (32.7-37.9), 12.2% (10.4-13.9), 10.9% (9.2-12.6), 9.8% (8.2-11.4), 8.3% (6.8-9.8) respectively. Less commonly present variants included CYP2C9*2 (rs1799853) (2.5%[1.7-3.4]), TPMT*3C (rs1142345) (1.9%[1.1-2.6]), TPMT*3B (rs1800460) (0.2%[0-0.5]), CYP3A5*6 (rs10264272) (0.2%[0-0.4]) and CYP3A4*18 (rs28371759) (0.1%[0-0.2]). The SLC19A1 (rs1051266), NUD15*3 (rs116855232), CYP2C9*3 (rs1057910), FCGR3A (rs396991), and ITPA (rs1127354) showed significantly higher frequencies in Sri Lankans compared to many other populations, exceptions include FCGR3A in Ashkenazi-Jewish and ITPA in East-Asians. Conversely, MTHFR (rs1801133), TPMT*3B (rs1800460), and CYP2C9*2 (rs1799853) were significantly less prevalent among Sri Lankans than in  many other populations. Sri Lankans exhibited lower prevalence of TPMT*3C (rs1142345) compared to European-non-Finnish, Latino-Americans, and African/African-Americans; CYP3A4*18 (rs28371759) compared to East-Asians; and CYP3A5*6 (rs10264272) compared to African/African-Americans and Latino-Americans.

Conclusion: Sri Lankans exhibit higher frequencies in variants reducing methotrexate efficacy (SLC19A1), increasing azathioprine myelotoxicity (NUDT15), and lower frequencies in variants linked to increased azathioprine toxicity (TPMT*3B, TPMT*3C), reduced tacrolimus efficacy (CYP3A4*18), and methotrexate toxicity risk (MTHFR). Beneficial variants enhancing rituximab efficacy (FCGR3A) are more prevalent, while those reducing tacrolimus dosage (CYP3A5*6) are less common. This highlights need for targeted medication strategies to improve treatment outcomes.

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斯里兰卡南亚人群中影响免疫调节剂和生物制剂安全性和有效性的药物基因组变异的频率。
背景:免疫调节剂是治疗自身免疫性疾病和血液恶性肿瘤的重要药物。由于基因多态性,个体间对药物的反应存在显著差异。我们描述了在斯里兰卡人中发现的基因多态性的频率:斯里兰卡的数据来自一个包含 670 名参与者的匿名数据库。其他人群(南亚人、犹太人、东亚人、欧洲人-芬兰人、欧洲人-非芬兰人、拉丁美洲人、非洲人/非洲裔美国人)的变异和小等位基因频率(MAF)的全球分布数据来自 pharmGKB 在线数据库:SLC19A1(rs1051266)变异的MAF(95% CI)为63.3%(60.7-65.9)。其他常见变异包括 FCGR3A (rs396991)、MTHFR (rs1801133)、ITPA (rs1127354)、CYP2C9*3 (rs1057910) 和 NUD15*3 (rs116855232),其 MAF 为 35.3%(32.7-37.9)、12.2%(10.4-13.9)、10.9%(9.2-12.6)、9.8%(8.2-11.4)、8.3%(6.8-9.8)。较少出现的变异包括 CYP2C9*2 (rs1799853) (2.5%[1.7-3.4])、TPMT*3C (rs1142345) (1.9%[1.1-2.6])、TPMT*3B(rs1800460)(0.2%[0-0.5])、CYP3A5*6(rs10264272)(0.2%[0-0.4])和 CYP3A4*18(rs28371759)(0.1%[0-0.2])。与许多其他人群相比,SLC19A1 (rs1051266)、NUD15*3 (rs116855232)、CYP2C9*3 (rs1057910)、FCGR3A (rs396991)和 ITPA (rs1127354)在斯里兰卡人中的频率明显较高,例外情况包括阿什肯纳齐犹太人中的 FCGR3A 和东亚人中的 ITPA。相反,MTHFR(rs1801133)、TPMT*3B(rs1800460)和 CYP2C9*2(rs1799853)在斯里兰卡人中的流行率明显低于许多其他人群。与欧洲-非芬兰人、拉丁美洲人和非洲/非裔美国人相比,斯里兰卡人的 TPMT*3C (rs1142345) 患病率较低;与东亚人相比,斯里兰卡人的 CYP3A4*18 (rs28371759) 患病率较低;与非洲/非裔美国人和拉丁美洲人相比,斯里兰卡人的 CYP3A5*6 (rs10264272) 患病率较低:结论:斯里兰卡人在降低甲氨蝶呤疗效(SLC19A1)和增加硫唑嘌呤骨髓毒性(NUDT15)的变异中表现出较高的频率,而在与增加硫唑嘌呤毒性(TPMT*3B、TPMT*3C)、降低他克莫司疗效(CYP3A4*18)和甲氨蝶呤毒性风险(MTHFR)相关的变异中表现出较低的频率。提高利妥昔单抗疗效的有益变异(FCGR3A)更为普遍,而降低他克莫司剂量的变异(CYP3A5*6)则较少见。这突显出需要有针对性的用药策略来改善治疗效果。
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来源期刊
Human Genomics
Human Genomics GENETICS & HEREDITY-
CiteScore
6.00
自引率
2.20%
发文量
55
审稿时长
11 weeks
期刊介绍: Human Genomics is a peer-reviewed, open access, online journal that focuses on the application of genomic analysis in all aspects of human health and disease, as well as genomic analysis of drug efficacy and safety, and comparative genomics. Topics covered by the journal include, but are not limited to: pharmacogenomics, genome-wide association studies, genome-wide sequencing, exome sequencing, next-generation deep-sequencing, functional genomics, epigenomics, translational genomics, expression profiling, proteomics, bioinformatics, animal models, statistical genetics, genetic epidemiology, human population genetics and comparative genomics.
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