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Network pharmacology prediction, molecular docking and in vitro experiment explored the potential mechanism of Gaoyuan’an capsule in improving hypoxia tolerance 网络药理学预测、分子对接和体外实验探索高元安胶囊改善缺氧耐受性的潜在机制
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2024-03-14 DOI: 10.1038/s41397-024-00327-0
Tianbo Jin, Xiaoli Liu, Yuhe Wang, Yijin Qi, Xuemei Li, Li Wang, Xue He
Tibetan medicine Gaoyuan’an capsule (GYAC) is widely used to prevent pulmonary edema at high altitude, but the specific mechanism has not been explored. In this study, we analyzed the mechanism of GYAC in hypoxia tolerance, and provided a new idea for the prevention and treatment of altitude disease. The effective components and corresponding targets of GYAC were screened out by the Chinese herbal medicine network database, and the key targets of hypoxia tolerance were retrieved by Genecards, OMIM and PubMed database. Cytoscape 3.7.2 was used to construct GYAC ingredient-target-hypoxia tolerance-related target network. GO function annotation and KEGG enrichment analysis were performed to predict the pathways in which target genes may be involved, and molecular docking was used to verify the binding ability of the compound to target genes. In vitro, the above results were further verified by molecular experiment. We found that GYAC can improve hypoxia tolerance by regulating various target genes, including IL6, IFNG, etc. The main regulatory pathways were HIF-1 signaling pathway. Molecular docking showed that the affinity between luteolin and target genes (IL6, IFNG) were better. In vitro, we observed that hypoxia can inhibit cell viability and promote apoptosis of H9C2 cell. And hypoxia can promote the expression of LDH. After the addition of luteolin, the decrease of cell viability, the increase of cell apoptosis, LDH release and the decrease of mitochondrial membrane potential were inhibited. Besides, inflammatory related factors (IL-6, IL-10, IL-2, IFNG and VEGFA) expression were also inhibited hypoxic cell models. The results of network pharmacology and molecular docking showed that luteolin, a monomeric component of GYAC, played a role in hypoxia tolerance through a variety of target genes, such as IL6, IFNG. What’s more, we have discovered that luteolin can reduce the inflammatory response in cardiac myocytes, thereby alleviating mitochondrial damage, and ultimately enhancing the hypoxia tolerance of H9C2 cardiomyocytes.
背景藏药高原安胶囊(GYAC)被广泛用于预防高原肺水肿,但其具体机制尚未探明。方法通过中药网络数据库筛选出高原安胶囊的有效成分及相应靶点,并通过Genecards、OMIM和PubMed数据库检索到耐缺氧的关键靶点。利用Cytoscape 3.7.2构建了GYAC成分-靶标-耐缺氧相关靶标网络。通过 GO 功能注释和 KEGG 富集分析预测了靶基因可能参与的通路,并通过分子对接验证了化合物与靶基因的结合能力。结果我们发现 GYAC 可通过调控 IL6、IFNG 等多个靶基因来改善缺氧耐受性。主要调控途径为 HIF-1 信号通路。分子对接显示,木犀草素与靶基因(IL6、IFNG)的亲和力较好。在体外,我们观察到缺氧能抑制 H9C2 细胞的活力并促进其凋亡。缺氧可促进 LDH 的表达。添加叶黄素后,细胞活力的降低、细胞凋亡的增加、LDH 的释放和线粒体膜电位的降低均受到抑制。结论 网络药理学和分子对接的结果表明,GYAC 的单体成分叶黄素通过多种靶基因(如 IL6、IFNG)在耐缺氧过程中发挥作用。此外,我们还发现,木犀草素能减轻心肌细胞的炎症反应,从而减轻线粒体损伤,最终提高H9C2心肌细胞的耐缺氧能力。
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引用次数: 0
Being precise with anticoagulation to reduce adverse drug reactions: are we there yet? 精确抗凝以减少药物不良反应:我们做到了吗?
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2024-03-05 DOI: 10.1038/s41397-024-00329-y
Benjamin Cross, Richard M. Turner, J. Eunice Zhang, Munir Pirmohamed
Anticoagulants are potent therapeutics widely used in medical and surgical settings, and the amount spent on anticoagulation is rising. Although warfarin remains a widely prescribed oral anticoagulant, prescriptions of direct oral anticoagulants (DOACs) have increased rapidly. Heparin-based parenteral anticoagulants include both unfractionated and low molecular weight heparins (LMWHs). In clinical practice, anticoagulants are generally well tolerated, although interindividual variability in response is apparent. This variability in anticoagulant response can lead to serious incident thrombosis, haemorrhage and off-target adverse reactions such as heparin-induced thrombocytopaenia (HIT). This review seeks to highlight the genetic, environmental and clinical factors associated with variability in anticoagulant response, and review the current evidence base for tailoring the drug, dose, and/or monitoring decisions to identified patient subgroups to improve anticoagulant safety. Areas that would benefit from further research are also identified. Validated variants in VKORC1, CYP2C9 and CYP4F2 constitute biomarkers for differential warfarin response and genotype-informed warfarin dosing has been shown to reduce adverse clinical events. Polymorphisms in CES1 appear relevant to dabigatran exposure but the genetic studies focusing on clinical outcomes such as bleeding are sparse. The influence of body weight on LMWH response merits further attention, as does the relationship between anti-Xa levels and clinical outcomes. Ultimately, safe and effective anticoagulation requires both a deeper parsing of factors contributing to variable response, and further prospective studies to determine optimal therapeutic strategies in identified higher risk subgroups.
抗凝剂是广泛应用于内科和外科的强效治疗药物,用于抗凝的费用也在不断增加。虽然华法林仍是广泛使用的口服抗凝药,但直接口服抗凝药(DOAC)的处方量也在迅速增加。以肝素为基础的肠外抗凝剂包括非分数肝素和低分子量肝素(LMWHs)。在临床实践中,抗凝剂的耐受性一般都很好,但个体间的反应差异明显。抗凝剂反应的这种变异性可导致严重的血栓形成、出血和非目标不良反应,如肝素诱导的血小板减少症(HIT)。本综述旨在强调与抗凝剂反应变异相关的遗传、环境和临床因素,并审查当前的证据基础,以便根据已确定的患者亚群调整药物、剂量和/或监测决策,从而提高抗凝剂的安全性。此外,还确定了可从进一步研究中获益的领域。VKORC1、CYP2C9 和 CYP4F2 中已验证的变异构成了不同华法林反应的生物标志物,而根据基因型确定华法林剂量已被证明可减少不良临床事件的发生。CES1 的多态性似乎与达比加群的暴露有关,但侧重于出血等临床结果的基因研究却很少。体重对 LMWH 反应的影响以及抗 Xa 水平与临床结果之间的关系值得进一步关注。归根结底,安全有效的抗凝治疗需要对导致不同反应的因素进行更深入的解析,还需要进一步的前瞻性研究来确定已识别的高风险亚组的最佳治疗策略。
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引用次数: 0
Pharmacogenetic and clinical risk factors for bevacizumab-related gastrointestinal hemorrhage in prostate cancer patients treated on CALGB 90401 (Alliance) 接受 CALGB 90401(联盟)治疗的前列腺癌患者发生贝伐珠单抗相关消化道出血的药物遗传学和临床风险因素。
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2024-03-04 DOI: 10.1038/s41397-024-00328-z
Jai N. Patel, Chen Jiang, Kouros Owzar, Daniel L. Hertz, Janey Wang, Flora A. Mulkey, William K. Kelly, Susan Halabi, Yoichi Furukawa, Cameron Lassiter, Susan G. Dorsey, Paula N. Friedman, Eric J. Small, Michael A. Carducci, Michael J. Kelley, Yusuke Nakamura, Michiaki Kubo, Mark J. Ratain, Michael J. Morris, Howard L. McLeod
The objective of this study was to discover clinical and pharmacogenetic factors associated with bevacizumab-related gastrointestinal hemorrhage in Cancer and Leukemia Group B (Alliance) 90401. Patients with metastatic castration-resistant prostate cancer received docetaxel and prednisone ± bevacizumab. Patients were genotyped using Illumina HumanHap610-Quad and assessed using cause-specific risk for association between single nucleotide polymorphisms (SNPs) and gastrointestinal hemorrhage. In 1008 patients, grade 2 or higher gastrointestinal hemorrhage occurred in 9.5% and 3.8% of bevacizumab (n = 503) and placebo (n = 505) treated patients, respectively. Bevacizumab (P < 0.001) and age (P = 0.002) were associated with gastrointestinal hemorrhage. In 616 genetically estimated Europeans (n = 314 bevacizumab and n = 302 placebo treated patients), grade 2 or higher gastrointestinal hemorrhage occurred in 9.6% and 2.0% of patients, respectively. One SNP (rs1478947; HR 6.26; 95% CI 3.19–12.28; P = 9.40 × 10−8) surpassed Bonferroni-corrected significance. Grade 2 or higher gastrointestinal hemorrhage rate was 33.3% and 6.2% in bevacizumab-treated patients with the AA/AG and GG genotypes, versus 2.9% and 1.9% in the placebo arm, respectively. Prospective validation of these findings and functional analyses are needed to better understand the genetic contribution to treatment-related gastrointestinal hemorrhage.
本研究旨在发现与贝伐珠单抗相关的胃肠道出血的临床和药物遗传学因素,研究对象为癌症和白血病 B 组(联盟)90401 例患者。转移性阉割耐药前列腺癌患者接受多西他赛和泼尼松以及贝伐珠单抗治疗。使用 Illumina HumanHap610-Quad 对患者进行基因分型,并使用病因特异性风险评估单核苷酸多态性 (SNP) 与胃肠道出血之间的关联。在1008例患者中,贝伐珠单抗(n = 503)和安慰剂(n = 505)治疗患者中分别有9.5%和3.8%发生2级或2级以上胃肠道出血。贝伐单抗(P -8)超过了 Bonferroni 校正的显著性。贝伐单抗治疗的 AA/AG 和 GG 基因型患者中,2 级或以上胃肠道出血率分别为 33.3% 和 6.2%,而安慰剂组分别为 2.9% 和 1.9%。需要对这些发现进行前瞻性验证和功能分析,以更好地了解基因对治疗相关胃肠道出血的影响。
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引用次数: 0
Upregulation of p300 in paclitaxel-resistant TNBC: implications for cell proliferation via the PCK1/AMPK axis 紫杉醇耐药 TNBC 中 p300 的上调:通过 PCK1/AMPK 轴对细胞增殖的影响。
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2024-02-20 DOI: 10.1038/s41397-024-00324-3
Peng-Wei Zhao, Jia-Xian Cui, Xiu-Mei Wang
To explore the role of p300 in the context of paclitaxel (PTX) resistance in triple-negative breast cancer (TNBC) cells, focusing on its interaction with the phosphoenolpyruvate carboxykinase 1 (PCK1)/adenosine monophosphate-activated protein kinase (AMPK) pathway. The expression of p300 and PCK1 at the messenger ribonucleic acid (mRNA) level was detected using a quantitative polymerase chain reaction. The GeneCards and GEPIA databases were used to investigate the relationship between p300 and PCK1. The MDA-MB-231/PTX cell line, known for its PTX resistance, was chosen to understand the specific role of p300 in such cells. The Lipofectamine™ 3000 reagent was used to transfer the p300 small interfering RNA and the overexpression of PCK1 plasmid into MDA-MB-231/PTX. The expression levels of p300, PCK1, 5′AMPK and phosphorylated AMPK (p-AMPK) were determined using the western blot test. In TNBC cancer tissue, the expression of p300 was increased compared with TNBC paracancerous tissue (P < 0.05). In the MDA-MB-231 cell line of TNBC, the expression of p300 was lower than in the PTX-resistant TNBC cells (MDA-MB-231/PTX) (P < 0.05). The PCK1 expression was decreased in the TNBC cancer tissue compared with TNBC paracancerous tissue, and the PCK1 expression was reduced in MDA-MB-231/PTX than in MDA-MB-231 (P < 0.05) indicating that PCK1 was involved in the resistance function. Additionally, p-AMPK was decreased in MDA-MB-231/PTX compared with MDA-MB-231 (P < 0.05). The adenosine triphosphate (ATP) level was also detected and was significantly lower in MDA-MB-231/PTX than in MDA-MB-231 (P < 0.05). Additionally, cell proliferation increased significantly in MDA-MB-231/PTX at 48 and 72 h (P < 0.05) suggesting that MDA-MB-231/PTX cells obtained the resistance function which was associated with AMPK and ATP level. When p300 was inhibited, p-AMPK and ATP levels elevated in MDA-MB-231/PTX (P < 0.05). When PCK1 was suppressed, the ATP consumption rate decreased, and cell proliferation increased (P < 0.05). However, there were no changes in p300. In MDA-MB-231/PTX, p300 can inhibit p-AMPK and ATP levels by inhibiting PCK1 expression. Our findings suggest that targeting p300 could modulate the PCK1/AMPK axis, offering a potential therapeutic avenue for overcoming PTX resistance in TNBC.
目的探讨p300在三阴性乳腺癌(TNBC)细胞的紫杉醇(PTX)抗性中的作用,重点研究其与磷酸烯醇丙酮酸羧激酶1(PCK1)/腺苷酸单磷酸激活蛋白激酶(AMPK)通路的相互作用:采用定量聚合酶链反应检测信使核糖核酸(mRNA)水平上 p300 和 PCK1 的表达。利用 GeneCards 和 GEPIA 数据库研究 p300 和 PCK1 之间的关系。为了了解 p300 在此类细胞中的特殊作用,研究人员选择了以 PTX 抗性著称的 MDA-MB-231/PTX 细胞系。使用 Lipofectamine™ 3000 试剂将 p300 小干扰 RNA 和 PCK1 过表达质粒转入 MDA-MB-231/PTX。采用Western印迹检测p300、PCK1、5'AMPK和磷酸化AMPK(p-AMPK)的表达水平:结果:与 TNBC 癌旁组织相比,p300 在 TNBC 癌组织中的表达增加(P 结论):在MDA-MB-231/PTX中,p300可通过抑制PCK1的表达来抑制p-AMPK和ATP水平。我们的研究结果表明,以 p300 为靶点可以调节 PCK1/AMPK 轴,为克服 TNBC 对 PTX 的耐药性提供了一条潜在的治疗途径。
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引用次数: 0
Composite CYP3A (CYP3A4 and CYP3A5) phenotypes and influence on tacrolimus dose adjusted concentrations in adult heart transplant recipients 成人心脏移植受者的复合 CYP3A(CYP3A4 和 CYP3A5)表型及其对他克莫司剂量调整浓度的影响。
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2024-02-15 DOI: 10.1038/s41397-024-00325-2
Michelle Liu, Savine Hernandez, Christina L. Aquilante, Kimberly M. Deininger, Joann Lindenfeld, Kelly H. Schlendorf, Sara L. Van Driest
CYP3A5 genetic variants are associated with tacrolimus metabolism. Controversy remains on whether CYP3A4 increased [*1B (rs2740574), *1 G (rs2242480)] and decreased function [*22 (rs35599367)] genetic variants provide additional information. This retrospective cohort study aims to address whether tacrolimus dose-adjusted trough concentrations differ between combined CYP3A (CYP3A5 and CYP3A4) phenotype groups. Heart transplanted patients (n = 177, between 2008 and 2020) were included and median age was 54 years old. Significant differences between CYP3A phenotype groups in tacrolimus dose-adjusted trough concentrations were found in the early postoperative period and continued to 6 months post-transplant. In CYP3A5 nonexpressers, carriers of CYP3A4*1B or *1 G variants (Group 3) compared to CYP3A4*1/*1 (Group 2) patients were found to have lower tacrolimus dose-adjusted trough concentrations at 2 months. In addition, significant differences were found among CYP3A phenotype groups in the dose at discharge and time to therapeutic range while time in therapeutic range was not significantly different. A combined CYP3A phenotype interpretation may provide more nuanced genotype-guided TAC dosing in heart transplant recipients.
CYP3A5 基因变异与他克莫司的代谢有关。关于 CYP3A4 功能增强[*1B (rs2740574), *1 G (rs2242480)]和功能减弱[*22 (rs35599367)]基因变异是否能提供更多信息,目前仍存在争议。这项回顾性队列研究旨在探讨他克莫司剂量调整谷浓度在 CYP3A(CYP3A5 和 CYP3A4)联合表型组之间是否存在差异。研究纳入了心脏移植患者(n = 177,2008 年至 2020 年),中位年龄为 54 岁。术后早期,CYP3A 表型组之间的他克莫司剂量调整后谷浓度存在显著差异,这种差异一直持续到移植术后 6 个月。在 CYP3A5 非表达者中,与 CYP3A4*1/*1 组(第 2 组)患者相比,CYP3A4*1B 或 *1 G 变体携带者(第 3 组)在 2 个月时的他克莫司剂量调整谷浓度较低。此外,CYP3A 表型组之间在出院时的剂量和达到治疗范围的时间上存在显著差异,而在治疗范围内的时间则无显著差异。对 CYP3A 表型的综合解释可为心脏移植受者提供更细致的基因型指导 TAC 剂量。
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引用次数: 0
The pharmacogenetics of tacrolimus in renal transplant patients: association with tremors, new-onset diabetes and other clinical events 肾移植患者他克莫司的药物遗传学:与震颤、新发糖尿病和其他临床事件的关系
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2024-01-22 DOI: 10.1038/s41397-024-00323-4
Amani Abderahmene, Yassine khalij, Amira Moussa, Meriam Ammar, Amel Ellouz, Dorra Amor, Houwaida Abbes, Mohamed Rayen Ganouni, Wissal Sahtout, Saoussen Chouchene, Asma omezzine, Dorsaf zellama, Ali Bouslama
Our study is the first study to investigate the effect of SNPs in CYP3A5, CYP3A4, ABCB1 and POR genes on the incidence of tremors, nephrotoxicity, and diabetes mellitus. A total of 223 renal transplant patients receiving tacrolimus and mycophenolate mofetil (MMF) were recruited. Both adults and children patients participated in the study. Genotyping was performed using PROFLEX-PCR followed by RFLP. MPA and tacrolimus plasma concentrations were measured by immunoassay. The AUC0-12h of MMF was estimated by a Bayesian method. We found a statistically significant association between the CYP3A5*3 and CYP3A4*1B genotypes and the tacrolimus exposure. We found a lower occurrence of nephrotoxicity (p = 0.03), tremor (p = 0.01), and new-onset diabetes (p = 0.002) associated with CYP3A5*1 allele. The CYP3A4*1B allele was significantly associated with a lower occurrence of new-onset diabetes (p = 0.026). The CYP3A5*1 allele was significantly associated with an increased risk of acute and chronic rejection (p = 0.03 and p < 0.001, respectively). Our results support the usefulness of tacrolimus pharmacokinetics in pre-kidney transplant assessments.
我们的研究是首次调查 CYP3A5、CYP3A4、ABCB1 和 POR 基因中的 SNPs 对震颤、肾毒性和糖尿病发病率影响的研究。研究共招募了 223 名接受他克莫司和霉酚酸酯(MMF)治疗的肾移植患者。成人和儿童患者均参与了研究。基因分型是通过 PROFLEX-PCR 和 RFLP 进行的。MPA 和他克莫司的血浆浓度通过免疫测定法测定。MMF 的 AUC0-12h 用贝叶斯法估算。我们发现 CYP3A5*3 和 CYP3A4*1B 基因型与他克莫司的暴露量之间存在统计学意义上的显著关联。我们发现,与 CYP3A5*1 等位基因相关的肾毒性(p = 0.03)、震颤(p = 0.01)和新发糖尿病(p = 0.002)发生率较低。CYP3A4*1B 等位基因与较低的新发糖尿病发病率(p = 0.026)显著相关。CYP3A5*1 等位基因与急性和慢性排斥反应风险的增加明显相关(分别为 p = 0.03 和 p <0.001)。我们的研究结果支持他克莫司药代动力学在肾移植前评估中的作用。
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引用次数: 0
Pharmacogenomic biomarker information on drug labels of the Spanish Agency of Medicines and Sanitary products: evaluation and comparison with other regulatory agencies 西班牙药品和卫生产品管理局药品标签上的药物基因组生物标记信息:评估以及与其他监管机构的比较
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2024-01-17 DOI: 10.1038/s41397-023-00321-y
María Estévez-Paredes, M. Carmen Mata-Martín, Fernando de Andrés, Adrián LLerena
This work aimed to analyse the pharmacogenetic information in the Spanish Drug Regulatory Agency (AEMPS) Summary of Products Characteristics (SmPC), evaluating the presence of pharmacogenetic biomarkers, as well as the associated recommendations. A total of 55.4% of the 1891 drug labels reviewed included information on pharmacogenetic biomarker(s). Pharmacogenomic information appears most frequently in the “antineoplastic and immunomodulating agents”, “nervous system”, and “cardiovascular system” Anatomical Therapeutic Chemical groups. A total of 509 different pharmacogenetic biomarkers were found, of which CYP450 enzymes accounted for almost 34% of the total drug-biomarker associations evaluated. A total of 3679 drug–biomarker pairs were identified, 102 of which were at the 1A level (PharmGKB® classification system), and 33.33% of these drug-pharmacogenetic biomarker pairs were assigned to “actionable PGx”, 12.75% to “informative PGx”, 4.9% to “testing recommended”, and 4.9% to “testing required”. The rate of coincidence in the assigned PGx level of recommendation between the AEMPS and regulatory agencies included in the PharmGKB® Drug Label Annotations database (i.e., the FDA, EMA, SWISS Medic, PMDA, and HCSC) ranged from 45% to 65%, being ‘actionable level’ the most frequent. On the other hand, discrepancies between agencies did not exceed 35%. This study highlights the presence of relevant pharmacogenetic information on Spanish drug labels, which would help avoid interactions, toxicity, or lack of treatment efficacy.
这项研究旨在分析西班牙药品管理局(AEMPS)《产品特征概要》(SmPC)中的药物遗传信息,评估药物遗传生物标志物的存在情况以及相关建议。在接受审查的 1891 个药品标签中,共有 55.4% 包含药物基因生物标记物信息。药物基因组学信息最常出现在 "抗肿瘤和免疫调节剂"、"神经系统 "和 "心血管系统 "解剖治疗化学组中。共发现了 509 种不同的药物基因生物标记物,其中 CYP450 酶占所评估的药物生物标记物关联总数的近 34%。共鉴定出 3679 对药物-生物标记物,其中 102 对属于 1A 级(PharmGKB® 分类系统),这些药物-药物遗传生物标记物中有 33.33% 被归入 "可操作的 PGx",12.75% 被归入 "有参考价值的 PGx",4.9% 被归入 "建议检测",4.9% 被归入 "需要检测"。AEMPS与PharmGKB®药物标签注释数据库中的监管机构(即FDA、EMA、SWISS Medic、PMDA和HCSC)所分配的PGx建议级别的重合率在45%到65%之间,其中 "可操作级别 "最为常见。另一方面,各机构之间的差异不超过 35%。这项研究强调了西班牙药品标签上相关药物遗传学信息的存在,这将有助于避免相互作用、毒性或缺乏疗效。
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引用次数: 0
Integrating rare genetic variants into DPYD pharmacogenetic testing may help preventing fluoropyrimidine-induced toxicity 将罕见基因变异纳入 DPYD 药物基因检测,可能有助于预防氟嘧啶引起的毒性。
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2024-01-12 DOI: 10.1038/s41397-023-00322-x
Romain Larrue, Sandy Fellah, Benjamin Hennart, Naoual Sabaouni, Nihad Boukrout, Cynthia Van der Hauwaert, Clément Delage, Meyling Cheok, Michaël Perrais, Christelle Cauffiez, Delphine Allorge, Nicolas Pottier
Variability in genes involved in drug pharmacokinetics or drug response can be responsible for suboptimal treatment efficacy or predispose to adverse drug reactions. In addition to common genetic variations, large-scale sequencing studies have uncovered multiple rare genetic variants predicted to cause functional alterations in genes encoding proteins implicated in drug metabolism, transport and response. To understand the functional importance of rare genetic variants in DPYD, a pharmacogene whose alterations can cause severe toxicity in patients exposed to fluoropyrimidine-based regimens, massively parallel sequencing of the exonic regions and flanking splice junctions of the DPYD gene was performed in a series of nearly 3000 patients categorized according to pre-emptive DPD enzyme activity using the dihydrouracil/uracil ([UH2]/[U]) plasma ratio as a surrogate marker of DPD activity. Our results underscore the importance of integrating next-generation sequencing-based pharmacogenomic interpretation into clinical decision making to minimize fluoropyrimidine-based chemotherapy toxicity without altering treatment efficacy.
涉及药物药代动力学或药物反应的基因变异可导致疗效不佳或易引起药物不良反应。除了常见的基因变异外,大规模的测序研究还发现了多种罕见的基因变异,预测这些变异会导致编码与药物代谢、转运和反应有关的蛋白质的基因发生功能性改变。为了了解 DPYD 罕见基因变异的功能重要性,对 DPYD 基因的外显子区和侧翼剪接接头进行了大规模平行测序,并使用二氢尿嘧啶/尿嘧啶([UH2]/[U])血浆比值作为 DPD 活性的替代标志物,对近 3000 名患者进行了分类,并根据先期 DPD 酶活性进行了分类。我们的研究结果凸显了将基于新一代测序的药物基因组学解释纳入临床决策的重要性,从而在不改变疗效的前提下最大限度地降低氟嘧啶类化疗的毒性。
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引用次数: 0
Cytochrome P450-2D6 activity in people with codeine use disorder 可待因使用障碍患者的细胞色素P450-2D6活性。
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2023-11-09 DOI: 10.1038/s41397-023-00319-6
Mark R. C. Daglish, Sarah R. Reilly, Sam Mostafa, Cameron Edwards, Thomas M. O’Gorman, Jeremy S. Hayllar
Compound-analgesics containing codeine (CACC) have been a common source of codeine for people seeking opioid replacement therapy (ORT) for codeine use disorder (CUD). Our previous work demonstrated no relationship between pre-treatment CACC and ORT buprenorphine doses; we hypothesised that CYP2D6 activity would partially account for this disconnection. One hundred six participants with CUD were compared to a published population sample of 5408 Australian patients. Mean age of participants with CUD at treatment entry was 35 years, with mean 6.1 years duration of CUD. Mean codeine dose was 660 mg/day (range 40–2700 mg). Mean calculated CYP2D6 activity scores were significantly higher in the codeine group (CUD 1.65 + 0.63 vs. Gen pop 1.39 + 0.65, Wilcoxon W = 347,001, p < 0.001). Pre-treatment CACC dose weakly predicted sublingual buprenorphine doses overall; there was a stronger relationship within ultrarapid metabolisers. While normal and ultrarapid metabolisers of codeine were more likely to have a diagnosis of CUD, poor or intermediate CYP2D6 metaboliser status may protect against CUD.
含有可待因的复合止痛药(CACC)一直是寻求可待因使用障碍阿片类替代疗法(ORT)的人的可待因的常见来源。我们之前的工作表明,治疗前CACC和口服丁丙诺啡剂量之间没有关系;我们假设CYP2D6活性将部分解释这种断开。将106名CUD参与者与5408名澳大利亚患者的已公布人群样本进行了比较。CUD参与者在进入治疗时的平均年龄为35岁,CUD的平均持续时间为6.1年。可待因的平均剂量为660 mg/天(范围40-2700 mg)。可待因组的平均计算CYP2D6活性评分显著较高(CUD 1.65 + 0.63对流行一代1.39 + 0.65,Wilcoxon W = 347001,第页
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引用次数: 0
A software tool to adjust codeine dose based on CYP2D6 gene-pair polymorphisms and drug-drug interactions 一种基于CYP2D6基因对多态性和药物相互作用调整可待因剂量的软件工具。
IF 2.8 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2023-11-09 DOI: 10.1038/s41397-023-00318-7
Yolande Saab, Zahi Nakad
Codeine is metabolized by the CYP2D6 enzyme, and individuals with certain genetic variations of the CYP2D6 gene may metabolize codeine differently, leading to variable efficacy and toxicity. Drug-drug interactions can also affect the metabolism of codeine. A tool to adjust codeine dose based on these factors does not currently exist. Healthcare providers should use their clinical judgment and reference different established dosing guidelines to determine the appropriate dose of codeine for individual patients. The study provides a tool that assists prescribers in adjusting codeine dose based on CYP2D6 gene-pair polymorphisms and drug-drug interactions. Highlighted is the need to consider pharmacogenetics and drug-drug interactions when determining the appropriate dosing of codeine and provide a framework for implementing individualized dosing based on these factors.
可待因由CYP2D6酶代谢,具有CYP2D6基因某些遗传变异的个体可能以不同的方式代谢可待因,导致不同的疗效和毒性。药物相互作用也会影响可待因的代谢。目前还不存在基于这些因素调整可待因剂量的工具。医疗保健提供者应根据其临床判断并参考不同的既定给药指南,为个别患者确定可待因的适当剂量。该研究提供了一种工具,帮助处方医生根据CYP2D6基因对多态性和药物相互作用调整可待因剂量。强调的是,在确定可待因的适当给药时,需要考虑药物遗传学和药物-药物相互作用,并提供一个基于这些因素实施个性化给药的框架。
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Pharmacogenomics Journal
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