RESUMO
We have analyzed influence of genetic variants CYP2D6*3 (2549delA) and CYP2D6*4 (1846G>A), as well as other factors on effects of bisoprolol in patients with acute coronary syndrome. The study included 97 patients with acute coronary syndrome. Mean age was 63±10 years; 60 men and 37 women. We have found association between carriage of CYP2D6*4 (1846G>A) and maximal heart rate at exertion (R-0,21; Ñ<0,05). When the correction for potential confounders was made, age was the only significant predictor of maximal heart rate (ß=ï0,6; SE=0,07; p<0,001). At the same time it was found that CYP2D6*4 was associated with more advanced age of the patients (r=0,2; p<0,05).
Assuntos
Síndrome Coronariana Aguda , Bisoprolol , Citocromo P-450 CYP2D6/genética , Frequência Cardíaca , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/tratamento farmacológico , Síndrome Coronariana Aguda/genética , Idoso , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
AIM: To evaluate an association of genetic polymorphisms CYP2C19, MDR1, and IL-1ß on the eradication rate by 10-day modified therapy in patients with H. pylori - associated diseases. MATERIALS AND METHODS: In this study was conducted a prospective, randomized trial, included 89 patients with H. pylori - associated diseases. They were divided into 2 groups depending on therapy: clarithromycin 500 mg, b.i.d., amoxicillin 1000 mg, b.i.d., bismuth subcitrate 240 mg, b.i.d. rabeprazole 20 mg or 40 mg, b.i.d. for 10 days. All subjects underwent pharmacogenetic testing of CYP2C19, MDR1, and IL-1ß. RESULTS AND DISCUSSION: Per - protocol (PP) eradication rates in group with rabeprazole 40 mg were 97.6% (41/42; 95% CI 87.7-99.6), in group with rabeprazole 20 mg were 82.1% (32/39; 95% CI 67.3-91.0). Intention - to - treat analysis in group with rabeprazole 40 mg eradication rates were 89.1% (41/46; 95% CI 77.0-95.3), in group with standard dose rabeprazole - 74.4% (32/43; 95% CI 59.8-85.1). No significant differences in eradication rates between the groups of ultrarapid, rapid, normal and intermediate CYP2C19 metabolizers (PP: 93.5%/90.3%/84.6% respectively; χ2=0.87, p=0.65). Eradication rates in group with IL-1ß CC genotype there was no difference among the IL-1ß CT and TT genotype groups (PP: 92.9%/85.7%/94.7% respectively; χ2=1.34; p=0.51). The cure rate among MDR1 TT genotype was significantly lower than among subjects in the MDR1 CC/CT genotype groups (PP: 76.2% vs 96.3%: χ2=5.04; p=0.025; OR=8.13). CONCLUSION: Ten - day modified triple therapy with high dose rabeprazole significantly high eradication rates in patients with H. pylori - associated diseases. Independent factor for treatment failure is MDR1 CC/CT genotype status.
Assuntos
Hidrocarboneto de Aril Hidroxilases , Citocromo P-450 CYP2C19 , Infecções por Helicobacter , Helicobacter pylori , Polimorfismo Genético , Subfamília B de Transportador de Cassetes de Ligação de ATP/genética , Amoxicilina/uso terapêutico , Antibacterianos , Claritromicina/uso terapêutico , Citocromo P-450 CYP2C19/genética , Quimioterapia Combinada , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/genética , Humanos , Estudos Prospectivos , Inibidores da Bomba de Prótons/uso terapêuticoRESUMO
To improve the treatment of hepatotoxic responses to antituberculosis polychemotherapy, the impact of remaxol on the biochemical indices and parameters of the antioxidant system in patients with tuberculosis and HIV infection was estimated. The use of remaxol having cytoprotective, anticholestatic, antihypoxitic and antioxidant effects in the treatment of patients with tuberculosis and HIV infection and liver drug damage due to tuberculosis polychemotherapy significantly improved the biochemical indices and lowered the level of the cytolytic and cholestatic syndromes. Remaxol increased the antioxidant system potential and had an antihypoxitic effect.
