新疆双相情感障碍患儿体内拉莫三嗪血药浓度与UGT2B7-161C>T基因多态性的相关性研究

    A Study on the Correlation Between the Blood Concentration of Lamotrigine and UGT2B7-161C>T Gene Polymorphism in Pediatric Patient with Bipolar Disorder in Xinjiang

    • 摘要:
      目的  探讨新疆双相情感障碍患儿体内拉莫三嗪血药浓度与UDP葡萄糖醛酸转移酶2家族多肽B7(UDP glucuronosyltransferase 2 family polypeptide B7,UGT2B7)-161C>T基因多态性的相关性。
      方法 收集82例因双相情感障碍服用拉莫三嗪治疗≥21 d的患儿血样,采用超高效液相色谱法测定拉莫三嗪血浆药物浓度。采用第1代测序技术检测患儿UGT2B7-161C>T基因型,分析患儿UGT2B7-161C>T基因多态性与拉莫三嗪血药浓度的相关性。
      结果 41例患儿服用拉莫三嗪作为单药治疗,而其他41例患儿同时服用其他双相情感障碍药物,合并富马酸喹硫平组和氟西汀组患儿浓度/剂量比(concentration-to-dose ratio,CDR)值显著高于拉莫三嗪单药治疗组(P<0.05)。UGT2B7-161C>T的不同基因型组患儿的拉莫三嗪血浆药物浓度和CDR值均差异均具有统计学意义(P<0.05)。其中,UGT2B7-161C>T CT和TT基因型患儿的血药浓度和CDR结果均显著低于CC型患儿(P<0.05)。
      结论 UGT2B7-161C>T基因突变影响拉莫三嗪的血药浓度,在为双相情感障碍患者开具拉莫三嗪处方时,建议检测UGT2B7-161C>T的基因型。

       

      Abstract:
      OBJECTIVE  To explore the correlation between the serum concentration of lamotrigine and UDPglucuronosyltransferase 2 family polypeptide B7(UGT2B7)-161C>T genetic polymorphism in pediatric patient with bipolar disorder in Xinjiang.
      METHODS  Blood samples of 82 pediatric patient treated with lamotrigine for bipolar disorder for at least 21 d were collected, and the plasma concentration of lamotrigine was determined by ultra-performance liquid chromatography. The first-generation sequencing method was used to detect the UGT2B7-161C>T genotypes, and the correlation between the polymorphisms of UGT2B7-161C>T genes and the plasma concentration of lamotrigine was analyzed.
      RESULTS  The concentration-to-dose ratio(CDR) values of the 41 pediatric patient who took lamotrigine as monotherapy and the other 41 pediatric patient who took other bipolar disorder drugs at the same time were significantly higher than those in the quetiapine fumarate group and fluoxetine group(P<0.05). There were significant differences in plasma drug concentration and CDR of lamotrigine of the different genotypes of UGT2B7-161C>T(P<0.05). Among them, the plasma concentrations and CDR results of UGT2B7 -161C>T CT and TT genotypes were significantly lower than those of CC genotypes(P<0.05).
      CONCLUSION  Mutations in the UGT2B7-161C>T genes affect serum levels of lamotrigine, and it is recommended to test the genetic phenotype of UGT2B7-161C>T when prescribing lamotrigine in patients with bipolar disorder.

       

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