CYP2C8 polymorphism frequencies among malaria patients in Zanzibar

Objective The determination of the prevalence of the CYP2C8 main alleles in a typical set of malaria patients in Zanzibar, as these patients represent a typical population exposed to amodiaquine, an antimalarial mainly metabolized by CYP2C8. Also, to determine for the first time the frequencies of CYP2C8 alleles in native African populations.Methods Polymerase chain reaction–restriction fragment polymorphism for the identification of CYP2C8*1, CYP2C8*2, CYP2C8*3 and CYP2C8*4 on a random population of 165 unrelated malaria patients.Results The allele frequencies found were: CYP2C8*1 (wild type, 83.4%), CYP2C8*2 (13.9%), CYP2C8*3 (2.1%) and CYP2C8*4 (0.6%). In terms of genotypes, 70.4% of the patients showed the CYP2C8*1/ CYP2C8*1 genotypes, while heterozygous between the wild type and other minor alleles were seen in 26.0%. Finally, 3.6% of the patients were homozygous for slow metabolizer alleles. The frequencies observed are equivalent to those documented for African-Americans.Conclusions CYP2C8 non-wild type alleles have a significant prevalence in the East African population studied. The consequent frequency of 3.6% of patients homozygous for slow metabolizer alleles represent a significant fraction of the population potentially in higher risk of adverse effects due to a less efficient metabolism of amodiaquine. As approximately 10⁶ first-line treatments are currently performed in Zanzibar per year, this represents a non-negligible absolute number of amodiaquine exposures. This information constitutes a background for the pharmacovigilance programs presently being employed in Zanzibar.     

Polymorphism of alpha-estrogen receptor and aryl hydrocarbon receptor genes in dementia patients in Shanghai suburb

AIM: To explore the possible association of different polymorphic forms of human alpha-estrogen receptor (ER-alpha) and aryl hydrocarbon receptor gene (Ahr) with the risk to senile dementia in farmers in Shanghai suburb. METHODS: Senile dementia patients (n=52) were examined for ER-alpha and Ahr gene polymorphism genotyping. Healthy individuals (n=125) in the same area were selected as a community control group. Two polymorphic loci, Pvu II locus and Xba I locus, of human ER- a gene were investigated by a PCR-RFLP-based procedure. The population frequencies of two polymorphic loci in exon 10 of Ahr gene, G1721A (R554K) and G1768A (V570I) were compared between patients and healthy controls using an allele-specific PCR (AS-PCR) procedure. RESULTS: The mutant allele frequencies of ER-alpha gene in the AD group were significantly higher than those in the control group (P=0.023, OR=2.94, 95 % CI 1.13-7.71 for Pvu II locus; P=0.046, OR=2.28, 95 % CI 1.003-5.17 for Xba I locus). The mutant allele frequencies among female AD patients were higher than those in the female controls (P=0.016, OR=3.68, 95 % CI 1.22-11.08 for Pvu II locus, P=0.029, OR=2.95, 95 % CI 1.10-7.94 for Xba I locus). The mutant form, neither in the homozygous, nor in the heterozygous form was detected at the locus of Ahr G1768A in a normal local population. No significant difference of Ahr genotype frequency at locus G1721A was noticed between the patients and healthy individuals. CONCLUSION: The distribution of ER polymorphisms was significantly different between Chinese and some other ethnic populations. The results suggested that ER-alpha gene polymorphisms might be related to the individual susceptibility to AD, especially in the females. However, it did not support the association of Ahr gene polymorphism with higher risk of senile dementia.     

胆固醇结石患者肝脏核受体基因蛋白的表达

目的 探讨胆囊胆固醇结石(CGs)患者肝脏的核受体基因的蛋白表达.方法 对20例CGS(胆石组)和10例无胆石症的胆囊息肉患者(对照组)测定了胆石胆固醇成分及血清脂类成分:总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和胆汁脂类成分(胆固醇、磷脂和胆汁酸),并计算胆汁总脂和胆汁胆固醇饱和指数.Western blot法测定肝脏肝受体同类物1(LRH-1)、法尼醇受体(FXR)、人类固醇异生物受体(SXR)及肝脏X受体a(LXRa)基因的蛋白表达量.结果 胆石组血清HDL-C浓度明显低于对照组[(0.91±0.05)mmol/L vs.(1.31±0.09)mmol/L](P<0.01);胆汁胆固醇摩尔百分比浓度较对照组高[(7.89±0.39)mol%vs.(5.15±0.89)mol%](P<0.01);胆汁总脂较对照组明显下降[(105.62±10.51)g/L vs.(153.50±13.20)g/L](P<0.05);胆石组LRH-1蛋白表达高于对照组[(0.88±0.05)vs.(0.69±0.03)3(P<0.05),LXRa、FXR和SXR表达两组差异无统计学意义(P>0.05).结论 人肝脏LRH-1的蛋白表达增高与胆囊胆固醇结石形成有关.     

Herb-drug interactions: methods to identify potential influence of genetic variations in genes encoding drug metabolizing enzymes and drug transporters

Herbal supplements are often used concomitantly with conventional medications resulting in considerable potential for herb-drug interactions. These interactions, which are generally through interfering with pharmacokinetic and/or pharmacodynamic pathways, may result in beneficial effects or more often adverse reactions such as toxicity or treatment failure and may be influenced by multiple environmental and/or genetic factors. The pharmacogenetic approach may help to identify some interactions which may be more pronounced or only occur in specific groups of subjects although the complex nature of the herbal medicines may limit the discovery of such an interaction. Preclinical studies such as gene expression profiling in rodent liver may help to define metabolic pathways influenced by herbal medicines and facilitate more accurate targeting of human in vivo studies. This review discusses the mechanisms of herb-drugs interaction and the potential influence of genetic variation on herb-drug interactions based on available clinical evidence.     

Profile of drug metabolizing enzymes in the nuclear and microsomal fractions from rat liver nodules and normal liver

The activities of UDP-glucuronyl transferase, DT-diaphorase, epoxide hydrolase, aryl hydrocarbon hydroxylase, -glutamyl transferase and NADPH-cytochrome c reductase were measured in the nuclear and microsomal fractions from normal rat liver and rat liver nodules. Nodules were produced by intermittent feeding of Wistar rats with a standard diet supplemented with 0.05% (w/w) 2-acetylaminofluorene. The nuclear and microsomal fractions were isolated by differential centrifugation. The activities of UDP-glucuronyl transferase, DT-diaphorase, epoxide hydrolase and -glutamyl transferase were significantly increased in the nuclear and microsomal fractions obtained from nodules as compared with normal liver. Aryl hydrocarbon hydroxylase activity was decreased in the microsomal fraction from the pathological tissue but not in the nuclear fraction. NADPH-cytochrome c reductase activity was similar in nodular and normal liver tissue. The nuclear/microsomal ratio for phase I reactions in xenobiotic metabolism was increased over normal more than two fold. Thus the nuclear and microsomal systems for drug metabolism are both changed in liver nodules. The relative enhancement of nuclear activating reactions is remarkable in the light of the increased risk for malignant transformation exhibited by nodular cells.     

Effect of prototypical inducers on ligand activated nuclear receptor regulated drug disposition genes in rodent hepatic and intestinal cells

Aim:

The aim of this study was to investigate the impact on expression of mRNA and protein by paradigm inducers/activators of nuclear receptors and their target genes in rat hepatic and intestinal cells. Furthermore, assess marked inter laboratory conflicting reports regarding species and tissue differences in expression to gain further insight and rationalise previously observed species differences between rodent and human based systems.

Methods:

Quantitative real time-polymerase chain reaction (QRT-PCR) and immunoblots were used to assess messenger RNA (mRNA) and protein expression for CYP2B2, CYP3A1, CYP3A2, CYP3A9, ABCB1a, ABCB1b, ABCC1, ABCC2, pregnane X receptor (PXR), farnesoid X receptor (FXR) and constituitive androstane receptor (CAR) in rat hepatoma cell line H411E, intestinal cells, Iec-6, and rat primary hepatocytes, in response to exposure for 18 h with prototypical inducers.

Results:

Dexamethasone (DEX) and pregnenolone 16α carbonitrile (PCN) significantly induced PXR, CYP3A9, ABCB1a and ABCB1b. However, when co-incubated, DEX appeared to restrict PCN-dependent induction. Chenodeoxycholic acid (CDCA) was the only ligand to induce FXR in all three cell types. Despite previously reported species differences between PCN and rifampicin (RIF), both compounds exhibited a similar profile of induction.

Conclusion:

Data presented herein may explain some of the discrepancies previously reported with respect to species differences from different laboratories and have important implications for study design.     

Focused DNA microarray analysis for sex-dependent gene expression of drug metabolizing enzymes, transporters and nuclear receptors in rat livers and kidneys

Cytochrome P450(CYP)s are known to show a sexual dimorphic expression in rat livers. However, the comprehensive analysis for the sex-dependent gene expressions of drug metabolizing enzymes except for CYPs, transporters and nuclear receptors in rat livers and kidneys has not been investigated yet. The purpose of the present study was to identify the novel drug metabolizing and pharmacokinetics (DMPK)-related gene(s) which show the sex difference in the mRNA expressions in rat livers and kidneys. Total RNAs were prepared from livers and kidneys in both male and female rats (Crl:CD(SD) and Crlj:WI). A DNA microarray analysis using a "GeneSQUARE Multiple Assay DNA Microarray Drug Metabolism Gene Expression for Rat" was performed. DMPK-related genes which showed sex differences in the mRNA expression were identified in rat livers or kidneys. Especially, the female dominant expressions of UDP glucuronosyltransferase (UGT) s were seen in rat livers and kidneys. The sex difference of UGT expressions in rats might be one of the causal factors of the sex difference of the biological response to UGT substrates.     

Dichloromethane inhalation, carboxyhemoglobin concentrations, and drug metabolizing enzymes in rabbits.

The relationship between inhaled dichloromethane (DCM) and percentage of carboxyhemoglobin (% COHb) in blood has been investigated in rabbits. After a single 20-min exposure to DCM, % COHb rose to a maximum within 2–3 hr and usually declined to basal values within 8 hr. The maximum COHb concentration and the time to reach that value were DCM concentration-dependent. In rabbits given a 4-hr exposure to DCM, % COHb increased over the first 2–3 hr, reaching a peak by about 4 hr with a return to basal levels within 24 hr. Studies were carried out to determine whether treatment with modifiers of hepatic mixed-function oxidase changed the % COHb response after DCM exposure. Of the compounds investigated, only CCl₄ and phenobarbital altered % COHb resulting from DCM inhalation. As expected, CCl₄, a potent hepatotoxin, reduced the % COHb resulting from DCM inhalation. Contrary to expectations phenobarbital also lowered the COHb response from DCM inhalation although the decrease was not as marked as that caused by CCl₄.     

Hepatic drug metabolizing capacity of patients of cirrhosis before and after clinico-biochemical recovery

The present study was undertaken to determine whether, along with clinico-biochemical recovery there was associated restoration of hepatic drug metabolizing capacity in patients of cirrhosis after treatment of their cirrhosis, using serum antipyrine half life, the ideal index. Estimation of serum antipyrine half life before (26.34 +/- 2.4 hr) and after (18.83 +/- 2 hr) clinico-biochemical recovery showed significant (P less than 0.01) improvement in drug metabolizing capacity of liver. Biochemical parameters of liver function tests except serum total proteins and prothrombin time showed simultaneous improvement.     

Clomipramine plasma levels among depressed outpatients in Benin, west Africa: drug compliance and comparison with Caucasian patients.

A 75 mg/day clomipramine treatment was prescribed for 4 weeks to 92 outpatients with major depression at the Neuropsychiatric Clinic of the National University Hospital of Cotonou in Benin, West Africa. Among them, only 42 followed the treatment during the 4 weeks and had a clomipramine and desmethylclomipramine plasma level measure (gas chromatography technique). The rate of noncompliance appeared high: 10 patients had no trace and another 2 had only traces of antidepressant in their plasma. For the remaining 29, a comparison with 29 Caucasian patients treated by clomipramine (the two samples are matched for sex and age, and the variables of weight, dosage and drug association are controlled) shows no significantly higher plasma levels in the Beninese sample.     

Urinary excretion ofD-glucaric acid,an indicator of drug metabolizing enzyme activity,in patients with impaired renal function

Summary The urinary excretion rate ofD-glucaric acid, an in vivo parameter of the activity of drug metabolizing enzymes, has been determined in patients with chronic renal insufficiency (glomerular filtration rate 4.5–80 ml/min/1.73 m²). The mean value of 22.3 µmoles/d (SD 7.2; n 28) was almost identical to that of healthy controls (22.1 µmoles/d, SD 7.3; n 22). Thus, no inhibitory or enhancing effect of renal insufficiency could be detected. The ability of this parameter to indicate alterations in the activity of hepatic drug metabolism, even in patients with renal insufficiency, was demonstrated by the increased excretion rate of glucaric acid (107 µmoles/d, SD 43.5; n 8; p<0.001) after treatment for 7 days with the enzyme inducer phenobarbital. No significant correlation was found between glucaric acid excretion and sex, age, body weight or body surface in 50 patients. Glucaric acid excretion, therefore, should not be related to the creatinine content of urine samples, since creatinine excretion decreases with severity of renal insufficiency and varies with sex, age, body weight and many other conditions. A single dose of dipyrone (Novalgin^®), a further in vivo indicator of drug metabolism, increased glucaric acid excretion on the same day, but no interference was found after a single dose of cortisol.     

Association analysis of drug metabolizing enzyme gene polymorphisms in HIV-positive patients with co-trimoxazole hypersensitivity

The use of co-trimoxazole in HIV-positive patients has been associated with a high frequency (40-80%) of hypersensitivity reactions. This has been attributed to the bioactivation of the sulphonamide component, sulphamethoxazole (SMX), to its toxic hydroxylamine and nitroso metabolites. The aim of this study was to determine whether functionally significant polymorphisms in the genes coding for enzymes involved in SMX metabolism influence susceptibility to SMX hypersensitivity. HIV-positive patients with (n = 56) and without (n = 89) SMX hypersensitivity were genotyped for allelic variants in CYP2C9, GSTM1, GSTT1, GSTP1 and NAT2 using polymerase chain reaction (PCR) and/or PCR-restriction fragment length polymorphism analysis. The CYP2C9*2/*3 genotype and CYP2C9*3 allele frequencies were nine- and 2.5-fold higher in the hypersensitive group compared to non-sensitive patients, respectively, although they were not statistically significant when corrected for multiple testing. There were no differences in the frequencies of the GSTM1 and GSTT1 null genotypes, and the slow acetylator genotype, between hypersensitive and non-sensitive patients, while GSTP1 frequency was lower (although non-significant) in the hypersensitive group [21% versus 32%, odds ratio (OR) = 0.5, Pc = 0.24]. Comparison of the genotype frequencies in HIV-positive and -negative patients showed that the NAT2 slow acetylator genotype frequency in the HIV-positive patients (74%) was significantly (Pc = 0.0003, OR = 2.3) higher than in control subjects (56%). Our results show that genetic polymorphisms in drug metabolizing enzymes are unlikely to be major predisposing factors in determining individual susceptibility to co-trimoxazole hypersensitivity in HIV-positive patients.