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1.
Eur J Clin Pharmacol ; 64(3): 257-66, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18185926

ABSTRACT

BACKGROUND: OATP1B1 is one of the key hepatocellular uptake transporters providing extraction of diverse compounds, including bile acids, xenobiotics, and a variety of drugs, from portal venous blood into the liver. Polymorphisms of the SLCO1B1 gene have been demonstrated to influence in vitro transport function and the pharmacokinetic profile of compounds. OBJECTIVE: The goal of our study was the comparison of SLCO1B1 gene sequence variability in three ethnic groups as a basis for future genetic association studies. METHODS: Eighteen exonic SLCO1B1 single nucleotide polymorphisms (SNPs) were genotyped by PCR and RFLP analysis in 300 German, 94 Turkish, and 115 African subjects. Calculation of pairwise linkage disequilibrium and estimation of population haplotype frequencies were carried out, and haplotype block structure was determined. RESULTS: Only eight genotyped SNPs (c.388A>G, c.411G>A, c.463C>A, c.521T>C, c.571C>T, c.597C>T, c.1463G>>C, c.1929A>C) were found in at least one of our German, Turkish, or African samples. A total of 12 haplotypes with a frequency >or=1% in at least one of the three populations could be inferred. Between the Caucasian and African samples, significant differences in sequence variability were observed leading to a different haplotype profile in these populations. CONCLUSION: Our results demonstrate a high sequence variability of OATP1B1 within different popuations. In the future, distinct haplotypes should be taken into account when studying the effect of OATP1B1 on drugs in different populations.


Subject(s)
Organic Anion Transporters/genetics , Polymorphism, Single Nucleotide , Africa , Alleles , Base Sequence , Black People/genetics , Female , Gene Frequency , Germany , Haplotypes , Humans , Liver-Specific Organic Anion Transporter 1 , Male , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Sequence Analysis, DNA , Turkey , White People/genetics
2.
Eur J Clin Pharmacol ; 63(1): 9-16, 2007 Jan.
Article in English | MEDLINE | ID: mdl-17146660

ABSTRACT

OBJECTIVE: The multidrug resistance gene 1 (MDR1) seems to play a role in the carcinogenesis of colorectal tumors. The importance of MDR1 SNPs 2677G > T/A in exon 21 and 3435C > T in exon 26 for cancer susceptibility, however, has not yet been clearly defined. METHODS: Two hundred and eighty-five colorectal cancer patients and 275 controls from five hospitals in the European part of Russia were genotyped for the polymorphisms -129T > C (rs3213619) in exon 1b, 2677G > T/A (rs2032582), and 3435C > T (rs1045642) in this population-based case-control study. Genotype-phenotype analysis was performed with simultaneous consideration of lifestyle risk factors. RESULTS: Our analysis confirmed the preponderate impact of smoking on colorectal cancer development. The risk of heavy smokers (>/=60 pack years) to develop colorectal cancer by far exceeded that of lifelong non-smokers (OR = 3.9, 95% CI: 1.4 to 10.6). Smoking is a more potent risk factor than is the genetic influence of MDR1 in our study. However, a smoking and age-stratified analysis, revealed a statistically significant association between MDR1 genotypes and colorectal cancer in life-long non-smokers with an age > or =63 years (the median age in our sample). The association was stronger for rectal cancer than for colon cancer. Patients who carried the genotypes (-129TT; 2677GG; 3435CC) or (-129TT; 2677TT; 3435TT) developed more frequently colorectal cancer than others (OR = 3.9; 95% CI: 2.0 to 7.7). CONCLUSIONS: Our results show that the interaction of genetic and lifestyle risk factors should be taken into account to elucidate the genetic influence of MDR1 variability on cancer susceptibility.


Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics , Colorectal Neoplasms/genetics , Genetic Predisposition to Disease , Smoking/adverse effects , ATP Binding Cassette Transporter, Subfamily B , Adult , Aged , Aging , Alcohol Drinking/adverse effects , Case-Control Studies , Colorectal Neoplasms/etiology , Colorectal Neoplasms/pathology , Female , Genotype , Humans , Life Style , Male , Middle Aged , Polymorphism, Genetic , Risk Factors , Russia
3.
Pharmacogenet Genomics ; 16(12): 855-61, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17108809

ABSTRACT

BACKGROUND: Genetic variation of the human ABCB1 (P-glycoprotein; MDR1 gene product) efflux transporter is strongly suggested as a determinant factor governing the pharmacokinetics of diverse drugs and xenobiotics. Despite various efforts to associate polymorphisms in ABCB1 to actual clinical effect and transport function, information is still inconsistent or even controversial. METHODS AND RESULTS: Using membrane vesicle preparation from ABCB1-expressing HighFive insect cells, we report here that saturation kinectic parameters of the frequently occurring ABCB1 triallelic variants 893Ser (exon 21, 2677T) and 893Thr (2677A) were considerably different from wild-type 893Ala (2677G), despite similar protein expression levels. Of importance were significant differences in transport capacities between the tested 893Ala/Ser/Thr variants. In comparison with 893Ala, maximal transport rates for vincristine of 893Ser and 893Thr increased 50% and three-fold, respectively. Cis-inhibition by digoxin, didanosine or fexofenadine was least pronounced in 893Ser, whereas no genotype differences could be observed using verapamil. CONCLUSION: These results suggest an influence of ABCB1-893 triallelic variants on transport function and drug-drug interaction, which might be most pronounced in 893Thr. Furthermore, some of the mechanisms of 2677G/T/A-based haplotype-associated alterations in ABCB1 activity may have been unveiled.


Subject(s)
Organic Anion Transporters/genetics , Organic Anion Transporters/metabolism , Polymorphism, Single Nucleotide , ATP Binding Cassette Transporter, Subfamily B , ATP Binding Cassette Transporter, Subfamily B, Member 1 , Alleles , Amino Acid Substitution , Animals , Biological Transport, Active , Cell Line , Cloning, Molecular , Digoxin/pharmacology , Enzyme Inhibitors/pharmacology , Humans , In Vitro Techniques , Intestinal Mucosa/metabolism , Kinetics , Organic Anion Transporters/antagonists & inhibitors , Pharmacogenetics , Rats , Recombinant Proteins/antagonists & inhibitors , Recombinant Proteins/genetics , Recombinant Proteins/metabolism , Spodoptera , Verapamil/pharmacology , Vincristine/metabolism
4.
Naunyn Schmiedebergs Arch Pharmacol ; 373(1): 45-50, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16568260

ABSTRACT

We previously showed that variant SLCO1B1 haplotype *1b (A388G) accelerates and that *5 (T521C) delays hepatocellular uptake of the HMG-CoA reductase inhibitor pravastatin [Mwinyi et al. (2004): Clin Pharmacol Ther 75:415-421]. In the present study we checked for differential effects of variant SLCO1B1 haplotypes on hepatocellular cholesterol synthesis. We analyzed the serum levels of cholesterol, lathosterol, and campesterol in healthy white males which had been grouped on the basis of their SLCO1B1 haplotype: *1a (n=10), *1b (n=10), and *5 (n=8). The subjects received a single oral dose of 40 mg pravastatin. Cholesterol and lathosterol levels were lower in all subjects following pravastatin intake for up to 24. Median levels 6 h post-dosing of lathosterol decreased in each SLCO1B1 haplotype group in the rank order of *1b (-0.11 mg dl(-1); min-max: -0.20 to -0.04; p=0.005) > *1a (-0.09 mg dl(-1); min-max: -0.22 to -0.05; p=0.005) > *5 (-0.07 mg dl(-1); min-max: -0.17 to -0.05; p=0.012). Lathosterol median-change values were significantly greater in haplotype *1b than in haplotype *5 individuals (p=0.041, non-adjusted), which was congruent with the extent of mean changes in lathosterol-to-cholesterol ratios, although the latter did not reach statistical significance. Post-treatment serum levels of campesterol were not affected by SLCO1B1 haplotype. Interestingly, sterol basal serum levels tended to be highest in *1b carriers, followed by those in *1a and *5 individuals, with significant differences in lathosterol concentrations between the *1b and *5 (p=0.041, non-adjusted) haplotype group. Our findings suggest an association of SLCO1B1*1b and *5 haplotypes to pravastatin's inhibition of the hepatocellular HMG-CoA reductase. Furthermore, SLCO1B1 haplotypes seem to play a role in basal cholesterol homeostasis.


Subject(s)
Anticholesteremic Agents/pharmacology , Cholesterol/analogs & derivatives , Cholesterol/blood , Haplotypes , Organic Anion Transporters/genetics , Phytosterols/blood , Pravastatin/pharmacology , Adult , Humans , Liver-Specific Organic Anion Transporter 1 , Male , Middle Aged
5.
Article in English | MEDLINE | ID: mdl-15734167

ABSTRACT

A high performance liquid chromatography (HPLC) method for the estimation of pravastatin in human plasma and urine samples has been developed. The preparation of the samples was performed by automated solid phase extraction using clonazepam as internal standard. The compounds were separated by isocratic reversed-phase HPLC (C(18)) and detected at 239 nm. The method was linear up to concentrations of 200 ng/ml in plasma and 2000 ng/ml in urine. The intra-assay variability for pravastatin in plasma ranged from 0.9% to 3.5% and from 2.5% to 5.3% in urine. The inter-assay variability ranged from 9.1% to 10.2% in plasma and from 3.9% to 7.5% in urine. The validated limits of quantification were 1.9 ng/ml for plasma and 125 ng/ml for urine estimation. These method characteristics allowed the determination of the pharmacokinetic parameters of pravastatin after administration of therapeutic doses.


Subject(s)
Chromatography, High Pressure Liquid/methods , Hydroxymethylglutaryl-CoA Reductase Inhibitors/blood , Hydroxymethylglutaryl-CoA Reductase Inhibitors/urine , Pravastatin/blood , Pravastatin/urine , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/isolation & purification , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacokinetics , Male , Pravastatin/isolation & purification , Pravastatin/pharmacokinetics , Reproducibility of Results , Sensitivity and Specificity , Spectrophotometry, Ultraviolet
6.
Drug Metab Rev ; 36(3-4): 617-38, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15554239

ABSTRACT

Pharmacogenetics, one of the fields of clinical pharmacology, studies how genetic factors influence drug response. If hereditary traits are taken into account appropriately before starting drug treatment, the type of drug and its dosage can be tailored to the individual patient's needs. Pharmacogenetics adds a considerable amount of stringency to the doctor's therapeutic approach. Today, it is the relationship between dosage requirements and genetic variations in drug metabolizing enzymes like cytochrome P450 (CYP) 2D6 and CYP2C19, or in drug transporters like p-glycoprotein, that is substantiated best. A standard dose will bring about more adverse effects than usual if enzymatic activity is lacking or feeble. Sometimes, however, therapeutic response might be better due to higher concentrations: proton pump inhibitors for eradication of Helicobacter pylori are more efficacious in carriers of a deficient CYP2C19 variant. The drug's interaction with its target (e.g. receptor) also depends on genetic factors. In some cases genetic tests can help distinguish between responders and non-responders of a specific drug treatment. The first pharmacogenetic tests are already on the market.


Subject(s)
Cytochrome P-450 Enzyme System/metabolism , Pharmaceutical Preparations/metabolism , Pharmacogenetics/methods , Animals , Cytochrome P-450 Enzyme System/genetics , Genetic Variation/drug effects , Genetic Variation/genetics , Humans , Pharmaceutical Preparations/administration & dosage , Pharmacogenetics/statistics & numerical data , Polymorphism, Single Nucleotide/drug effects , Polymorphism, Single Nucleotide/genetics , Xenobiotics/metabolism
7.
Clin Pharmacol Ther ; 75(5): 415-21, 2004 May.
Article in English | MEDLINE | ID: mdl-15116054

ABSTRACT

OBJECTIVE: We compared the pharmacogenetic effects of OATP-C (organic anion transporting polypeptide C) *1a, *1b (A388G), and *5 (T521C) haplotypes on single-dose pharmacokinetics of pravastatin in white subjects. METHODS: Thirty healthy white male subjects were grouped according to their OATP-C haplotype. Each group contained 10 individuals who were either homozygous or heterozygous carriers of the *1a, *1b, or *5 haplotype. After a single oral dose of 40 mg pravastatin, we analyzed kinetic parameters of pravastatin disposition. RESULTS: Values for the area under the plasma concentration-time curve from time 0 to 6 hours [AUC(0-6)] in *1a/*1a, *1a/*1b or *1b/*1b, and *1a/*5 individuals were 114.5 +/- 68.6 microg. L(-1). h, 74.8 +/- 35.6 microg. L(-1). h, and 163.0 +/- 64.6 microg. L(-1). h, respectively, with highly significant differences across all 3 study groups (P =.006) and between subjects carrying the *1b and *5 haplotype (P =.002). Strikingly, values of AUC(0-6) from the OATP-C *1b group were more than 60% lower than those derived from carriers of the wild-type OATP-C *1a haplotype, although this difference failed to reach statistical significance. However, the amount of pravastatin excreted into the urine from time 0 to 12 hours [Ae(0-12)] was significantly diminished in the OATP-C *1b haplotype group (1729 +/- 907 microg) compared with *1a wild-type control subjects (2974 +/- 1590 microg) (P =.049). CONCLUSION: There was a significant effect of tested OATP-C variant haplotypes on pravastatin disposition. Whereas *5 expression delayed the hepatocellular uptake of pravastatin, *1b expression seemed to accelerate OATP-C-dependent uptake of the drug.


Subject(s)
Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacokinetics , Liver-Specific Organic Anion Transporter 1/genetics , Pravastatin/pharmacokinetics , Administration, Oral , Adult , Area Under Curve , Genotype , Haplotypes , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hydroxymethylglutaryl-CoA Reductase Inhibitors/urine , Male , Pharmacogenetics , Pravastatin/administration & dosage , Pravastatin/urine
8.
Naunyn Schmiedebergs Arch Pharmacol ; 369(1): 69-77, 2004 Jan.
Article in English | MEDLINE | ID: mdl-14598019

ABSTRACT

Active transport across biological membranes has become a noticeable factor in the absorption, distribution, and excretion of an increasing number of drugs. Different transmembrane transport systems including organic anion transporters (OATP, solute carrier family SLC21A), organic cation transporters (OCT, SLC22A), dipeptide transporters (PEPT, SLC15A), nucleoside transporters (CNT, SLC28A), monocarboxylate carriers (MCT, SLC2A), and members of the large ATP-binding cassette family (ABC, SLC3A) are involved in drug disposition. Genetic polymorphisms in transport proteins frequently occur and contribute to interindividual differences in the efficacy and safety of pharmatherapy. Currently, the most advanced research has been done on P-glycoprotein (ABCB1, SLC3A1.201.1). Knowledge of this transporter indicates that haplotype analysis rather than association with single nucleotide polymorphisms (SNPs) provides the most appropriate interpretation of pharmacogenetic data from drug transporters. This review gives an overview and update on the pharmacological impact of genetic variants in transmembrane transporters.


Subject(s)
Membrane Transport Proteins/genetics , Pharmaceutical Preparations/metabolism , Polymorphism, Genetic , Xenobiotics/pharmacokinetics , Animals , Humans , Inactivation, Metabolic/genetics , Substrate Specificity
9.
Fundam Clin Pharmacol ; 17(4): 463-9, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12914549

ABSTRACT

P-glycoprotein (Pgp) is a member of the ABC-transporter family, and in humans, is encoded by the MDR1 gene. Recently, several single-nucleotide polymorphisms in the MDR1 gene were identified. The aim of the present study was to evaluate the effect of the MDR1 genetic polymorphisms G2677T and C3435T on Pgp activity in CD56+ and CD4+ peripheral blood cells. Using flow cytometry, rhodamine 123 (Rh123) efflux was determined in 46 male healthy volunteers. Median Rh123 fluorescence in control sample, after baseline dye uptake, was set as 100%. Rh123 fluorescence in efflux samples, exposed to different efflux periods, was used to calculate the percentage of Rh123 retained in the cells in comparison with control. There was no significant difference in Rh123 efflux in CD56+ cells after 5, 10, 15, and 30 min efflux between individuals with different MDR1 genotypes. Also, in CD4+ cells after 15, 30, 60, and 90 min, Rh123 efflux did not reveal statistically different results for the three genotypes at 2677 and 3435. Rh123 efflux was not enhanced by a 10-day rifampin administration, as determined in 15 individuals before and after rifampin treatment. In conclusion, we found no impact of the MDR1 G2677T and C3435T polymorphisms on Pgp activity in CD56+ and CD4+ peripheral blood lymphocytes.


Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , Genes, MDR , Lymphocytes/metabolism , Polymorphism, Genetic , Rhodamine 123/metabolism , ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics , Adult , CD4 Antigens/metabolism , CD56 Antigen/metabolism , Exons , Humans , In Vitro Techniques , Killer Cells, Natural/metabolism , Male , Middle Aged , Polymerase Chain Reaction , Rifampin/pharmacology , T-Lymphocytes, Helper-Inducer/metabolism , Verapamil/pharmacology
10.
Eur J Clin Pharmacol ; 59(4): 303-12, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12879168

ABSTRACT

OBJECTIVE: The frequency of functionally important mutations and alleles of genes coding for xenobiotic metabolizing enzymes shows a wide ethnic variation. However, little is known of the frequency distribution of the major allelic variants in the Russian population. METHODS: Using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP) genotyping assays and the real-time PCR with fluorescent probes, the frequencies of functionally important variants of the cytochromes P450 (CYP) 2C9, 2C19, 2D6, 1A1 as well as arylamine N-acetyltransferase 2 (NAT2) and P-glycoprotein (MDR1) were determined in a sample of 290 Russian volunteers derived from Voronezh area. RESULTS: CYP2C9*2 and * 3 alleles were found with allelic frequencies of 10.5% and 6.7%, respectively. The novel intron-2 T>C mutation at exon 2 +73 bp occurred in 24.8% of alleles. CYP2C19*2 and *3 alleles occurred in 11.4% and 0.3%, respectively. Six persons (2.1%) carried two of these CYP2C19 alleles responsible for poor metabolizing activity. Of all subjects, 5.9% were CYP2D6 poor metabolizers, whereas 3.4% were addressed to ultra-rapid metabolizers (CYP2D6*1x2/*1). The CYP1A1*2A allele was found in 4.7%, *2B in 5.0%, *4 in 2.6%, and the 5'-mutations -3219C>T, -3229G>A, and the novel -4335G>A in 6.0%, 2.9% and 26.0% of alleles, respectively. Genotyping of eight different single nucleotide polymorphisms in the NAT2 gene provided in 58.0% a genotype associated with slow acetylation. The MDR1 triple variants G2677T and G2677A in exon 21 had an allelic frequency of 41.9% and 3.3%, respectively, and the variant C3435T in exon 26 one of 54.3%. Frequencies of functionally important haplotypes were calculated. CONCLUSION: The overview of allele distribution of important xenobiotic-metabolizing enzymes among a Russian population shows similarity to other Caucasians. The data will be useful for clinical pharmacokinetic investigations and for drug dosage recommendations in the Russian population.


Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics , Arylamine N-Acetyltransferase/genetics , Cytochrome P-450 Enzyme System/genetics , Polymorphism, Genetic , Adolescent , Adult , Aged , Aryl Hydrocarbon Hydroxylases/genetics , Cytochrome P-450 CYP1A1/genetics , Cytochrome P-450 CYP2C19 , Cytochrome P-450 CYP2C9 , Cytochrome P-450 CYP2D6/genetics , Female , Gene Frequency , Genotype , Humans , Male , Middle Aged , Mixed Function Oxygenases/genetics , Russia , White People/genetics
11.
Hepatology ; 38(2): 345-54, 2003 Aug.
Article in English | MEDLINE | ID: mdl-12883478

ABSTRACT

Hepatobiliary transporters are down-regulated in toxic and cholestatic liver injury. Cytokines such as tumor necrosis factor alpha (TNF-alpha) and interleukin 1 beta (IL-1 beta) are attributed to mediate this regulation, but their particular contribution in vivo is still unknown. Thus, we studied the molecular mechanisms by which Ntcp, Oatp1, Oatp2, and Mrp2 are regulated by proinflammatory cytokines during liver injury. Rats were injected intraperitoneally with either carbon tetrachloride or endotoxin. Inactivation of TNF-alpha and IL-1 beta was achieved by repetitive intraperitoneal injection of etanercept and anakinra, respectively. Messenger RNA (mRNA) levels of transporters and binding activities as well as nuclear protein levels of Ntcp, Oatp2, and Mrp2 transactivators were determined 20 to 24 hours later. In contrast to IL-1 beta, TNF-alpha inactivation alone fully prevented down-regulation of Ntcp, Oatp1, and Oatp2 mRNA as well as reduced binding activity of hepatocyte nuclear factor 1 (HNF-1) in CCl(4)-induced toxic injury. In endotoxemia, down-regulation of Mrp2, and partially in case of Ntcp, could be prevented by IL-1 beta but not TNF-alpha blockade. However, inactivation of either cytokine led to preservation of HNF1 and partially of retinoid X receptor/retinoic acid receptor (RXR/RAR) binding activity. No effect of anticytokines was seen on pregnane X receptor (PXR) and constitutive androstane receptor (CAR) binding activity as well as nuclear protein mass. In conclusion, TNF-alpha represents the master cytokine responsible for HNF1-dependent down-regulation of Ntcp, Oatp1, and Oatp2 in CCl(4)-induced toxic liver injury. IL-1 beta predominates in a complex signaling network of Ntcp and Mrp2 regulation in cholestatic liver injury. In contrast to in vitro studies, HNF1 and RXR/RAR-independent mechanisms appear to be more important in regulation of Mrp2 and Ntcp gene expression in endotoxemia.


Subject(s)
ATP-Binding Cassette Transporters , Chemical and Drug Induced Liver Injury/metabolism , Cholestasis, Intrahepatic/metabolism , Interleukin-1/metabolism , Membrane Transport Proteins , Organic Anion Transporters, Sodium-Independent/metabolism , Tumor Necrosis Factor-alpha/metabolism , Animals , Antirheumatic Agents/pharmacology , Carbon Tetrachloride , Carrier Proteins/genetics , Carrier Proteins/metabolism , Chemical and Drug Induced Liver Injury/immunology , Cholestasis, Intrahepatic/immunology , Etanercept , Gene Expression/physiology , Immunoglobulin G/pharmacology , Interleukin 1 Receptor Antagonist Protein , Interleukin-1/antagonists & inhibitors , Male , Nuclear Proteins/metabolism , Organic Anion Transporters , Organic Anion Transporters, Sodium-Dependent , Organic Anion Transporters, Sodium-Independent/genetics , Organic Cation Transport Proteins/genetics , Organic Cation Transport Proteins/metabolism , RNA, Messenger/analysis , Rats , Rats, Sprague-Dawley , Receptors, Tumor Necrosis Factor , Sialoglycoproteins/pharmacology , Symporters , Transcription Factors/metabolism , Tumor Necrosis Factor-alpha/antagonists & inhibitors
12.
J Mol Med (Berl) ; 81(3): 154-67, 2003 Mar.
Article in English | MEDLINE | ID: mdl-12682724

ABSTRACT

Adverse drug reactions and ineffective drug treatment are responsible for a large health care burden. Considerable variability in drug response makes the prediction of the individual reaction difficult. Pharmacogenetics can help to individualize drug treatment in accordance with the genetic make-up of the patient. Drug response is best understood as a complex interplay between pharmacokinetics, pharmacodynamics, and other disease-associated factors. There are a large number of genetic variants in the enzymes of phase I and phase II drug metabolism, in drug transporters, and drug targets, all of which account for differences in drug response. The polymorphisms in the cytochrome P450 enzyme system have been investigated most extensively. Genotype-based dose adjustment which should ensure "bioequivalent" drug concentrations in all patients has been derived from pharmacokinetic parameters, but this approach will have to be verified in prospective studies. Drug transport has recently been recognized as a further crucial determinant in pharmacokinetics. The effect of genetics on disease susceptibility and drug treatment has been studied quite extensively; however, hardly any of this progress is at present reflected in routine health care. The integration of pharmacogenetic factors in clinical trials requires novel considerations for study design and data interpretation. It is to be hoped that the new science bioinformatics will (a) help us identify the contribution of genetics to disease and treatment response and will (b) create data-processing devices which help the physician in the face of the enormously expanding scientific knowledge in selecting the best individually adapted treatment for the patient.


Subject(s)
Clinical Trials as Topic , Pharmaceutical Preparations , Pharmacogenetics , ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics , ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , Cytochrome P-450 Enzyme System/genetics , Cytochrome P-450 Enzyme System/metabolism , Genotype , Glyburide/metabolism , Glyburide/therapeutic use , Humans , Hypoglycemic Agents/metabolism , Hypoglycemic Agents/therapeutic use , Tolbutamide/metabolism , Tolbutamide/therapeutic use
13.
Biochim Biophys Acta ; 1609(1): 87-94, 2003 Jan 10.
Article in English | MEDLINE | ID: mdl-12507762

ABSTRACT

BACKGROUND/AIMS: Estrogen-mediated cholestasis is an important clinical entity, but its molecular pathophysiology is still not fully understood. Impaired sodium-dependent uptake of bile acids has been associated with diminished expression of a basolateral Na(+)/bile acid cotransporter (Ntcp), whereas sodium-independent uptake is maintained despite a down-regulation of the organic anion transporter Oatp1. Thus, expression of the two other rat Oatps (Oatps2 and -4) was determined in estrogen-induced cholestasis. In addition, known transactivators of Oatp2 and Ntcp were studied to further characterize transcriptional regulation of these transporter genes. METHODS: Hepatic protein and mRNA expression of various Oatps (1, 2, 4) in comparison to Ntcp were analyzed after 0.5, 1, 3 and 5 days of ethinylestradiol (EE) treatment (5 mg/kg) in rats. Binding activities of Oatp2 and Ntcp transactivators were assessed by electrophoretic mobility shift assays. RESULTS: All basolateral Oatps (1, 2 and 4) were specifically down-regulated at the protein level by 30-40% of controls, but less pronounced than Ntcp (minus 70-80%). In contrast to unaltered Oatp4 mRNA levels, Oatp1 and Oatp2 mRNAs were reduced to various extents (minus 40-90% of controls). Binding activity of known transactivators of Ntcp and Oatp2 such as hepatocyte nuclear factor 1 (HNF1), CAAT enhancer binding protein alpha (C/EBPalpha) and pregnane X receptor (PXR) were also diminished during the time of cholestasis. CONCLUSIONS: Estrogen-induced cholestasis results in a down-regulation of all basolateral organic anion transporters. The moderate decline in expression of Oatp1, -2 and -4 may explain the unchanged sodium-independent transport of bile acids due to overlapping substrate specificity. Reduction in transporter gene expression seems to be mediated by a diminished nuclear binding activity of transactivators such as HNF1, C/EBP and PXR by estrogens.


Subject(s)
Cholestasis/metabolism , Ethinyl Estradiol/adverse effects , Organic Anion Transporters/metabolism , Animals , Base Sequence , Basement Membrane/drug effects , Basement Membrane/metabolism , Blotting, Northern , Blotting, Western , Cholestasis/chemically induced , Cholestasis/genetics , DNA Primers , Male , Organic Anion Transporters/genetics , Protein Binding , RNA, Messenger/genetics , RNA, Messenger/metabolism , Rats , Rats, Sprague-Dawley , Transcription Factors/metabolism
14.
Br J Clin Pharmacol ; 54(6): 610-6, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12492608

ABSTRACT

AIMS: A noncoding single nucleotide polymorphism (SNP) in exon 26 3435C > T of the highly polymorphic MDR1 gene has been demonstrated to alter digoxin absorption after induction of the MDR1 gene product P-glycoprotein by rifampicin or after multiple oral dosing. The aim of the study was to investigate the effects of the major known MDR1 SNPs on the absorption of digoxin after a single oral dose in a large sample without drug pretreatment. METHODS: Fifty healthy white male subjects between the age of 18 and 40 years were enrolled. Following an overnight fast, all subjects received a single oral dose of 1 mg digoxin. Venous blood samples were taken at intervals up to 4 h post dose to obtain a pharmacokinetic profile. RESULTS: AUC(0,4 h), Cmax and tmax, used as indices of digoxin absorption, were not significantly different in any of the genotype groups tested. In particular, there was no significant difference between homozygous carriers of the C and T allele in exon 26 3435 (AUC(0,4 h) 9.24 and 9.38 micro g l-1 h, Cmax 4.73 and 3.81 micro g l-1, tmax 0,83 and 01.14 h). CONCLUSIONS: This lack of effect of the major MDR1 SNPs on digoxin absorption might be explained by saturation of the maximum transport capacity of intestinal Pgp at the dose used.


Subject(s)
Cardiotonic Agents/pharmacokinetics , Digoxin/pharmacokinetics , Genes, MDR , Absorption , Administration, Oral , Adolescent , Adult , Area Under Curve , Cardiotonic Agents/administration & dosage , Digoxin/administration & dosage , Exons/genetics , Homozygote , Humans , Introns/genetics , Male , Polymorphism, Genetic
15.
Clin Pharmacol Ther ; 72(5): 584-94, 2002 Nov.
Article in English | MEDLINE | ID: mdl-12426522

ABSTRACT

OBJECTIVE: We investigated the effect of polymorphisms in the P-glycoprotein (P-gp) MDR1 gene on steady-state pharmacokinetics of digoxin in Caucasians. According to earlier data, homozygous TT of the exon 26 complementary deoxyribonucleic acid (cDNA) 3435C>T polymorphism was associated with low P-gp expression in the human intestine. METHODS: Eight healthy male homozygous carriers of the wild-type exon-26 3435C>T (CC), 8 heterozygous subjects (CT), and 8 homozygous mutant (TT) subjects were selected. Seven further MDR1 polymorphisms were determined. Digoxin was administered orally twice daily on the first two study days; on days 3 to 5, 0.25 mg was given in the morning. On day 5, kinetic parameters were analyzed for genotype-phenotype and haplotype-phenotype relationships. RESULTS: The area under the plasma concentration-time curve from time zero to 4 hours [AUC(0-4)] (P =.042) and C(max) (P =.043) values of digoxin were higher in subjects with the 3435TT genotype than in those with the 3435CC. No influence of other single nucleotide polymorphisms (SNPs) on digoxin parameters was detected. Comparison of genotypes deduced from SNPs 2677G>T (exon 21) and 3435C>T revealed significant differences for AUC(0-4) (P =.034) and C(max) (P =.039), which were substantiated by haplotype analysis. Haplotype 12 (2677G/3435T), which had a frequency of 13.3% in a randomly drawn Caucasian sample (n = 687), was associated (Mann-Whitney test) with higher AUC(0-4) values (P =.009) than were found in noncarriers (mean +/- SD, 5.7 +/- 0.9 microg. h/L [n = 7] versus 4.8 +/- 0.9 microg. h/L [n = 17]). Haplotype 11 (2677G/3435C) had lower AUC(0-4) values (P =.013) compared with those of noncarriers (mean +/- SD, 4.7 +/- 0.9 microg. h/L [n = 16] versus 5.6 +/- 0.9 microg. h/L [n = 8]). Results of haplotype analysis match data of other MDR1 studies. CONCLUSION: Haplotype 12 codes for high values of AUC(0-4) and C(max) of orally administered digoxin. Analysis of MDR1 haplotypes is superior to unphased SNP analysis to predict MDR1 phenotype.


Subject(s)
Digoxin/pharmacokinetics , Genes, MDR , Haplotypes , Animals , Female , Genotype , Male , Polymorphism, Single Nucleotide
16.
Eur J Biochem ; 269(14): 3495-503, 2002 Jul.
Article in English | MEDLINE | ID: mdl-12135489

ABSTRACT

The 5' flanking region of the bile salt export pump (Bsep) gene was systematically analysed to provide the basis for understanding the mechanisms which regulate Bsep transcription. In addition substrates and drugs were investigated for their ability to alter Bsep promoter activity. Bsep promoter function was restricted to hepatocyte derived HepG2 cells. The 5' deletional analysis revealed a biphasic shape of reporter gene activities, indicating a suppressive element between nucleotides -800 and -512. Two consensus sites for the farnesoid X receptor (FXR) were located at nucleotides -473 and -64. The latter was characterized as functionally active in bile acid-mediated feed-back regulation of Bsep transcription. Bsep promoter activity was reduced by rifampin and beta-estradiol. The anti-estrogen tamoxifen stimulated promoter activity. Dexamethasone, hydrocortisone and phenobarbital had no effect on Bsep promoter activity. In conclusion, the data suggest that transcriptional regulation of the Bsep gene can be modulated by a number of endogenous compounds and xenobiotics. FXR was a major regulatory factor, mediating bile acid feed-back stimulation of Bsep transcription.


Subject(s)
ATP-Binding Cassette Transporters/genetics , Bile Acids and Salts/pharmacology , Gene Expression Regulation/drug effects , Promoter Regions, Genetic/drug effects , Xenobiotics/pharmacology , ATP Binding Cassette Transporter, Subfamily B, Member 11 , ATP-Binding Cassette Transporters/metabolism , Animals , Base Sequence , Bile Acids and Salts/metabolism , Binding Sites , DNA-Binding Proteins/metabolism , Dexamethasone/pharmacology , Feedback , Genes , Genes, Reporter , Hepatoblastoma/pathology , Hepatocytes/drug effects , Hepatocytes/metabolism , Humans , Hydrocortisone/pharmacology , Liver Neoplasms/pathology , Molecular Sequence Data , Phenobarbital/pharmacology , Rats , Receptors, Cytoplasmic and Nuclear , Recombinant Fusion Proteins/biosynthesis , Rifampin/pharmacology , Tamoxifen/pharmacology , Transcription Factors/metabolism , Transcription, Genetic/drug effects , Transfection , Tumor Cells, Cultured/drug effects , Tumor Cells, Cultured/metabolism
17.
J Hepatol ; 37(2): 198-205, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12127424

ABSTRACT

BACKGROUND/AIMS: Hepatobiliary transporters are down-regulated in cholestasis, but their expression in acute, non-cholestatic, cytokine-mediated liver injury is unknown. Thus we studied the molecular mechanisms, by which sodium taurocholate cotransporting polypeptide (Ntcp), organic anion transporting polypeptide 1 (Oatp1), Oatp2, Oatp4, multidrug-resistance protein 2 (Mrp2) and bile salt export pump (Bsep) are regulated in liver injury induced by carbon tetrachloride (CCl(4)). METHODS: mRNA and protein levels were determined in rats 24 and 72h after CCl(4) injection. Transporter gene transcription and binding activities of Ntcp and Mrp2 transactivators were assessed by nuclear runoff and electrophoretic mobility shift assays. RESULTS: mRNA levels significantly declined to 41+/-44% for Ntcp, 65+/-41% for Oatp1 and 64+/-28% for Oatp2, but remained unchanged for Oatp4, canalicular Mrp2 and Bsep. Protein levels declined only for Oatp4 (-50+/-17%) and Ntcp (-23+/-13%) at 24h. Reduced mRNA levels (Ntcp, Oatp1, Oatp2) were associated with decreased transcriptional activities. Binding activity of Ntcp transactivators (hepatocyte nuclear factor 1 alpha (HNF1alpha) and CAAT enhancer binding protein alpha (C/EBPalpha) were reduced by 24h, whereas retinoid X receptor alpha (RXRalpha):retinoid acid receptor alpha (RARalpha) as transactivator of both Ntcp and Mrp2 remained unaltered. Recovery of acute hepatitis and changes in gene expression occurred after 72h. CONCLUSIONS: Acute liver injury results in down-regulation of basolateral organic anion transporters similar to liver regeneration after partial hepatectomy, but in contrast to endotoxin-induced cholestasis. Maintained binding activity of RXRalpha:RARalpha may explain differences in Mrp2 expression.


Subject(s)
DNA-Binding Proteins , Liver Diseases/metabolism , Liver Diseases/physiopathology , Membrane Transport Proteins , Nuclear Proteins , Organic Anion Transporters, Sodium-Independent/genetics , Organic Anion Transporters, Sodium-Independent/metabolism , Acute Disease , Animals , CCAAT-Enhancer-Binding Proteins/metabolism , Carbon Tetrachloride , Carrier Proteins/genetics , Carrier Proteins/metabolism , Chemical and Drug Induced Liver Injury , Cytokines/genetics , Gene Expression/drug effects , Hepatocyte Nuclear Factor 1 , Hepatocyte Nuclear Factor 1-alpha , Hepatocyte Nuclear Factor 1-beta , Male , Multidrug Resistance-Associated Protein 2 , Multidrug Resistance-Associated Proteins/genetics , Multidrug Resistance-Associated Proteins/metabolism , Organic Anion Transporters , Organic Anion Transporters, Sodium-Dependent , Organic Cation Transport Proteins/genetics , Organic Cation Transport Proteins/metabolism , RNA, Messenger/analysis , Rats , Rats, Sprague-Dawley , Solute Carrier Organic Anion Transporter Family Member 1B3 , Symporters , Transcription Factors/metabolism , Transcription, Genetic/drug effects
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