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引用本文:谢晓纯,顾庆玲,许百洁,莫守崎,蔡旭镇,黄丽娜,黄民,李嘉丽.SLCO1B3基因多态性对狼疮性肾炎患者吗替麦考酚酯疗效的影响[J].中国现代应用药学,2024,41(1):133-137.
XIE Xiaochun,GU Qingling,XU Baijie,MO Shouqi,CAI Xuzhen,HUANG Lina,HUANG Min,LI Jiali.Influence of SLCO1B3 Polymorphisms on Pharmacodynamics of Mycophenolate Mofetil in Lupus Nephritis Patients[J].Chin J Mod Appl Pharm(中国现代应用药学),2024,41(1):133-137.
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SLCO1B3基因多态性对狼疮性肾炎患者吗替麦考酚酯疗效的影响
谢晓纯1, 顾庆玲2, 许百洁3, 莫守崎3, 蔡旭镇1, 黄丽娜1, 黄民2, 李嘉丽2
1.揭阳市人民医院药学部,广东 揭阳 522000;2.中山大学药学院临床药理研究所,广州 510080;3.揭阳市人民医院风湿免疫科,广东 揭阳 522000
摘要:
目的 探讨有机阴离子转运体1B3(solute carrier organic anion transporter family, member 1B3,SLCO1B3)基因多态性对狼疮性肾炎患者吗替麦考酚酯(mycophenolate mofetil,MMF)药效学的影响。方法 以2019年9月—2021年4月于揭阳市人民医院就诊的新确诊的或既往确诊的狼疮性肾炎患者为研究对象。受试者均使用MMF治疗,且总疗程≥12个月,综合评估MMF的疗效。采用Agena MassARRAY®方法检测受试者SLCO1B3 334T>G/699G>A (rs4149117/rs7311358)基因型,应用SPSS 25.0软件分析基因多态性与MMF药效学的相关性。结果 SLCO1B3 334T>G/699G>A基因型频率符合Hardy-Weinberg 平衡。334GG/699AA携带者MMF疗效差的几率显著高于334TT/699AA和334TG/699GA携带者(P<0.001);Logistics回归显示334GG/699AA和尿蛋白>2.5 g·(24 h)-1是MMF疗效差的危险因素[OR=4.038(1.731,9.420),P<0.001;OR=4.157(1.705,10.137),P=0.002]。经过联合分析表明,携带334GG/699AA型且尿蛋白>2.5 g·(24 h)-1的患者疗效差的风险是非334GG/699AA携带者的8.563倍[(3.301,22.216),P<0.001]。结论 SLCO1B3 334T>G/699G>A与狼疮性肾炎患者MMF疗效有关,334GG/699AA携带者MMF疗效差的可能性更高。
关键词:  吗替麦考酚酯  狼疮性肾炎  药效学  SLCO1B3  药物基因组学
DOI:10.13748/j.cnki.issn1007-7693.20221573
分类号:R969.3
基金项目:吴阶平医学基金会临床科研专项资助基金(320.6750.2020-04-21)
Influence of SLCO1B3 Polymorphisms on Pharmacodynamics of Mycophenolate Mofetil in Lupus Nephritis Patients
XIE Xiaochun1, GU Qingling2, XU Baijie3, MO Shouqi3, CAI Xuzhen1, HUANG Lina1, HUANG Min2, LI Jiali2
1.Jieyang People’s Hospital, Department of Pharmacy, Jieyang 522000, China;2.Institute of Clinical Pharmacology, School of Pharmacy, Sun Yat-sen University, Guangzhou 510080, China;3.Jieyang People’s Hospital, Division of Rheumatology, Jieyang 522000, China
Abstract:
OBJECTIVE To investigate the effect of polymorphisms of solute carrier organic anion transporter family, member 1B3(SLCO1B3) gene on the pharmacodynamics of mycophenolate mofetil(MMF) in patients with lupus nephritis. METHODS Patients with lupus nephritis who were treated in Jieyang People’s Hospital from September 2019 to April 2021 were selected. All subjects were treated with MMF for at least 12 months, or discontinued due to poor efficacy. The efficacy of MMF was evaluated. The SLCO1B3 334T>G/699G>A(rs4149117/rs7311358) genotype was detected using Agena MassARRAY®, and the correlation between gene polymorphisms and MMF pharmacodynamics was analyzed using SPSS 25.0 software. RESULTS The genotype frequencies of SLCO1B3 334T>G/699G>A were in Hardy-Weinberg equilibrium. The probability of poor MMF treatment effect of 334GG/699AA carriers was significantly higher than that of 334TT/699AA and 334TG/699GA carriers(P<0.001); Logistic regression showed that both 334GG/699AA and urine protein>2.5 g·(24 h)-1 were the risk factors for poor MMF treatment[OR=4.038(1.731, 9.420), P<0.001; OR=4.157(1.705, 10.137), P=0.002]. Combined analysis showed that patients with both 334GG/699AA genotype and urine protein>2.5 g·(24 h)-1 were at higher risk for poor efficacy[OR=8.563(3.301, 22.216), P<0.001]. CONCLUSION SLCO1B3 334T>G/699G>A is related to the efficacy of MMF treating lupus nephritis, and 334GG/699AA carriers are more likely to result in poor efficacy.
Key words:  mycophenolate mofetil  lupus nephritis  pharmacodynamics  SLCO1B3  pharmacogenomics
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