VKORC1-1639 G/A、CYP2C93*基因多态性对华法林使用剂量的影响

目的 基于VKORC1-1639 G/A及CYP2C93^*的基因多态性初步探讨华法林的使用剂量。方法 收集2016年10月-2018年2月进行华法林用药指导相关基因检测的100例患者,记录患者基本信息（身高、体质量等）。采用数字荧光分子杂交检测VKORC1-1639 G/A,CYP2C93^*的基因型分布,并结合患者年龄、身高、体质量等,根据国际华法林药物基因组学联合会（IWPC）公式计算患者华法林理论剂量。结果 VKORC1-1639 G/A AA、AG、GG基因型实际频率分别为84%,15%,1%;等位基因A,G频率分别为91.5%,8.5%。CYP2C9 3^* AA型、AC型、CC型实际频数分别为91%,9%,0%;等位基因A,C频率分别为95.5%,4.5%。不同VKORC1-1639 G/A、CYP2C93^*基因型华法林理论用量不同,VKORC1-1639 G/A AA型并CYP2C93^* AA型和VKORC1-1639 G/A AG型并CYP2C93^* AA型患者华法林剂量均高于VKORC1-1639 G/A AA型并CYP2C93^* AC型患者;VKORC1-1639 G/A AG型并CYP2C93^* AA型患者华法林用量高于VKORC1-1639 G/A AA型并CYP2C93^* AA型患者,3组间两两比较,差异有统计学意义（P<0.05）。结论 华法林代谢相关基因的基因多态性为VKORC1-1639 G/A AA及CYP2C93^* AA型占多数,表明VKORC1-1639 G/A基因突变率高,CYP2C93^*基因突变率较低,且两者多态性影响个体间华法林的理论剂量。     

VKORC1-3673G>A、CYP2C9*3、CYP4F2 rs2108622和CYP2C19*2基因多态性对中国汉族房颤患者华法林维持剂量的影响

目的 探讨VKORC1-3673G>A、CYP2C9^*3、CYP4F2 rs2108622和CYP2C19^*2位点基因多态性对中国汉族房颤患者华法林维持剂量的影响。方法 收集107例服用华法林达维持剂量的汉族房颤患者的血样和临床相关资料,应用PCR-RFLP法检测VKORC1-3673G>A、CYP2C9^*3、CYP4F2 rs2108622和CYP2C19^*2基因型,采用独立样本t检验分析基因型与华法林维持剂量的相关性。多元线性回归建立给药模型,探讨基因多态性对华法林维持剂量的影响。结果 VKORC1-3673G>A、CYP2C9^*3、CYP4F2 rs2108622基因多态性和患者年龄、体质量能解释45.2%的华法林维持剂量差异。CYP2C19^*2基因多态性对本研究人群华法林维持剂量无影响。结论 VKORC1-3673G>A、CYP2C9^*3、CYP4F2 rs2108622基因多态性显著影响中国汉族房颤患者的华法林维持剂量。     

NUDT15c.415C>T和TPMT*3C基因多态性检测方法的比较与临床应用

目的 建立准确、快速、经济的方法,检测NUDT15 c.415C>T和TPMT*3C基因多态性,探讨临床应用价值。方法 收集2017年5月-2018年5月期间福建汉族患者服用硫唑嘌呤2周以上的血清样本,提取DNA或白细胞后分别采用PCR-RFLP法、PCR-Sanger测序法和荧光定量PCR法对NUDT15 c.415C>T和TPMT*3C进行基因多态性分型,比较这3种方法的准确性、简便性及经济性。根据白细胞值分组,结合临床资料,探讨基因多态性等因素与硫唑嘌呤致白细胞减少的相关性。结果 共纳入129例患者,其中硫唑嘌呤致白细胞减少15例（11.6%）。3种方法的基因多态性检测结果一致,TPMT*3C未发现突变纯合子。携带NUDT15c.415C>T突变等位基因者服用硫唑嘌呤致白细胞减少的风险高于携带野生等位基因者（OR=6.2,95%CI：2.5~15.4,P=0.000 054）,而携带TPMT*3C突变等位基因者与野生等位基因者出现白细胞减少比例并无显著性差异（P=0.393）。NUDT15c.415C>T基因多态性预测白细胞减少敏感度为53.3%,特异度为85.1%,ROC曲线AUC为0.69。结论 3种方法都可用于临床检测NUDT15 c.415C>T和TPMT*3C基因多态性。PCR-RFLP法不需要专用试剂盒,也不需要昂贵的仪器设备,成本较低,过程简单,易于操作,特别适合条件有限的单位开展工作。福建汉族患者在服用硫唑嘌呤前进行NUDT15c.415C>T基因多态性检测比TPMT*3C更具临床价值。     

异基因造血干细胞移植患者体内环孢素A和伏立康唑的相互作用

目的 分析异基因造血干细胞移植（Allo-HSCT）患者,静脉滴注伏立康唑（VRZ）与环孢素A（CsA）后的药物相互作用（DDI）,为临床精准药物治疗提供依据。方法 进行一项患者自身对照研究,根据纳入排除标准,收集2019年1月—12月在某院进行Allo-HSCT的患者,采用LC-MS/MS法测定术前CsA给药后3～5 d的血药浓度2次,测定术后VRZ给药5～7 d后,CsA和VRZ同一时间的血药浓度2次,分别求其给药前后CsA、VRZ血药浓度的平均值。使用SPSS 20.0对VRZ给药前后CsA标准化血药浓度（C/D）的差异及VRZ血药浓度对CsA的C/D变化进行统计分析。结果 共纳入Allo-HSCT患者15例,用Wilcoxon符号秩和检验比较给药VRZ前后,CsA的C/D中位数变化,有显著性差异（P<0.001）。对VRZ血药浓度与CsA的C/D比值增幅进行Spearman相关性分析,两者无显著相关性（ρ=?0.273,P=0.32）。结论 CsA与VRZ之间存在明显的药物相互作用（DDI）,VRZ使CsA血药浓度显著升高,但VRZ与CsA之间的DDI程度大小与VRZ血药浓度无关,可能与患者个体差异有关。     

超薄瓷贴面修复牙体的美学效果观察

目的 观察超薄瓷贴面修复牙体前后颜色的匹配效果。方法 选取2018年8~12月在安徽医科大学第二附属医院口腔科拟行超薄瓷贴面修复牙体的患者20例，共51颗患牙，采用口腔扫描仪采集光学印模联合电子比色仪比色数据制作超薄瓷贴面，通过电子比色仪对患牙、预备后基牙、超薄瓷贴面、试戴（未粘接、未使用试戴糊剂）的瓷贴面修复体及粘接后的复合体进行测色，比较粘接前后超薄瓷贴面唇面的明度值（L^*）、红绿色品值（a^*）和黄蓝色品值（b^*）的变化以及色差值。结果 与粘接前试戴的超薄瓷贴面比较，粘接后的超薄瓷贴面复合体色差均值为（2.70±1.27）NBS，L^*值降低，但差异无统计学意义（P>0.05）；a^*b^*值升高，差异均有统计学意义（P<0.05）；粘接后的超薄瓷贴面复合体与基牙期望色比较，色差均值为（2.07±0.91）NBS，L^*a^*b^*值均降低，a^*值差异无统计学意义（P>0.05），L^*b^*值差异均有统计学意义（P<0.05）；加工厂制作的超薄瓷贴面，其L^*a^*b^*值均低于基牙期望色，a^*值差异无统计学意义（P>0.05），L^*b^*值差异均有统计学意义（P<0.05）。结论 超薄瓷贴面可恢复天然牙颜色及牙体缺陷，粘接后修复体颜色与期望色匹配，色差在患者可接受范围内。     

肇庆地区人群华法林相关基因CYP2C9*3和VKORC1的多态性分布研究及指导价值

目的 探讨广东省肇庆地区人群华法林相关基因细胞色素P450复合物亚基2C9（CYP2C9）和维生素K环氧还原酶复合物亚基1（VKORC1）多态性分布,并比较性别和中国西双版纳傣族、北京汉族、南方汉族间差异性的分布,为临床医生精准使用华法林进行抗凝治疗提供理论基础。方法 选取2019年5月-2022年1月于肇庆市第一人民医院进行华法林相关基因检测的患者122例,所有患者均采用数字荧光分子杂交技术对CY92C9^*3和VKORC1进行基因多态性检测,比较患者性别间和中国西双版纳傣族、北京地区汉族、南方地区汉族间的基因多态性分布情况,并对比基于药物基因组学指导下的华法林使用剂量与常规剂量使用华法林治疗后2~3 d后国际标准化比值（INR）达标率。结果 122例检测样本中,CY92C9^*3基因位点AA、AC、CC基因型所占的比例分别为95.90%、4.10%、0,C等位基因和T等位基因频率分别为97.95%和2.05%;VKORC1基因位点GG、GA、AA基因型分别为0.82%、19.67%、79.51%,A等位基因和C等位基因频率分别为10.66%和89.34%。不同性别间CY92C9^*3与VKORC1的基因型分布和等位基因分布差异均无统计学意义（P>0.05）。通过已有的数据库进行对比,肇庆地区的CY92C9^*3基因型、等位基因与1000 Genomes Project （1000 GP）西双版纳傣族、北京汉族与南方汉族对比无统计学差异（P>0.05）;但与1000 GP北京汉族对比,VKORC1的基因型和等位基因频率有统计学差异（P<0.05）;与1000GP西双版纳傣族对比,VKORC1的等位基因频率有统计学差异（P<0.05）;华法林在基因组学指导下的剂量与常规剂量治疗后INR达标率差异有统计学意义（P<0.01）。结论 肇庆地区人群存在CY92C9^*3和VKORC1基因多态性,其中VKORC1基因可能存在地域的差异,进行华法林相关基因检测可以为临床制定个体化华法林抗凝方案提供重要的参考价值。     

类风湿关节炎中miR-146a多态性与临床表现及血清中肿瘤坏死因子α水平之间的相关性

目的 探讨类风湿关节炎（rheumatoid arthritis,RA）中miR-146a上rs2910164位点单核苷酸多态性（SNP）与患者临床表现及血清中肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）表达水平之间的相关性。方法 以高分辨率熔解（high-resolution melting,HRM）法对126例RA患者进行miR-146a上rs2910164位点的SNP分型,并分析其与RA患者病情活动性、临床表现及患者血清中TNF-α表达水平之间是否有关。结果 RA患者中miR-146a上rs2910164位点G等位基因频率为30.6%,C等位基因频率为69.4%,G/G型纯合子患者的比例为12.7%,C/C型纯合子患者的比例为51.6%,G/C型杂合子患者的比例为35.7%。未发现miR-146a上rs2910164位点的不同基因型组之间的病情活动性有显著差异,但具有G/C基因型的RA患者出现关节外表现的比例显著增高（P<0.05）,具有G/C基因型的RA患者血清中细胞因子TNF-α表达水平显著高于具有G/G基因型[（5.41±0.69）vs（3.63±0.37）,P<0.05]和C/C基因型[（5.41±0.69）vs（3.27±0.82）,P<0.05]的RA患者。结论 miR-146a上rs2910164位点SNP与RA病情活动性无明显相关性,但G/C基因型与RA特定的临床表现及血清中TNF-α表达水平有关,提示miR-146a可能在RA发病中可能具有一定的作用。     

川芎嗪对大鼠灌服环孢素A药代动力学的影响

目的研究中药成分川芎嗪(TMP)对大鼠灌服环孢素A(CsA)药代动力学的影响。方法40只雄性SD大鼠按体重进行随机区组设计，分为4组。试验d 1，每只大鼠灌服CsA(10 mg·kg^-1)后，于0，1，2，3,4，6，8，12，24，36和48 h从尾静脉处采血0.2～0.25 mL。然后各组大鼠从试验的d 4到d 8进行不同的预处理，即每日分别灌服蒸馏水、维拉帕米(Ver)、低剂量和高剂量的TMP。d 9时各组大鼠单次合用CsA(10 mg·kg^-1)和上述的各种化合物后，按d 1的时间点采样。用HPLC法测定全血中CsA的浓度，计算其主要药代动力学参数并进行统计学分析。结果合用蒸馏水组的CsA药代动力学参数前后无显著性差异；Ver预处理并合用后，CsA的AUC^{0-48 h}和C_max均显著增加(P<0.01和P<0.05)，T^1/2β显著延长(P<0.05)，CL显著降低(P<0.05)，而T_max和V的变化无统计学差异。低剂量TMP预处理并合用后，CsA的AUC^{0-48 h}和C_max有增加的趋势，但无统计学差异，其余药代动力学参数的变化也无统计学的差异。高剂量TMP预处理并合用后，CsA的AUC^{0-48 h}和C_max均有显著的增加(P<0.01)，但其他药代动力学参数的变化无统计学差异。结论高剂量的TMP能显著提高CsA的灌服生物利用度，但对CsA的体内消除过程几乎没有影响。     

疾病以及配伍对人参皂苷在大鼠体内的药动学影响

目的 建立SD大鼠血浆中人参皂苷Rb1、Rb2和Rg1的HPLC分析方法,对比分析配伍白术挥发油前后,人参皂苷在慢性萎缩性胃炎模型大鼠体内药动学特征。方法 SD大鼠分为4组,其中单用正常组和单用模型组均给药人参总皂苷292 mg·kg^-1,配伍正常组和配伍模型组均给药人参总皂苷292 mg·kg^-1和白术挥发油0.1 mL·kg^-1。于给药前和给药后不同时间点进行眼眶取血,采用HPLC测定各成分的血药浓度,并采用Winnolin 6.3软件计算其药动学参数。结果 与单用正常大鼠比较,单用模型组大鼠体内人参皂苷Rb1的C_max和AUC值降低,T_max、T_1/2以及MRT增加,人参皂苷Rb2和Rg1则呈现出AUC增加的变化;而配伍正常组大鼠体内人参皂苷Rb1、Rb2和Rg1的C_max和AUC值均增加,T_max、T_1/2以及MRT值均缩短。与单用模型组大鼠比较,配伍模型组大鼠体内人参皂苷Rb1和Rg1的C_max和AUC值均增加,T_max、T_1/2以及MRT值均降低。结论 在相同给药剂量下,疾病状态机体对人参皂苷的吸收和代谢呈现缓慢趋势,而配伍后能促进皂苷成分在体内的吸收,同时加快代谢消除,为人参的临床用药提供参考依据。     

非线性混合效应模型法计算1型糖尿病大鼠环孢素药代动力学参数

目的 研究糖尿病对环孢素(Ciclosporin, CsA)体内药物代谢动力学的影响。方法 大鼠腹腔注射65 mg·kg^-1链脲菌素(STZ)建立1型糖尿病大鼠模型。造模5周后通过荧光偏振免疫分析(FPIA)法检测大鼠灌胃环孢素(10 mg·kg^-1)后全血中的环孢素浓度,采用非线性混合效应法(Nonlinear mixed effect model, NONMEM)建立药物代谢动力学模型,贝叶斯(Bayes)反馈法获取个体参数并比较。结果 STZ注射1周后,大鼠空腹血糖超过11.1 mmol·L^-1,确认1型糖尿病大鼠造模成功。造模5周后,糖尿病大鼠的血糖显著增高。给药后,环孢素在大鼠体内呈现一房室模型,群体典型值及个体间差异(Between Subject Variability, BSV)分别为：CL/F=0.525 L·h^-1, BSV=32.1%;V/F=5.18 L, BSV=35.6%; Ka=1.82,BSV= 71.1%。正常组与糖尿病组大鼠CL/F无显著性差异(P>0.05);V/F无显著性差异(P>0.05);Ka有显著性差异(P<0.05) 。结论 1型糖尿病大鼠灌胃环孢素的吸收速率常数显著改变,且存在较大的个体间差异,提示糖尿病状态下会影响环孢素的吸收。     

5-HTR2A 102T>C基因多态性与抗精神病药物疗效的Meta-分析

目的 系统评价5-HTR2A 102T>C基因多态性与抗精神病药物疗效的相关性。方法 计算机检索Web of Science、PubMed、中国学术期刊全文数据库（CNKI）、万方数据库、维普数据库中研究5-HTR2A 102T>C基因多态性与抗精神病药物疗效的研究,检索年限从建库至2017年5月2日。按纳入与排除标准筛选文献、提取资料并评价纳入研究的方法学质量后,采用Stata 12.0软件进行Meta分析。结果 共纳入10项研究,Meta-分析结果表明,5-HTR2A 102T>C基因多态性与抗精神病药物疗效在等位基因模型、共显性基因模型、显性基因模型中均无统计学意义（P>0.05）：等位基因模型OR=1.16,95% CI（1.00~1.36）;共显性基因（TT vs CC）模型OR=1.23,95% CI（0.91~1.65）;共显性基因（TT vs TC）模型OR=0.90,95% CI（0.68~1.19）;显性基因模型OR=1.04,95% CI（0.80~1.34）;而隐性基因模型和超显性基因模型具有统计学意义（P<0.05）：隐性基因模型OR=1.37,95% CI（1.09~1.72）;超显性基因模型OR=0.78,95% CI（0.62~0.96）。结论 5-HTR2A 102T>C基因多态性与抗精神病药物疗效有关联性。     

Association of CYP3A polymorphisms with the pharmacokinetics of cyclosporine A in early post-renal transplant recipients in China

Aim:

To evaluate retrospectively the association of cytochrome P450 3A (CYP3A) and ATP-binding cassette sub-family B member 1 (ABCB1) gene polymorphisms with the pharmacokinetics of cyclosporine A (CsA) in Chinese renal transplant patients.

Methods:

One hundred and twenty-six renal transplant patients were recruited. Blood samples were collected, and corresponding clinical indices were recorded on the seventh day after the procedure. The patients were genotyped for CYP3A4*1G, CYP3A5*3C, ABCB1 1236 C>T, ABCB1 2677 G>T/A, and ABCB1 3435 C>T polymorphisms. Whole blood trough concentrations of CsA at time zero (C₀) were measured before the drug administration. A multiple regression model was developed to analyze the effects of genetic factors on the CsA dose-adjusted C₀ (C₀/dose) based on several clinical indices.

Results:

The CYP3A5*3C polymorphism influenced the C₀ and C₀/dose of CsA, which were significantly higher in patients with the GG genotype than in patients with the AA or GA genotypes. No significant differences were detected for other SNPs (CYP3A4*1G, ABCB1 1236 C>T, ABCB1 2677 G>T/A, and ABCB1 3435 C>T). In a univariate analysis using Pearson''s correlation test, age, hemoglobin, blood urea nitrogen and blood creatinine levels were significantly correlated with the log-transformed CsA C₀/dose. In the multiple regression model, CYP3A5*3C, age, hemoglobin and blood creatinine level were associated with the log-transformed CsA C₀/dose.

Conclusion:

CYP3A5*3C correlates with the C₀/dose of CsA on the seventh day after renal transplantation. The allele is a putative indicator for the optimal CsA dosage in the early phase of renal transplantation in the Chinese population.     

Association of MDR1, CYP3A4*18B, and CYP3A5*3 polymorphisms with cyclosporine pharmacokinetics in Chinese renal transplant recipients

Objective  The objective of this study was to retrospectively evaluate the effects of MDR1, CYP3A4*18B, and CYP3A5*3 genetic polymorphisms on cyclosporine A (CsA) pharmacokinetics in Chinese renal transplant patients during the first month after transplantation. Methods  A total of 103 renal transplant recipients receiving CsA were genotyped for MDR1 (C1236T, G2677T/A, and C3435T), CYP3A4*18B, and CYP3A5*3. The predose and 2-h postdose concentrations of CsA (C₀ and C₂, respectively) were determined by fluorescence polarization immunoassay, and their relationships with corresponding genotypes and haplotypes were investigated. Results  Patients with a CYP3A4*1/*1 genotype were found to have a higher dose-adjusted concentration compared with those with CYP3A4*18B/*18B, as follows: for C₂, 19.3% (P = 0.008) during days 8-15, 35.2% (P = 0.008) during days 16–30, and for C₀, 39.7% (P = 0.012) during days 16–30. The dose-adjusted C₀ was higher in patients with MDR1 1236CC compared with those with 1236TT in the first month postoperation. The dose-adjusted C₀ in patients with the CYP3A5*3/*3 genotype was 25.5% and 30.7% higher than those with the wild-type genotype during days 8–15 (P = 0.011) and days 16–30 (P = 0.015), respectively. Haplotype analysis revealed that the dose-adjusted C₀ was higher in the first month following surgery in carriers of haplotype MDR1 CAC than in noncarriers. Polymorphisms of MDR1 and CYP3A5*3 did not affect dose-adjusted C_2. Conclusion  The data suggests that the CYP3A4*18B genotype affects CsA pharmacokinetics during the first month following surgery in Chinese renal transplant recipients. Patients with CYP3A4*18B alleles may require higher doses of CsA to reach the target levels. Large prospective studies may be needed to further explore the impact of MDR1 and CYP3A5*3 polymorphisms on CsA pharmacokinetics in renal transplant recipients.     

Influence of the MDR1 haplotype and CYP3A5 genotypes on cyclosporine blood level in Chinese renal transplant recipients

1. The purpose of the study was to elucidate the influence of multidrug resistance gene (MDR1) haplotype and CYP3A5 genotype on cyclosporine (CsA) blood level in Chinese renal transplant recipients.

2. CsA trough level (C₀) and peak level (C₂) of 115 patients 1 week and 1 month after renal transplantation were determined. MDR1 C1236T, G2677T/A, C3435T and CYP3A5*3 genotypes were determined by polymerase chain reaction (PCR) assays based on amplification refractory mutation.

3. Dose-adjusted C₀ (C₀/D), C₂ (C₂/D) were 50.5?±?22.5, 267.8?±?110.1 ng·kg·(ml·mg)^?1 after 1 week of therapy, and 79.3?±?29.4, 406.0?±?135.3 ng·kg·(ml·mg)^?1 after 1 month of therapy. Frequencies of MDR1 haplotype TTT, CGC, and TGC were 27.0%, 25.2% and 20.0%, respectively. After 1 month of therapy, C₂/D of TTT/TTT patients were 30% (p = 0.057) and 53% (p = 0.003) higher than CGC/TTT and CGC/CGC patients. C₀/D of CYP3A5 *1/*1, *1/*3 and *3/*3 patients after 1 month of therapy were 51.8?±?25.0, 71.5?±?27.6, and 86.7?±?28.6 ng·kg·(ml·mg)^?1 (p < 0.05).

4. MDR1 haplotypes and CYP3A5*3 genotypes can be related to C₂ and C₀ of CsA, respectively.

     

<Emphasis Type="Italic">TPMT</Emphasis> but not <Emphasis Type="Italic">ITPA</Emphasis> gene polymorphism influences the risk of azathioprine intolerance in renal transplant recipients

Purpose  Thiopurine drugs have to be withdrawn in 10–30% of cases due to side effects, and it has been presented that genetic factors may be responsible for some of reported toxicity cases. Among polymorphic enzymes of thiopurines’ metabolic pathway, thiopurine S-methyltransferase (TPMT) has been studied most extensively, and some recent studies point to inosine triphosphate pyrophosphohydrolase (ITPA) polymorphism as an additional toxicity risk factor. Methods  The aim of the current study was to evaluate an association between TPMT and ITPA gene polymorphisms and drug intolerance in a cohort of 157 renal transplant recipients treated with azathioprine (AZA). Each subject was genotyped for the presence of variant TPMT (*2, *3A, *3B, and *3C) and ITPA (94C>A and IVS2+21A>C) alleles. Results  Mean AZA dose, mean white-blood-cell count, and platelet count in the course of treatment were lower in carriers of variant TPMT alleles compared to patients with TPMT wild-type genotype. Leukocyte numbers fell below 4.0 × 10⁹/L in 41.2% of TPMT heterozygous renal transplant recipients, compared to only 18.0% of wild-type patients (P < 0.01). In contrast, ITPA genotype did not influence AZA dose, hematological parameters, or leucopenia risk. Conclusions  Our results suggest that routine genotyping of renal transplant recipients for TPMT variants may be useful in reducing the risk of AZA-related myelotoxicity, but there is not enough evidence to introduce ITPA testing into clinical practice.     

Role of cytochrome P4502D6 in the metabolism of brofaromine

Summary The intraindividual variability and circadian variation of oral cyclosporine (CsA) pharmacokinetics were studied over 24 h in 18 renal transplant recipients at steady state, and in 10 of the patients during a second 24 h period.The absolute percentage intraindividual difference in daytime AUC (0–12 h) ranged from 2% to 54% (mean 30%), and the corresponding variability in nighttime AUC (0–12 h) ranged from 5% to 80% (mean 34%). The pharmacokinetic variables t_1/2, t_max and C_max were more variable than the AUC (0–12 h) both during the day and at night. The evening trough level was significantly lower than the morning trough level; 185 ng · ml^–1 versus 223 ng · ml^–1. This, together with a significantly longer t_1/2 in the night than the day, suggested circadian variability in the pharmacokinetics of CsA.In a separate retrospective study in 162 renal transplant recipients given CsA by constant intravenous infusion, repeated CsA blood concentration measurements at steady state showed lower concentrations during the day than the night, suggesting higher CsA clearance during daytime.It is concluded that CsA pharmacokinetics in renal transplant recipients, besides the well-known interindividual variability, also displays large intraindividual variability as well as circadian variation. Our findings further emphasize the necessity and difficulty of pharmacological monitoring in the clinical use of CsA in organ transplantation.     

Lack of effect of genetic polymorphisms of SLCO1B1 on the lipid-lowering response to pitavastatin in Chinese patients

Aim:

To investigate the SLCO1B1 388A>G and 521T>C polymorphisms in hyperlipidemia patients and evaluate the effect of the two polymorphisms on the lipid-lowering efficacy of pitavastatin.

Methods:

The functional polymorphisms of SLCO1B1 (388A>G and 521T>C) were genotyped in 140 Chinese patients with essential hyperlipidemia using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and one-step tetra-primers ARMS-PCR. Eighty-five patients were enrolled in the clinical trial and given 2 mg of pitavastatin daily for 8 weeks. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) serum levels were measured at baseline, after 4 weeks and after 8 weeks of treatment.

Results:

The allele frequencies of SLCO1B1 388A>G and 521T>C in essential hyperlipidemia patients were 71.1% and 11.1%, respectively. The 4- and 8-week treatment with pitavastatin significantly reduced TC, TG, and LDL levels, but there was no statistical difference among patients with wild type, SLCO1B1 388A>G or SLCO1B1 521T>C in the lipid-lowering efficacy of pitavastatin.

Conclusion:

The present study found that the allele frequencies of SLCO1B1 388A>G and 521T>C in Chinese patients with essential hyperlipidemia are comparable to those in healthy Chinese population. SLCO1B1 388A>G and 521T>C do not affect the lipid-lowering efficacy of pitavastatin.     

Molecular Mobility of Protein in Lyophilized Formulations Linked to the Molecular Mobility of Polymer Excipients,as Determined by High Resolution 13C Solid-State NMR

Purpose. The mobility of protein molecules in lyophilized protein formulations was compared with that of excipient molecules based on the spin-lattice relaxation time (T₁) of each molecule determined by high resolution ¹³C solid-state NMR. The relationship between molecular mobility and protein stability is discussed. Methods. Protein aggregation of lyophilized bovine serum --globulin (BGG) formulation containing dextran was measured by size exclusion chromatography. The T₁ of the BGG carbonyl carbon and dextran methin carbon in the formulation was determined by high resolution ¹³C NMR, and subsequently used to calculate the correlation time (_C) of each carbon. The spin-spin relaxation time (T₂) of BGG and dextran protons was measured by pulsed NMR spectrometry, and the critical temperature of appearance of Lorentzian relaxation due to liquid BGG and dextran protons (T_mc) was determined. Results. The _C of dextran methin carbon in BGG-dextran formulations exhibited a linear temperature dependence according to the Adam-Gibbs-Vogel equation at lower temperatures, and a nonlinear temperature dependence described by the Vogel-Tamman-Fulcher equation at higher temperatures. The temperature at which molecular motion of dextran changed was consistent with the T_mc. The _C of BGG carbonyl carbon exhibited a similar temperature dependence to the _C of the dextran methin carbon and substantially decreased at temperatures above T_mc in the presence of dextran. The temperature dependence of BGG aggregation could be described by the Williams-Landel-Ferry equation even at temperatures 20°C lower than T_mc. Conclusions. High resolution ¹³C solid-state NMR indicated that the molecular motion of BGG was enhanced above T_mc in association with the increased global segmental motion of dextran molecules.