ABCC3 Polymorphisms and mRNA Expression Influence the Concentration of a Carboxylic Acid Metabolite in Patients on Clopidogrel and Aspirin Therapy |
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| Authors: | André Ducati Luchessi Marta Concheiro Juliana de Freitas Germano Vivian Nogueira Silbiger Raul Hernandes Bortolin Angelines Cruz Oscar Quintela Maria Brion Angel Carracedo Andres Iñiguez Marisol Bravo Manuel López‐Rivadulla Rosario Dominguez Crespo Hirata Amanda Guerra Moraes Rego Sousa Mario Hiroyuki Hirata |
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| Institution: | 1. School of Pharmaceutical Science, University of Sao Paulo, Sao Paulo, Brazil;2. Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Natal, Brazil;3. Luis Concheiro Institute of Forensic Sciences, University of Santiago de Compostela, Santiago de Compostela, Spain;4. Department of Madrid, National Institute of Toxicology and Forensic Science, Madrid, Spain;5. Genetics of Cardiovascular and Ophthalmological Diseases, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain;6. Genomic Medicine, University of Santiago de Compostela, IDIS, CIBERER, Santiago de Compostela, Spain;7. Cardiology Service, Alvaro Cunqueiro Hospital, Vigo, Spain;8. Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil |
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| Abstract: | Acetylsalicylic acid (ASA) and clopidogrel combined therapy has been reported to be beneficial in patients with acute coronary syndrome (ACS). Antiplatelet drug resistance, especially to clopidogrel, is a multifactorial phenomenon that affects a large number of ACS patients. The genetic contribution to this drug response is not fully elucidated. We investigated the relationship of ABC‐type efflux subfamily C member 3 (ABCC3) polymorphisms and mRNA expression with plasma concentrations of clopidogrel, salicylic acid (SA) and a carboxylic acid metabolite (CAM). Clopidogrel, CAM and SA plasma concentrations were measured simultaneously by liquid chromatography–tandem mass spectrometry (LCMS/MS) from 83 ACS patients undergoing percutaneous coronary intervention. ABCC3 (rs757421, rs733392 and rs739923) and CYP2C19*2 (rs4244285) polymorphisms as well as mRNA expression were evaluated. A positive correlation was found between CAM concentrations and ABCC3 mRNA expression (r = 0.494, p < 0.0001). Patients carrying genotype AA (rs757421 variant) had higher CAM concentrations and ABCC3 mRNA expression as compared to those of GG + GA carriers (p = 0.017). A multiple linear regression analysis revealed that ABCC3 mRNA expression (p = 0.017), rs757421 AA genotype (p = 0.001), blood collection time (p = 0.018) and clopidogrel dose (p = 0.001) contributed to the concentration of CAM. No associations were observed for the CYP2C19*2 polymorphism. These results suggest that up‐regulation of ABCC3 mRNA expression leads to increased plasma CAM levels through MRP3‐mediated cell efflux. The ABCC3 rs757421 polymorphism may contribute to gene expression. Therefore, ABCC3 may be a potential biomarker for the response to clopidogrel. |
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