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Gallardo-Cóndor J, Naranjo P, Atarihuana S, Coello D, Guevara-Ramírez P, Flores-Espinoza R, Burgos G, López-Cortés A, Cabrera-Andrade A. Population-Specific Distribution of TPMT Deficiency Variants and Ancestry Proportions in Ecuadorian Ethnic Groups: Towards Personalized Medicine. Ther Clin Risk Manag 2023; 19:1005-1018. [PMID: 38050617 PMCID: PMC10693761 DOI: 10.2147/tcrm.s432856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/06/2023] [Indexed: 12/06/2023] Open
Abstract
Purpose Thiopurine S-methyltransferase (TPMT) is an enzyme that metabolizes purine analogs, agents used in the treatment of acute lymphoblastic leukemia. Improper drug metabolism leads to toxicity in chemotherapy patients and reduces treatment effectiveness. TPMT variants associated with reduced enzymatic activity vary across populations. Therefore, studying these variants in heterogeneous populations, such as Ecuadorians, can help identify molecular causes of deficiency for this enzyme. Methods We sequenced the entire TPMT coding region in 550 Ecuadorian individuals from Afro-Ecuadorian, Indigenous, Mestizo, and Montubio ethnicities. Moreover, we conducted an ancestry analysis using 46 informative ancestry markers. Results We identified 8 single nucleotide variants in the coding region of TPMT. The most prevalent alleles were TPMT*3A, TPMT*3B, and TPMT*3C, with frequencies of 0.055, 0.012, and 0.015, respectively. Additionally, we found rare alleles TPMT*4 and TPMT*8 with frequencies of 0.005 and 0.003. Correlating the ancestry proportions with TPMT-deficient genotypes, we observed that the Native American ancestry proportion influenced the distribution of the TPMT*1/TPMT*3A genotype (OR = 5.977, p = 0.002), while the contribution of African ancestral populations was associated with the TPMT*1/TPMT*3C genotype (OR = 9.769, p = 0.003). The rates of TPMT-deficient genotypes observed in Mestizo (f = 0.121) and Indigenous (f = 0.273) groups provide evidence for the influence of Native American ancestry and the prevalence of the TPMT*3A allele. In contrast, although Afro-Ecuadorian groups demonstrate similar deficiency rates (f = 0.160), the genetic factors involved are associated with contributions from African ancestral populations, specifically the prevalent TPMT*3C allele. Conclusion The distribution of TPMT-deficient variants offers valuable insights into the populations under study, underscoring the necessity for genetic screening strategies to prevent thiopurine toxicity events among Latin American minority groups.
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Affiliation(s)
| | - Pablo Naranjo
- Facultad de Ingeniería y Ciencias Aplicadas, Universidad de Las Américas, Quito, Ecuador
| | - Sebastián Atarihuana
- Facultad de Ingeniería y Ciencias Aplicadas, Universidad de Las Américas, Quito, Ecuador
| | - Dayana Coello
- Laboratorios de Investigación, Universidad de Las Américas, Quito, Ecuador
| | - Patricia Guevara-Ramírez
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Rodrigo Flores-Espinoza
- Laboratório de Diagnóstico por DNA (LDD), Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Germán Burgos
- One Health Research Group, Facultad de Medicina, Universidad de Las Américas, Quito, Ecuador
- Grupo de Medicina Xenomica, Instituto de Ciencias Forenses, Universidad de Santiago de Compostela, Satiago de Compostela, Spain
| | - Andrés López-Cortés
- Cancer Research Group (CRG), Faculty of Medicine, Universidad de Las Américas, Quito, Ecuador
- Latin American Network for the Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Madrid, Spain
| | - Alejandro Cabrera-Andrade
- Escuela de Enfermería, Facultad de Ciencias de la Salud, Universidad de Las Américas, Quito, Ecuador
- Grupo de Bio-Quimioinformática, Universidad de Las Américas, Quito, Ecuador
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3
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Medina-Sanson A, Núñez-Enríquez JC, Hurtado-Cordova E, Pérez-Saldivar ML, Martínez-García A, Jiménez-Hernández E, Fernández-López JC, Martín-Trejo JA, Pérez-Lorenzana H, Flores-Lujano J, Amador-Sánchez R, Mora-Ríos FG, Peñaloza-González JG, Duarte-Rodríguez DA, Torres-Nava JR, Flores-Bautista JE, Espinosa-Elizondo RM, Román-Zepeda PF, Flores-Villegas LV, González-Ulivarri JE, Martínez-Silva SI, Espinoza-Anrubio G, Almeida-Hernández C, Ramírez-Colorado R, Hernández-Mora L, García-López LR, Cruz-Ojeda GA, Godoy-Esquivel AE, Contreras-Hernández I, Medina-Hernández A, López-Caballero MG, Hernández-Pineda NA, Granados-Kraulles J, Rodríguez-Vázquez MA, Torres-Valle D, Cortés-Reyes C, Medrano-López F, Pérez-Gómez JA, Martínez-Ríos A, Aguilar-De Los Santos A, Serafin-Díaz B, Bekker-Méndez VC, Mata-Rocha M, Morales-Castillo BA, Sepúlveda-Robles OA, Ramírez-Bello J, Rosas-Vargas H, Hidalgo-Miranda A, Mejía-Aranguré JM, Jiménez-Morales S. Genotype-Environment Interaction Analysis of NQO1, CYP2E1, and NAT2 Polymorphisms and the Risk of Childhood Acute Lymphoblastic Leukemia: A Report From the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia. Front Oncol 2020; 10:571869. [PMID: 33072605 PMCID: PMC7537417 DOI: 10.3389/fonc.2020.571869] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/17/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Acute lymphoblastic leukemia (ALL) is the main type of cancer in children. In Mexico and other Hispanic populations, the incidence of this neoplasm is one of the highest reported worldwide. Functional polymorphisms of various enzymes involved in the metabolism of xenobiotics have been associated with an increased risk of developing ALL, and the risk is different by ethnicity. The aims of the present study were to identify whether NQO1, CYP2E1, and NAT2 polymorphisms or some genotype-environmental interactions were associated with ALL risk in Mexican children. Methods: We conducted a case-control study including 478 pediatric patients diagnosed with ALL and 284 controls (children without leukemia). Ancestry composition of a subset of cases and controls was assessed using 32 ancestry informative markers. Genetic-environmental interactions for the exposure to hydrocarbons were assessed by logistic regression analysis. Results: The polymorphisms rs1801280 (OR 1.54, 95% CI 1.21–1.93), rs1799929 (OR 1.96, 95% CI 1.55–2.49), and rs1208 (OR 1.44, 95% CI 1.14–1.81) were found to increase the risk of ALL; being the risks higher under a recessive model (OR 2.20, 95% CI 1.30–1.71, OR 3.87, 95% CI 2.20–6.80, and OR 2.26, 95% CI 1.32–3.87, respectively). Gene-environment interaction analysis showed that NAT2 rs1799929 TT genotype confers high risk to ALL under exposure to fertilizers, insecticides, hydrocarbon derivatives, and parental tobacco smoking. No associations among NQO1, CYP2E1, and ALL were observed. Conclusion: Our study provides evidence for the association between NAT2 polymorphisms/gene-environment interactions, and the risk of childhood ALL in Mexican children.
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Affiliation(s)
- Aurora Medina-Sanson
- Departamento de Hemato-Oncología, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Mexico City, Mexico.,Programa de Maestría y Doctorado en Ciencias Médicas de la Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM)Mexico City, Mexico
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Eduardo Hurtado-Cordova
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico.,Universidad Xochicalco, Campos Tijuana, Tijuana, Mexico
| | - María Luisa Pérez-Saldivar
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Anayeli Martínez-García
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico.,Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Elva Jiménez-Hernández
- Servicio de Hematología Pediátrica, Centro Médico Nacional "La Raza", Hospital General "Gaudencio González Garza", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | | | - Jorge Alfonso Martín-Trejo
- Servicio de Hematología Pediátrica, Centro Médico Nacional "Siglo XXI", UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Héctor Pérez-Lorenzana
- Servicio de Cirugía Pediátrica, Hospital General "Gaudencio González Garza", Centro Médico Nacional Siglo XXI (CMN) "La Raza", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Janet Flores-Lujano
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Raquel Amador-Sánchez
- Servicio de Hematología Pediátrica, Hospital General Regional "Carlos McGregor Sánchez Navarro", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Felix Gustavo Mora-Ríos
- Cirugía Pediátrica del Hospital Regional "General Ignacio Zaragoza", Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | | | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediátrico de Moctezuma, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | | | | | - Pedro Francisco Román-Zepeda
- Coordinación Clínica y Servicio de Cirugía pediátrica, Hospital General Regional (HGR) No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Luz Victoria Flores-Villegas
- Servicio de Hematología Pediátrica, Centro Médico Nacional "20 de Noviembre", Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Juana Esther González-Ulivarri
- Jefatura de Enseñanza, Hospital Pediátrico de Iztacalco, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Sofía Irene Martínez-Silva
- Jefatura de Enseñanza, Hospital Pediátrico de Iztapalapa, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Gilberto Espinoza-Anrubio
- Servicio de Pediatría, Hospital General Zona (HGZ) No. 8 "Dr. Gilberto Flores Izquierdo", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Carolina Almeida-Hernández
- Jefatura de Enseñanza, Hospital General de Ecatepec "Las Américas", Instituto de Salud del Estado de México (ISEM), Mexico City, Mexico
| | - Rosario Ramírez-Colorado
- Jefatura de Enseñanza, Hospital Pediátrico La Villa, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Luis Hernández-Mora
- Jefatura de Enseñanza, Hospital Pediátrico San Juan de Aragón, Secretaría de Salud (SS), Mexico City, Mexico
| | - Luis Ramiro García-López
- Servicio de Pediatría, Hospital Pediátrico de Tacubaya, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Gabriela Adriana Cruz-Ojeda
- Coordinación Clínica de Educación e Investigación en Salud, Hospital General de Zona (HGZ) No. 47, IMSS, Mexico City, Mexico
| | - Arturo Emilio Godoy-Esquivel
- Servicio de Cirugía Pediátrica, Hospital Pediátrico de Moctezuma, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Iris Contreras-Hernández
- Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Abraham Medina-Hernández
- Pediatría, Hospital Materno-Pediátrico de Xochimilco, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - María Guadalupe López-Caballero
- Jefatura de Enseñanza, Hospital Pediátrico de Coyoacán, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
| | - Norma Angélica Hernández-Pineda
- Coordinación Clínica y Pediatría del Hospital General de Zona 76, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Jorge Granados-Kraulles
- Coordinación Clínica y Pediatría del Hospital General de Zona 76, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - María Adriana Rodríguez-Vázquez
- Coordinación Clínica y Pediatría del Hospital General de Zona 68, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Delfino Torres-Valle
- Coordinación Clínica y Pediatría del Hospital General de Zona 71, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Carlos Cortés-Reyes
- Pediatría, Hospital General Dr. Darío Fernández Fierro, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Francisco Medrano-López
- Coordinación Clínica y Servicio de Pediatría, Hospital General Regional (HGR) No. 72 "Dr. Vicente Santos Guajardo", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Jessica Arleet Pérez-Gómez
- Coordinación Clínica y Servicio de Pediatría, Hospital General Regional (HGR) No. 72 "Dr. Vicente Santos Guajardo", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Annel Martínez-Ríos
- Cirugía Pediátrica del Hospital Regional "General Ignacio Zaragoza", Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
| | - Antonio Aguilar-De Los Santos
- Coordinación Clínica y Pediatría del Hospital General de Zona 98, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Berenice Serafin-Díaz
- Coordinación Clínica y Pediatría del Hospital General de Zona 57, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Vilma Carolina Bekker-Méndez
- Hospital de Infectología "Dr. Daniel Méndez Hernández", "La Raza", Instituto Mexicano del Seguro Social (IMSS), Unidad de Investigación Médica en Inmunología e Infectología, Mexico City, Mexico
| | - Minerva Mata-Rocha
- Unidad de Investigación Médica en Genética Humana, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Blanca Angélica Morales-Castillo
- Unidad de Investigación Médica en Genética Humana, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Omar Alejandro Sepúlveda-Robles
- Unidad de Investigación Médica en Genética Humana, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | | | - Haydeé Rosas-Vargas
- Unidad de Investigación Médica en Genética Humana, UMAE Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional "Siglo XXI", Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Alfredo Hidalgo-Miranda
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Juan Manuel Mejía-Aranguré
- Unidad de Investigación Médica en Epidemiología Clínica, Unidad Médica de Alta Especialidad Hospital de Pediatría "Dr. Silvestre Frenk Freund", Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.,Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Silvia Jiménez-Morales
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
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Cardoso de Carvalho D, Pereira Colares Leitão L, Mello Junior FAR, Vieira Wanderley A, de Souza TP, Borges Andrade de Sá R, Cohen-Paes A, Rodrigues Fernandes M, Santos S, Salim Khayat A, Pimentel de Assumpção P, Pereira Carneiro dos Santos N. Association between the TPMT*3C (rs1142345) Polymorphism and the Risk of Death in the Treatment of Acute Lymphoblastic Leukemia in Children from the Brazilian Amazon Region. Genes (Basel) 2020; 11:genes11101132. [PMID: 32992962 PMCID: PMC7601477 DOI: 10.3390/genes11101132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/11/2020] [Accepted: 09/18/2020] [Indexed: 12/21/2022] Open
Abstract
Acute lymphoblastic leukemia (ALL) is the leading cause of death from pediatric cancer worldwide. However, marked ethnic disparities are found in the treatment of childhood ALL with less effective results and higher mortality rates being obtained in populations with a high level of Native American ancestry. Genetic variations of the patient can affect resistance to ALL chemotherapy and potentially play an important role in this disparity. In the present study, we investigated the association of 16 genetic polymorphisms with the cell and metabolic pathways of the chemotherapeutic agents used in the treatment of ALL with the risk of death in treating childhood ALL in patients with a high contribution of Amerindian ancestry, coming from the Brazilian Amazon. The study included 121 patients with B-cell ALL treated with the BFM-2002 protocol. We are the first to identify the association between the TPMT gene rs1142345 polymorphism and the high risk of death in treating childhood ALL. Patients with the CC genotype had an approximately 25.5 times higher risk of dying during treatment of the disease than patients with other genotypes (p = 0.019). These results may help elucidate how the patient's genetic characteristics contribute to the mortality disparity in populations with a high contribution of Native American ancestry. The rs1142345 variant of the TPMT gene could be used as a potential marker to early stratify patients at high risk of death in treating childhood ALL in the investigated population.
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Affiliation(s)
- Darlen Cardoso de Carvalho
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
| | - Luciana Pereira Colares Leitão
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
| | - Fernando Augusto Rodrigues Mello Junior
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
| | - Alayde Vieira Wanderley
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
- Departamento de Pediatria, Ophir Loyola Hospital, Belém 66063-240, Brazil
| | - Tatiane Piedade de Souza
- Human and Medical Genetics Laboratory, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil;
| | - Roberta Borges Andrade de Sá
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
| | - Amanda Cohen-Paes
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
| | - Marianne Rodrigues Fernandes
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
| | - Sidney Santos
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
- Human and Medical Genetics Laboratory, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil;
| | - André Salim Khayat
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
| | - Paulo Pimentel de Assumpção
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
- João de Barros Barreto University Hospital, Universidade Federal do Pará, Belém 66063-023, Brazil
| | - Ney Pereira Carneiro dos Santos
- Oncology Research Nucleus, Universidade Federal do Pará, Belém 66063-023, Brazil; (D.C.d.C.); (L.P.C.L.); (F.A.R.M.J.); (A.V.W.); (R.B.A.d.S.); (A.C.-P.); (M.R.F.); (S.S.); (A.S.K.); (P.P.d.A.)
- Human and Medical Genetics Laboratory, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil;
- Correspondence:
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Ramirez-Florencio M, Jiménez-Morales S, Barbosa-Cobos RE, López-Cano DJ, Ramírez-Bello J. High frequency of mutant thiopurine S-methyltransferase genotypes in Mexican patients with systemic lupus erythematosus and rheumatoid arthritis. Clin Rheumatol 2017; 37:963-970. [PMID: 29264794 DOI: 10.1007/s10067-017-3955-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/24/2017] [Accepted: 12/12/2017] [Indexed: 12/20/2022]
Abstract
Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are treated with immunosuppressive purine analogs, 6-mercaptopurine/6-thioguanine/azathiopurine, which are inactivated by thiopurine S-methyltransferase (TPMT). Non-synonymous polymorphisms in TPMT are associated with increased risk of adverse effects in patients treated with thiopurines. This study aimed to determine the frequency of the most common mutant TPMT alleles in Mexican patients with SLE (a prototype autoimmune disease) and RA (one of the most common autoimmune diseases in Mexico). Five hundred fifty-three consecutive patients from Central Mexico with SLE (178) and RA (375) were included. Subjects were genotyped to identify TPMT*2 (rs1800462), TPMT*3A (rs1800460 and rs1142345), TPMT*3B (rs1800460), and TPMT*3C (rs1142345) mutant alleles. DNA samples were assayed with the 5' exonuclease technique and TaqMan probes. Mutant alleles were detected in 6.2 and 5.2% of SLE and RA cases, respectively. Of note, 12.4% of SLE cases and 10.1% of RA cases carried mutant genotypes. Among those, the null genotype (TPMT*2/*3A, 0.3%) and the TPMT*3B (0.5%) and TPMT*3C (1.0%) alleles were found in RA, but not SLE cases. Mexican SLE cases displayed the highest frequency of mutant TPMT genotypes worldwide. TPMT genotyping should be performed for Mexican patients with SLE and RA before prescribing purine analogs.
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Affiliation(s)
- Mireya Ramirez-Florencio
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Periferico Sur 4809, Tlalpan, Arenal Tepepan, 14610, Mexico City, CDMX, Mexico
| | - Silvia Jiménez-Morales
- Laboratorio de Genómica del Cáncer, Instituto Nacional de Medicina Genómica, Periferico Sur 4809, Tlalpan, Arenal Tepepan, 14610, Mexico City, CDMX, Mexico.
| | | | - Daniela Josabeth López-Cano
- Unidad de Investigación en Enfermedades Endócrinas y Metabólicas, Hospital Juárez de México, Av. Instituto Politécnico Nacional No. 5160 Delegación Gustavo A. Madero, C.P. 07760, Mexico City, D.F., Mexico
| | - Julian Ramírez-Bello
- Unidad de Investigación en Enfermedades Endócrinas y Metabólicas, Hospital Juárez de México, Av. Instituto Politécnico Nacional No. 5160 Delegación Gustavo A. Madero, C.P. 07760, Mexico City, D.F., Mexico.
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