PAI-1活性和基因多态性与重复性早期流产的相关性研究

目的探讨中国汉族妇女纤溶酶原激活物抑制物（PAI-1）血浆活性水平及其基因4G／5G多态性和重复性早期流产的关系。方法应用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）分析法和发色底物法检测自然流产组和正常对照组妇女PA1-1基因4G／5G多态性及其血浆中活性水平。结果自然流产组4G／4G基因型频率（38．3％）和4G等位基因频率（62．5％）显著高于正常非妊娠组（15．7％和45.1％）和正常妊娠组（16．7％和47.2％），有显著性差异（P〈0．01）；各基因型血浆PA1-1活性由高到低依次为4G／4G纯合子、4G／5G杂合子、5G／5G纯合子，且各基因型间两两比较均有显著性差异（P=0．000-0．041）。结论中国汉族妇女中存在PA1-1基因4G／SG多态性，且与不明原因重复性流产密切相关；各基因型血浆PAI-1活性由高到低依次为4G／4G、4G／5G、5G／5G，且与基因型密切相关；检测PA1-1易栓性突变对重复性早期流产的早期诊断和预防性治疗有一定指导意义。     

中国人CYP1A1和GSTM1基因多态性及其对个体肺癌易感性的联合效应

目的 在中国江苏肺癌患者和对照人群中,检测CYP1A1 Ile/Val,GSTM1 /0遗传多态性的各基因型及其联合基因型的分布,探讨这些基因型与肺癌个体易感性的关系。方法 配对的病例－对照组各106例,静脉血制备DNA。分别应用等位基因特异性（allele-specific,AS)-PCR和多重差别（multidifferential,MD)-PCR,检测CYP1A1 Ile/Val和GSTM1＋／0的等位基因型。结果 CYP1A1少见等位基因Val/Val纯合子及其与GSTM1基因缺失纯合子（0／0）的联合基因个体,与对照常见基因型个体相比,增加了对肺癌的易感性,其相对危险度（odds ratio,OR)分别为4．02（P＝0．03）和9．38（P＝0．04）;GSTM10／0纯合子及其与CYP1A1 Ile/Val杂合子的联合基因型个体,显著增加了肺癌易感性,其OR值分别是1．92（P＝0．019）和3．27（P＝0．01）。结论 中国江苏人群中,少见基因型CYP1A1 Val/Val,GSTM10/0增加了个体肺癌易感性,在肺癌发生中,上述两种易感基因型间存在协同或相乘作用。     

PAI-1基因4G4G基因型与IgA肾病易感性及临床表现的关系

目的探讨PAI-1基因启动子区4G／5G多态性与IgA肾病的发生、进展和临床表现的关系。方法收集IgA肾病患者的临床资料；应用PCR-限制性片段长度多态技术分析296例IgA肾病患者和310名健康人的PAI-1基因4G／5G多态性；分析PAI-1基因4G／5G多态性与IgA肾病的发生与临床表现及病理改变的关系。结果（1）PAI-1基因4G4G，4G5G，5G5G基因型频率在IgA肾病组和正常对照组分别为0．33、0．19、0．48和0．3、0．23、0．47，两组之间差异无统计学意义（X^2=1．63，P〉0．05）；（2）4G4G纯合子基因型频率在病理Lee氏分级Ⅲ级以下组（A组）和Ⅳ～Ⅴ级组（B组）分别为0．39和0．28，（X^20=7．86，P〈0．05）。（3）按基因型分组，4G4G组IgA肾病患者的肌酐清除率明显低于非4G4G组；4G4G组患者的血清甘油三酯水平明显高于5G5G组；4G4G组患者高甘油三酯血症发生率明显高于4G5G组（P〈0．05）。结论PAI-1基因启动子区4G／5G多态性不是IgA肾病发生的易感因素，但可能是IgA肾病病情加重的危险因子。     

CYP2C19基因多态性与苯妥英钠治疗癫痫疗效的关系

目的探讨CYP2C19基因多态性对苯妥英钠治疗癫痫疗效的影响。方法选取2009年1月至2010年6月在本院神经内科住院治疗的癫痫患者150例为研究对象,均口服苯妥英钠进行治疗。利用聚合酶链式反应．限制性片段长度多态性（PCR．RFLP）方法检测CYP2C19基因型,使用高效液相色谱法（HPLC）检测苯妥英钠的血药浓度,探讨苯妥英钠治疗癫痫疗效与CYP2C19基因多态性的关系。结果150例患者中,苯妥英钠治疗有效患者CYP2C19基因型CYP2C19＊2／＊2、CYP2C19＊3／＊3、CYP2C19＊2／＊3分别为44例、7例、1例,苯妥英钠治疗无效患者CYP2C19基因型CYP2C19＊2／＊2、CYP2C19＊3／＊3、CYP2C19＊2／＊3分别为1例、1例、96例,组间比较差异有统计学意义（P〈0．05）。苯妥英钠治疗有效患者中,各基因型患者血药浓度比较差异无统计学意义（P〉0．05）。结论CYP2C19基因多态性与苯妥英钠的疗效有关。     

CYP19A1基因 R264C在中国上海BRCA1/2基因突变阴性的遗传倾向乳腺癌中的作用

目的研究CYP19A1基因R264C的（C→T）单核苷酸多态性基因型在上海地区BRCA1／BR-CA2基因突变阴性的遗传倾向乳腺癌人群中的分布及其与乳腺癌发病风险的相关性。方法对114例无BRCA1／2突变的家族性／早发性乳腺癌患者和121名正常对照者进行CYP19A1基因第7外显子的聚合酶链反应扩增，随后进行DNA直接测序鉴定其R264C的单核苷酸多态性基因型，比较基因型分布和发病风险的关系；危险度比值比（odd ratio，OR）及95％可信区间（confidence interval，CI）应用非条件Logistie回归分析计算。结果CYP19A1基因R264C多态的CC、CT、TT基因型在病例组中的分布频率分别为84（77．8％），22（20．4％），2（1、8％）；在对照组的分布频率分别为87（77．7％），24（21、4％），1（0．9％）；在研究的总人群中，CT基因型的频率为20．9％（46／220），TT基因型的频率为1．4％（3／220）。以CC基因型为参照，CT或TT基因型没有显著性地提高乳腺癌的发病危险，其中携带CT基因型风险为（OR=1．16，95％CI：0．53。2．55），携带TT基因型风险为（OR=1．44，95％CI：0．12-17．15）；经过月经状态和身体质量指数分层，也未能发现其与乳腺癌发病的相关性。结论CYP19A1基因R264C的单核苷酸多态性在中国汉族人群中的分布有别于其他种族，有其自身的分布特点；R264C可能与上海地区中国汉族人群乳腺癌发生的遗传易感性无关，尚不足作为低外显率的乳腺癌易感基因位点，不建议作为未来临床基因筛查的候选指标。     

韩国人CYP450 1A1、CYP450 2E1和GSTM1、GSTT1、GSTP1基因座遗传多态性分析

目的 调查代谢相关的CYP4501A1、CYP4502E1和GSTM1、GSIT1、GSTP1基因座在韩国人群中的遗传多态性分布状况。方法 采用多重聚合酶链式反应、聚合酶链式反应-限制性片段长度多态性技术，分析300名韩国健康大学生的CYP1A1基因3′端限制性内切酶Msp Ⅰ位点、CYP2E1基因5′端转录调节区Pst Ⅰ位点和GSTM1、GSTT1缺失与存在、GSTP1基因第5外显子BsmA Ⅰ位点的基因型，计算基因型和基因频率。结果 CYP1A1基因型频率为ml／ml型39．7％、ml／m2型49．7％、m2／m2型10．7％，基因频率为ml 0．645、m2 0．355。CYP2E1基因型频率为cl／cl型66．7％、cl／c2型30％、c2／c2型3．3％，基因频率为C1 0．818、C2 0．182。GSTM1基因缺失型频率为53．3％。GSTT1基因缺失型频率为54．7％。GSTP1基因型频率为Ile／Ile型62％、Ile／Val型34．3％、VaL／Val型3．7％，基因频率为Ile 0．792、Val 0．208。基因分布符合Hardy-Weirtberg平衡定律。结论 韩国人CYP1A1、CYP2E1、GSTM1、GSTT1基因分布与我国人群较为相近，半数以上人缺乏GSTM1和GSTT1基因，纯合缺失型频率超过印度人的3倍。     

用聚合酶链反应-直接测序分型法研究江苏汉族人群HLA-DQA1和DQB1基因多态性

目的检测江苏地区汉族人群HLA-DQA1和DQB1等位基因及单倍型的频率，分析该人群DQA1、DQB1基因多态性和DQA1-DQB1单倍型特点。方法应用聚合酶链反应-直接测序分型法（PCR-sequence-based typing ，PCR-SBT）方法对100名健康、无血缘关系的江苏汉族人群的HLA-DQA1和DQB1进行基因分型。结果共检出7个DQA1等位基因和13个DQB1等位基因。DQA1等位基因中，DQA1＊0301／02／03的基因频率最高（29．5％），其次为DQA1＊0501（18．5％）、DQA1＊0102（17．0％）、DQA1＊0201（12．5％）；DQB1等位基因中，DQB1＊0201／02（21．5％）、DQB1＊0301／09（14．5％）、DQB1＊0303（13．5％）和DQB1＊0603（11．5％）最为常见。分析得出30种DQA1-DQB1单倍型，DQA1＊0301／02／03-DQB1＊0303（12．5％）、DQA1＊0201．DOB1＊0201／02（10．5％）、DQA1＊0501-DQB1＊0201／02（9．5％）、DQA1＊0501-DQB1＊0301／09（7．0％）为常见的单倍型。结论江苏汉族人群HLA-DQA1和DQB1基因具有较为丰富的多态性，基因频率分布具有中国北方群体的特征且具有一定的独特性。     

造血干细胞移植中HLA—Ⅱ类基因分型影响因素的探讨

目的：为了准确地进行造血干细胞移植供－受体的ＨＬＡ－Ⅱ类配型，对ＨＬＡ－Ⅱ类基因分型实验的影响因素进行了探讨。方法：采用美国莱姆达公司提供的微量ＳＳＰ＾ＴＭＨＬＡ－Ⅱ类ＰＣＲ－ＳＳＰ分型试剂盒对４００例造血干细胞移植供－受体进行基因分型。结果：采用０．５％ＥＤＴＡ抗凝的血标本与肝素抗凝的血标本相比，前者的护增效果好。ＤＮＡ终浓度为２５～２００ｎｇ／ｕｌ，最佳浓度为１００ｎｇ／ｕｌ，Ａ２６０／Ａ２８     

胆固醇7α-羟化酶基因-204A/C多态性与内源性高甘油三酯血症关联的研究

目的探讨成都地区内源性高甘油三酯血症（hypertriglyceridemia，HTG）患者胆固醇7α-羟化酶（cholesterol 7α-hydroxylase，CYP7A1）基因一204A／C多态性与血脂及载脂蛋白的关系。方法应用聚合酶链反应-限制性片段长度多态性技术检测212名正常对照者和132例内源性HTG患者CYP7A1-204A／C基因多态性。酶法测定血清甘油三酯（triglyceride，TG）、总胆固醇（total cholesterol，TC）及高密度脂蛋白胆固醇（high density lipoprotein cholesterol，HDL-C），用本校载脂蛋白研究室研制的RID试剂盒测定血清apoAI、A1I、B100、CH、C111及E。结果CYP7A1—204A／C多态位点等位基因A、C频率在HTG组和正常对照组分别为0．602、0．398和0．601、0．399。等位基因频率和基因型频率分布均符合Hardv—Weinberg平衡定律。CYP7A1—204A／C多态性基因型频率，等位基因A、c频率在HTG组和正常对照组间比较差异无统计学意义（P〉0．05）。HTG组CC、AC基因型患者血清TG和apoCⅢ水平较从基因型患者显著增高（P〈0．05）。血清HDL-C水平在正常对照组中CC、AC基因型者较AA基因型者显著降低（P〈0．05），正常对照组中男性CC、AC基因型者血清TG水平较从基因型者显著增高（P〈0．05）。结论CYP7A1基因-204A／C多态性与HTG无关联，但HTG患者CYP7A1基因-204A／C多态性与血清TG和apoCⅢ水平密切相关。CYP7A1基因-204A／C多态性在正常对照组中与血清HDL-C水平密切相关，在正常男性人群中与血清TG水平增高密切相关。     

中国北方汉族人细胞色素P4501 A1基因MspⅠ多态性的研究

目的　探讨中国北方汉族人细胞色素P(cytochromeP ,CYP) 4 5 0 1A1基因MspⅠ多态性。方法　用聚合酶链反应 限制性片段长度多态性 (PCR RFLP)技术 ,分析了 172名北方汉族正常健康成人CYP1A1基因 3′端限制性内切酶MspⅠ位点的3种基因型 (A、B、C)的分布频率。结果　MspⅠ等位基因m1、m2分别占 6 0 8%、39 2 %。MspⅠ基因型A占 34 9% ,基因型B占 5 1 7% ,基因型C占 13 4 %。结论　本研究结果提示中国北方汉族人解毒酶CYP1A1基因存在MspⅠ多态性。     

Influence of CYP3A5 and ABCB1 gene polymorphisms and other factors on tacrolimus dosing in Caucasian liver and kidney transplant patients

Tacrolimus is a substrate of cytochrome P4503A (CYP3A) enzymes as well as of the drug transporter ABCB1. We have investigated the possible influence of CYP3A5 and ABCB1 single nucleotide polymorphisms (SNPs) and other factors (e.g. albumin, hematocrit and steroids) on tacrolimus blood levels achieved in a population of Caucasian liver (n=51) and kidney (n=50) transplant recipients. At 1, 3 and 6 months after transplantation, tacrolimus doses (mg/kg/day) and trough blood levels (C0) were recorded and the weight-adjusted tacrolimus dosage (mg/kg/day) was calculated. Polymerase chain reaction followed by restriction fragment length polymorphism analysis was used for genotyping CYP3A5*1 and *3 [6986A>G] as well as ABCB1 at exons 21 [2677G>T/A] and 26 [3435C>T] in both liver transplant donors and recipients and in kidney transplant recipients. Of the 152 subjects studied, 84.9% showed a CYP3A5*3/*3 genotype. The total frequency of the allelic variant *3 was 93%. For the G2677T/A and C3435T polymorphisms the total frequencies of the allelic variants T/A and T were 44.7 and 46.7%, respectively. At 1, 3 and 6 months after transplantation the dose-adjusted C0 levels were significantly lower in patients with one copy of the *1 allele compared to those homozygous for the *3 allele. In the case of liver transplant patients the tacrolimus dose requirements were dominantly influenced by the polymorphisms of the CYP3A5 gene in the donors. With regard to the ABCB1 SNPs, in general they did not show any appreciable influence on tacrolimus dosing requirements; however, kidney transplant recipients carrying the 2677T/A allele required significantly higher daily tacrolimus doses than subjects homozygous for the wild-type allele. Identification of CYP3A5 single nucleotide polymorphisms prior to transplantation could contribute to evaluate the appropriate initial dosage of tacrolimus in the patients.     

CYP3A5基因多态性与肾移植后钙调神经蛋白抑制剂慢性肾毒性的相关性

背景：钙调神经蛋白抑制剂是实体器官移植后抗排斥治疗中最重要的一线药物之一,主要通过包括CYP3A5在内的CYP3A亚家族进行代谢。但关于CYP3A5基因多态性与钙调神经蛋白抑制剂慢性肾毒性的相关研究国内外鲜有报道。 目的：观察CYP3A5基因多态性与中国人群中钙调磷酸酶抑制剂慢性肾毒性发生的关系。 方法：分别收集200例肾移植后出现慢性肾毒性的中国人种患者设为肾毒组;200例肾移植至少12个月后没有出现慢性肾毒性的中国人种患者设为对照组,取两组血样和临床数据。采用聚合酶链反应-限制性内切酶片段长度多态性技术分别检测两组的CYP3A5突变位点基因型。通过统计学分析CYP3A5的基因多态性与钙调神经蛋白抑制剂慢性肾毒性之间的关系。 结果与结论：慢性肾毒组中CYP3A5基因型*1/*1+*1/*3(显示CYP3A5活性)和*3/*3(不显示CYP3A5活性)分别占39.5%(79/200)和60.5%(121/200);对照组中CYP3A5基因型*1/*1+*1/*3(显示CYP3A5活性)和*3/*3(不显示CYP3A5活性)分别占28.5%(57/200)和71.5%(143/200)。两组间差异有显著性意义(χ²=9.000,P < 0.05,OR=1.638,95%CI=1.078-2.488)。通过Logistic回归分析CYP3A5*1/*1和CYP3A5*1/*3是显著的引起CNI慢性肾毒性的危险因素(P < 0.05,OR=1.638,95%CI=1.078~2.488)。提示,CYP3A5的基因多态性可能增加肾移植患者慢性肾毒性的遗传易感性;参与钙调神经蛋白抑制剂慢性肾毒性疾病的发生。     

Factors affecting the long-term response to tacrolimus in renal transplant patients: Pharmacokinetic and pharmacogenetic approach

Background: The aim of our study was to determine the impact of CYP3A5*1 and CYP3A5*3 on the kinetics of tacrolimus in renal transplant recipients.Material and methods: Forty kidney recipients were selected to participate. Maintenance scheme consisted of tacrolimus, a purine inhibitor and a steroid. CYP3A5 genotyping was performed with PCR and RFLP. Pharmacokinetic model was developed with Linear Regression and General Linear Model repeated measures approach. The impact of sex, CYP3A5*1 allele, age at transplantation, hepatic and renal function on tacrolimus kinetics was examined.Results: The frequency of CYP3A5*3/*3 and CYP3A5*1/*3 genotype was 35/40 and 5/40, respectively. No CYP3A5*1/*1 was detected. CYP3A5*1 variant was associated with significant lower TAC dose adjusted concentration at 3, 6, 12 and 36 months after transplantation. Hepatic and renal function showed a significant effect on tacrolimus dose adjusted concentration 3 months after transplantation (p=0.000 and 0.028, respectively). Sex did not show a significant impact on tacrolimus kinetics. Carriers of CYP3A5*1 allele had lower predicted measures for tacrolimus dose adjusted concentration and higher predicted measures for volume of distribution.Conclusion: We proved that CYP3A5*1 carriers need higher tacrolimus dose than CYP3A5*3 homozygotes to achieve the target blood concentration.     

肾移植受者CYP3A5基因多态性对他克莫司血药浓度及疗效的影响*

背景：关于欧美人群中CYP3A5基因与他克莫司血药浓度之间关系已有报道,然而这些研究的数据多来自于移植后1个   月~1年,缺乏移植后早期的资料。 目的：探讨CYP3A 基因多态性与肾移植受者他克莫司血药浓度的关系,分析CYP3A5基因型对肾移植后排斥反应和毒性及不良反应的影响。 方法：按CYP3A5基因多态性将45例采用他克莫司+霉酚酸酯+泼尼松三联免疫抑制方案的肾移植患者分为*1/*1型组(11例)、*1/*3型组(15例)和*3/*3型组(19例),他克莫司初始剂量均为0.15 mg/(kg•d),1周后根据目标浓度调整他克莫司剂量。 结果与结论：术后7 d,1个月,3个月* 3/* 3型组他克莫司血药浓度/剂量比显著高于* 1/*3型组和*1/*1型组(P < 0.05) ;3个月内*1/*1型组急性排斥反应的比例显著高于*1/*3型组和*3/*3型组(P < 0.05)。3个月内*3/*3型组高血糖、神经及肾毒性等不良反应显著高于*1/*1型组。结果可见*1/*1基因型患者在肾移植早期难以达到有效目标血药浓度,使该组3个月内的急性排斥反应发生率明显升高,不合适采用目前他克莫司的初始剂量方案作为早期的抗排斥反应方案;*3/*3基因型患者他克莫司血药浓度明显升高,使3个月内毒性及不良反应发生率也明显升高。因此,根据CYP3A5 基因多态性作为他克莫司个体化用药的依据,既能使* 1 /* 1型患者早期急性排斥反应的发生率下降,又能使* 3 /*3型患者的药物不良反应减少,提高肾移植的临床效果。      

湖北地区房颤患者VKORC1、CYP2C9基因多态性及其对华法林用量的影响

目的:检测房颤患者维生素K环氧化物还原酶复合物1基因(VKORC1)和细胞色素P450酶2C9基因(CYP2C9)多态性及其对临床使用华法林用量的影响。方法:选择口服华法林抗凝治疗的房颤患者94例,采用PCR扩增和DNA直接测序技术检测患者VKORC1和CYP2C9基因型,同时记录不同基因型患者华法林日用量,比较不同基因型房颤患者华法林日用量的统计学差异。结果:94例房颤患者检出VKORC1 AA型84例,VKORC1AG型10例,CYP2C9*1/*1型88例,CYP2C9*1/*3型6例。不同VKORC1、CYP2C9基因型房颤患者华法林用量不同,VKORC1AA型并CYP2C9*1/*1型和VKORC1AG型并CYP2C9*1/*1型患者华法林日用量均高于VKORC1AA型并CYP2C9*1/*3型患者,VKORC1AA型并CYP2C9*1/*1型患者华法林用量又高于VKORC1AG型并CYP2C9*1/*1型患者。结论:湖北地区房颤患者基因型主要为VKORC1AA型与CYP2C9*1/*1型,少量VKORC1AG型与CYP2C9*1/*3型。VKORC1、CYP2C9基因型是华法林用量的重要影响因素。     

The effect of CYP2C9, VKORC1 genotypes and old age on warfarin pharmacologic sensitivity in korean patients with thromboembolic disease

The therapeutic dose of warfarin is dependent upon intrinsic patient characteristics that are highly variable. We assessed the effects of CYP2C9, VKORC1 1173 C/T polymorphisms, and old age on warfarin dosing and sensitivity by measuring plasma S-/R-warfarin levels in Korean patients. INR and the plasma S-/R-warfarin concentrations were determined in 58 patients who had the VKORC1 1173C/T CYP2C9 genotypes, were on a long-term anticoagulation regimen with warfarin, and took a daily dose of warfarin. The pharmacokinetic sensitivity of warfarin was significantly higher in the CYP2C9 *1/*3 genotypes than in the CYP2C9 *1/*1 genotypes [ratio of S-warfarin concentration/dose, 0.53 vs. 0.21; p=0.01]. Pharmacodynamic sensitivity in older patients (≥ 75 years) with the CYP2C9 *1/*1 and VKORC1 1173 TT genotypes was significantly higher as compared to younger patients (<75 years) [Ratio of INR/S-warfarin concentration, 4.88 vs. 3.41; p = 0.026]. The CYP2C9*3 allele and old age (≥ 75 years) with the VKORC1 1173 T allele were also associated with increased risk of over-anticoagulation. The increase of over-anticoagulation risk and warfarin sensitivity is related to the CYP2C9*3 allele and old age with the VKORC1 1173 T allele in Korean patients with thromboembolic disease. These findings suggest that a lower initial and maintenance dose should be considered for the patients with CYP2C9 *3 allele and advanced age in this patient population. However, due to the limited number of patients in the study population, our finding needs to be confirmed by a larger, well-controlled study.     

等位基因特异荧光PCR法检测CYP2C19基因型

目的了解人群CYP2C19基因型的分布,评价等位基因特异荧光PCR法检测CYP2C19基因型。方法等位基因特异荧光PCR法和金标准Sanger DNA直接测序法检测356名供者外周血CYP2C19基因型,实验采用同步盲法。结果 CYP2C19*1/*1型、CYP2C19*1/*2型、CYP2C19*2/*3型、CYP2C19*3/*3型、CYP2C19*2/*2型及CYP2C19*1/*3型的频率分布:使用PCR荧光法检测时分别为46.6%(166/356)、33.2%(118/356)、2.0%(7/356)、0.8%(3/356)、10.7%(38/356)及6.7%(24/356);采用DNA测序法时分别为46.3%(165/356)、33.4%(119/356)、2.0%(7/356)、0.8%(3/356)、11.0%(39/356)及6.5%(23/356)。两种方法检测CYP2C19基因型具有一致性(P=0.392),且一致性较好(Kappa=0.987);两种方法基因型检测结果一致率为99.2%。结论为保障医疗安全,临床需开展CYP2C19基因型检测;等位基因特异荧光PCR法检测CYP2C19基因型简便可靠。     

A study on the genetic polymorphisms of CYP3A5 among the Orang Asli in Malaysia using a next generation sequencing platform

Background: CYP3A5 is the predominant sub-family of biotransformation enzymes in the liver and the genetic variations in CYP3A5 are an important determinant of inter-individual and inter-ethnic differences in CYP3A-mediated drug disposition and response.

Aim: This study aims to investigate the genetic polymorphisms of CYP3A5 among the Orang Asli in Peninsular Malaysia using a next generation sequencing platform.

Methods: Genomic DNAs were extracted from blood samples of the three main Orang Asli tribes and whole-genome sequencing was performed.

Results: A total of 61 single nucleotide polymorphisms were identified and all the SNPs were located in introns except rs15524, which is in the 3’UTR, and 11 of these polymorphisms were novel. Two allelic variants and three genotypes were identified in the Orang Asli. The major allelic variant was the non-functional CYP3A5*3 (66.4%). The percentages of Orang Asli with CYP3A5*3/*3 (47.2%) and CYP3A5*1/*3 (38.1%) genotypes are more than twice the percentage of Orang Asli with CYP3A5*1/*1 (14.8%) genotype. Almost half of the Orang Asli harboured CYP3A5 non-expressor genotype (CYP3A5*3/*3).

Conclusions: The predominance of the CYP3A5 non-expressor genotype among the Orang Asli was unravelled and the findings in this study may serve as a guide for the optimisation of pharmacotherapy for the Orang Asli community.     

山东人群华法林稳定剂量预测模型的准确性验证

目的比较5种华法林稳定剂量预测模型以及经验给药方式(2.5 mg/day)对山东人群预测的准确性。方法招募正在或曾经服用华法林并已达到稳定剂量的患者,检测重要的华法林药物代谢基因的型别,收集患者的临床信息,采用预测百分比及绝对误差均值法评价各模型预测的准确性。结果在入组的125例患者中,CYP2C9*1/*1、CYP2C9*1/*3和CYP2C9*1/*2基因型分别占92.00%、7.20%和0.80%。VKORC1-1639 AA、AG、GG基因型分别占82.40%、15.20%、2.40%;CYP4F2*1/*1、*1/*3,*3/*3基因型分别占50.40%、39.20%、10.40%。在其他位点型别固定的情况下,CYP2C9*1/*3和CYP2C9*1/*2基因型个体与CYP2C9*1/*1相比华法林剂量明显降低。VKORC1-1639 AG型与AA型相比华法林稳定剂量增加45%~50%(P<0.05)。CYP4F2*1/*3与CYP4F2*1/*1基因型个体相比,华法林稳定剂量增加约5.9%(P=0.02);CYP4F2*3/*3与CYP4F2*1/*1基因型个体相比华法林剂量增加约13.0%(P=0.129)。预测效果较好的模型包括IWPC(59.20%)、Huang(57.60%)、Ohno(52.80%),绝对误差均值分别为0.35(95%CI:0.11~0.49)、0.15(95%CI:0.10~0.32)、0.39(95%CI:0.12~0.51)。结论CYP2C9、VKORC1、CYP4F2等3个基因的多态性对山东人群的华法林稳定剂量存在影响。IWPC模型更适用于山东人群。     

Detection and identification of cytochrome P-450 2C9 alleles *1, *2, and *3 by high-resolution melting curve analysis of PCR amplicons

High-resolution melting curve analysis using a fluorescent DNA binding dye can detect sequence variations in a closed-tube system without labeled primers or probes. We developed and verified a melting analysis assay for common single nucleotide polymorphisms of cytochrome P-450 (CYP) 2C9 that affect warfarin metabolism. We used this method to genotype 84 patients receiving warfarin. For wild-type, *1/*1, 50% fluorescence corresponded to a mean+/-SD of 87.17+/-0.05 degrees C, whereas *2/*2 was 0.4 degrees C lower. The *1/*2 melting curve was easily distinguished from *1/*1 and *2/*2 based on transition temperature and shape. Exon 7 showed a more complex melting curve; however, genotypes *1/*1, *1/*3, and *3/*3 were easily distinguishable. Melting curves were highly reproducible (SD of temperature for multiple fluorescence values 0.04 degrees C-0.11 degrees C; mean, 0.06 degrees C). Heterozygotes (*1/*2 or *1/*3) required significantly lower mean maintenance warfarin doses compared with wild-type (30.67 and 29.56 vs 42.81 mg/wk; P<.05). High-resolution melting analysis provides a simple and accurate method for genotyping of CYP2C9.