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Ghorbannezhad G, Mehrabadi S, Golampour-Shamkani N, Barjasteh A, Etesamizadeh P, Tayyebi M, Khazaei M, Hassanian SM, Ferns GA, Avan A. Genetic Determinants of Response to Statins in Cardiovascular Diseases. Curr Cardiol Rev 2024; 20:20-28. [PMID: 38204221 PMCID: PMC11107471 DOI: 10.2174/011573403x267793231220114042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/28/2023] [Accepted: 11/15/2023] [Indexed: 01/12/2024] Open
Abstract
Despite extensive efforts to identify patients with cardiovascular disease (CVD) who could most benefit from the treatment approach, patients vary in their benefit from therapy and propensity for adverse drug events. Genetic variability in individual responses to drugs (pharmacogenetics) is considered an essential determinant in responding to a drug. Thus, understanding these pharmacogenomic relationships has led to a substantial focus on mechanisms of disease and drug response. In turn, understanding the genomic and molecular bases of variables that might be involved in drug response is the main step in personalized medicine. There is a growing body of data evaluating drug-gene interactions in recent years, some of which have led to FDA recommendations and detection of markers to predict drug responses (e.g., genetic variant in VKORC1 and CYP2C9 genes for prediction of drug response in warfarin treatment). Also, statins are widely prescribed drugs for the prevention of CVD. Atorvastatin, fluvastatin, rosuvastatin, simvastatin, and lovastatin are the most common statins used to manage dyslipidemia. This review provides an overview of the current knowledge on the pharmacogenetics of statins, which are being used to treat cardiovascular diseases.
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Affiliation(s)
- Ghazaleh Ghorbannezhad
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Mehrabadi
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negar Golampour-Shamkani
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Barjasteh
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Poorya Etesamizadeh
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Tayyebi
- Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khazaei
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hassanian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK
| | - Amir Avan
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Wazir M, Olanrewaju OA, Yahya M, Kumari J, Kumar N, Singh J, Abbas Al-Itbi AY, Kumari K, Ahmed A, Islam T, Varrassi G, Khatri M, Kumar S, Wazir H, Raza SS. Lipid Disorders and Cardiovascular Risk: A Comprehensive Analysis of Current Perspectives. Cureus 2023; 15:e51395. [PMID: 38292957 PMCID: PMC10825376 DOI: 10.7759/cureus.51395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 12/31/2023] [Indexed: 02/01/2024] Open
Abstract
The increasing worldwide prevalence of cardiovascular diseases (CVDs) highlights the need to understand the complex relationships between lipid abnormalities and elevated cardiovascular risk. This review thoroughly investigates the complex terrain of lipid abnormalities, highlighting their crucial significance in developing CVDs. Dyslipidemia, which is closely connected to atherosclerosis, is a significant risk factor for CVDs, including coronary artery disease, myocardial infarction, and stroke. This review thoroughly examines the intricate relationship between lipoproteins, cholesterol metabolism, and the inflammatory cascade, providing a detailed comprehension of the mechanisms that contribute to atherogenic processes. An extensive analysis of the occurrence and distribution of lipid diseases worldwide indicates a concerning high frequency, which calls for a reassessment of public health approaches. Dyslipidemia is caused by a combination of genetic predispositions, lifestyle factors, and metabolic abnormalities, as supported by significant data. Moreover, investigating different types of lipoproteins and their specific functions in the development of atherosclerosis provides insight into the complex causes of CVDs. In addition to conventional lipid profiles, newly identified biomarkers and advanced imaging techniques are being carefully examined for their ability to improve risk classification and treatment strategies' effectiveness. From a critical perspective, the review thoroughly examines the current state of lipid-modifying medicines, specifically statins, fibrates, and new therapeutic approaches. The text discusses the emerging concept of precision medicine, which involves tailoring treatment approaches to individuals based on their genetic and molecular characteristics. This approach has the potential to improve treatment outcomes. In addition, this study critically assesses the effects of lifestyle changes and nutritional interventions on lipid homeostasis, offering a comprehensive view of preventive strategies. This review consolidates current viewpoints on lipid diseases and their complex correlation with cardiovascular risk. This review contributes to the ongoing cardiovascular disease prevention and management dialogue by clarifying the molecular mechanisms, exploring new therapeutic options, and considering broader societal implications.
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Affiliation(s)
- Maha Wazir
- Department of Medicine, Khyber Teaching Hospital, Peshawar, PAK
| | - Olusegun A Olanrewaju
- Department of Pure and Applied Biology, Ladoke Akintola University of Technology, Ogbomoso, NGA
- Department of General Medicine, Stavropol State Medical University, Stavropol, RUS
| | - Muhammad Yahya
- Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Jaya Kumari
- Department of Internal Medicine, Mehran Medical Centre, Karachi, PAK
| | - Narendar Kumar
- Department of Internal Medicine, Burjeel Hospital, Abu Dhabi, ARE
| | - Jagjeet Singh
- Department of Internal Medicine, Lahore General Hospital, Lahore, PAK
| | | | - Komal Kumari
- Department of Medicine, NMC Royal Family Medical Centre, Abu Dhabi, ARE
| | - Aqsa Ahmed
- Department of Medicine, Medicare Hospital, Faisalabad, PAK
| | - Tamur Islam
- Department of Internal Medicine, Allied Hospital, Faisalabad, PAK
| | | | - Mahima Khatri
- Department of Internal Medicine/Cardiology, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Hina Wazir
- Department of Internal Medicine, Khyber Medical College, Peshawar, PAK
| | - Syed S Raza
- Department of Physiology, Gajju Khan Medical College, Swabi, PAK
- Department of Physiology, Khyber Medical College, Peshawar, PAK
- Robert and Suzanne Tomsich Department of Cardiothoracic Surgery, Cleveland Clinic Florida, Peshawar, PAK
- Department of Physiology, Gandhara University, Peshawar, PAK
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3
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Marzolini C, Cavassini M, Braun DL, Hachfeld A, Bernasconi E, Calmy A, Schmid P, Battegay M, Elzi L. Effect of SLCO1B1 c.521T>C polymorphism on the lipid response to statins in people living with HIV on a boosted protease inhibitor-containing regimen. Br J Clin Pharmacol 2023; 89:2739-2746. [PMID: 37101315 DOI: 10.1111/bcp.15754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/21/2023] [Accepted: 04/22/2023] [Indexed: 04/28/2023] Open
Abstract
AIMS We previously observed that some individuals on HIV boosted protease inhibitor-containing regimen do not achieve their lipid targets despite elevated statin concentrations. This study evaluated whether the common single polymorphism c.521T>C in SLCO1B1, associated with reduced statin uptake in the liver, could explain this observation. METHODS People living with HIV in the Swiss HIV Cohort Study were eligible if they were on a boosted protease inhibitor concomitantly with a statin for at least 6 months and if their SLCO1B1 genotype was available. Furthermore, their lipids had to be documented before and after the introduction of the statin. The statin efficacy was defined as % change in total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol and triglycerides levels after statin initiation compared to pretreatment levels. Lipid response was adjusted for differences in potency and dose between statins. RESULTS In total, 88 people living with HIV were included, of whom 58, 28 and 2 carried the SLCO1B1 TT, TC and CC genotypes, respectively. The change in lipid levels after statin initiation tended to be lower in carriers of the polymorphism although the difference was not statistically significant (TT vs. TC/CC: total cholesterol: -11.7 vs. -4.8%; low-density lipoprotein- cholesterol: -20.6 vs. -7.4%; high-density lipoprotein-cholesterol: 1.6 vs. 0%; triglycerides: -11.5 vs. -7.9%). In the multiple linear regression, change in total cholesterol was inversely correlated with the total cholesterol level prestatin treatment (coefficient -6.60, 95% confidence interval: -9.63 to -3.56, P < .001). CONCLUSION The lipid-lowering effect of statins tended to be attenuated by SLCO1B1 polymorphism and progressively declined as total cholesterol under the boosted protease inhibitor treatment decreased.
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Affiliation(s)
- Catia Marzolini
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Matthias Cavassini
- Service of Infectious Diseases, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Dominique L Braun
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland
| | - Anna Hachfeld
- Department of Infectious Diseases, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Ente Ospedaliero Cantonale Lugano, University of Geneva and University of Southern Switzerland, Lugano, Switzerland
| | - Alexandra Calmy
- Division of Infectious Diseases, University Hospital Geneva, University of Geneva, Geneva, Switzerland
| | - Patrick Schmid
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Luigia Elzi
- Division of Infectious Diseases, Regional Hospital Bellinzona, Bellinzona, Switzerland
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Andrianto, Puspitasari M, Ardiana M, Dewi IP, Shonafi KA, Kusuma Wardhani LF, Nugraha RA. Association between single nucleotide polymorphism SLCO1B1 gene and simvastatin pleiotropic effects measured through flow-mediated dilation endothelial function parameters. Ther Adv Cardiovasc Dis 2022; 16:17539447221132367. [PMID: 36314075 PMCID: PMC9629567 DOI: 10.1177/17539447221132367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Atherosclerosis is a condition in which the medium to large arteries become inflamed over time. The cornerstone to the atherosclerosis process is endothelial dysfunction. Simvastatin is a cholesterol-lowering drug known for its endothelial cell pleiotropic properties. The role of genetic polymorphisms in simvastatin-resistance difficulties has recently piqued people's interest. This problem is thought to be linked to the pleiotropic action of simvastatin, particularly in terms of restoring endothelial function. The goal of this study is to see if there is a link between the single nucleotide polymorphism (SNP) c.521T>C and the pleiotropic effect of simvastatin as determined by the endothelial function parameter, flow-mediated dilation (FMD). METHODS This research was a multicentre cross-sectional study including 71 hypercholesterolemia patients who have been on simvastatin for at least 3 months. The real-time polymerase chain reaction identified SNP c.521T>C. The right brachial artery ultrasonography was used to measure FMD. RESULTS In 71 hypercholesterolemia patients, the SNP c.521T>C was found in 9.9% of them. On χ2 analysis, there was no significant association between SNP c.521T>C (TC genotype) and FMD (p = 0.973). On logistic regression analysis, the duration of simvastatin medication was linked with an increased incidence (Adj. OR (adjusted odds ratio) = 2.424; confidence interval (CI) = 1.117-5.260, p = 0.025) and a reduction in systolic blood pressure (Adj. OR = 0.92; CI = 0.025-0.333, p = 0.001). CONCLUSION There was no association between FMD and the SNP c.521T>C (TC genotype). The duration of simvastatin medication and systolic blood pressure were both associated to FMD.
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Affiliation(s)
| | - Mia Puspitasari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University – Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Meity Ardiana
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University – Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Ivana Purnama Dewi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University – Dr. Soetomo General Hospital, Surabaya, Indonesia,Faculty of Medicine, Duta Wacana Christian University, Yogyakarta, Indonesia
| | - Khubay Alvia Shonafi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University – Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Louisa Fadjri Kusuma Wardhani
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University – Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University – Dr. Soetomo General Hospital, Surabaya, Indonesia
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Sivkov A, Chernus N, Gorenkov R, Sivkov S, Sivkova S, Savina T. Relationship between genetic polymorphism of drug transporters and the efficacy of Rosuvastatin, atorvastatin and simvastatin in patients with hyperlipidemia. Lipids Health Dis 2021; 20:157. [PMID: 34749751 PMCID: PMC8573942 DOI: 10.1186/s12944-021-01586-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background To determine the effect of genetic polymorphism of drug transporters on the efficacy of treatment with Rosuvastatin, Atorvastatin and Simvastatin in patients with hyperlipidemia. Methods The study consists of 180 patients, aged 40–75 years, with hyperlipidemia. All patients were divided into two equal groups: patients with different SLCO1B1 (521CC, 521CT and 521TT) and MDR1 (3435CC, 3435TC and 3435TT) genotypes. Each group was divided into rosuvastatin-treated, atorvastatin-treated and simvastatin-treated subgroups. The lipid-lowering effect of statins was assessed by tracing changes in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels. Results The use of statins over a 4-month period led to substantial reductions in TC and LDL-C levels. The hypolipidemic effect of studied agents was seen in both groups. However, it was less pronounced in patients with 521CC genotype. No statistically significantly differences were found between carriers of 3435TT, 3435CT and 3435CC genotypes. Conclusions The lipid-lowering efficacy of rosuvastatin was higher compared to other two statins. Patients with SLCO1B1 521CC genotype are more likely to encounter a decrease in the hypolipidemic effect of statins. Such a risk should be considered when treating this category of patients. MDR1 polymorphism had no significant effect on statin efficacy.
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Affiliation(s)
- Andrey Sivkov
- N.V. Sklifosovsky Institute of Clinical Medicine, Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
| | - Natalya Chernus
- N.V. Sklifosovsky Institute of Clinical Medicine, Department of Polyclinical Therapy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Roman Gorenkov
- Institute of Leadership and Health Management, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.,Federal State Budget Scientific Institution, «The N. A. Semashko National Research Institute of Public Health», Moscow, Russian Federation
| | - Sergey Sivkov
- N.V. Sklifosovsky Institute of Clinical Medicine, Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Svetlana Sivkova
- N.V. Sklifosovsky Institute of Clinical Medicine, Department of Polyclinical Therapy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Tamara Savina
- N.V. Sklifosovsky Institute of Clinical Medicine, Department of Polyclinical Therapy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
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6
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Gebremichael LG, Suppiah V, Wiese MD, Mackenzie L, Phillips C, Williams DB, Roberts MS. Efficacy and safety of statins in ethnic differences: a lesson for application in Indigenous Australian patient care. Pharmacogenomics 2021; 22:553-571. [PMID: 34120458 DOI: 10.2217/pgs-2020-0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Although statins are effective in treating high cholesterol, adverse effects do occur with their use. Efficacy and tolerability vary among statins in different ethnic groups. Indigenous Australians have a high risk for cardiovascular and kidney diseases. Prescribing statins to Indigenous Australians with multi-morbidity requires different strategies to increase efficacy and reduce their toxicity. Previous studies have reported that Indigenous Australians are more susceptible to severe statin-induced myopathies. However, there is a lack of evidence in the underlying genetic factors in this population. This review aims to identify: inter-ethnic differences in the efficacy and safety of statins; major contributing factors accounting for any identified differences; and provide an overview of statin-induced adverse effects in Indigenous Australians.
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Affiliation(s)
- Lemlem G Gebremichael
- UniSA Clinical & Health Science, University of South Australia, Adelaide, SA 5000, Australia
| | - Vijayaprakash Suppiah
- UniSA Clinical & Health Science, University of South Australia, Adelaide, SA 5000, Australia.,Australian Centre for Precision Health, University of South Australia, Adelaide, SA 5000, Australia
| | - Michael D Wiese
- UniSA Clinical & Health Science, University of South Australia, Adelaide, SA 5000, Australia
| | - Lorraine Mackenzie
- UniSA Clinical & Health Science, University of South Australia, Adelaide, SA 5000, Australia
| | - Craig Phillips
- UniSA Clinical & Health Science, University of South Australia, Adelaide, SA 5000, Australia
| | - Desmond B Williams
- UniSA Clinical & Health Science, University of South Australia, Adelaide, SA 5000, Australia
| | - Michael S Roberts
- UniSA Clinical & Health Science, University of South Australia, Adelaide, SA 5000, Australia.,Therapeutics Research Centre, Diamantina Institute, The University of Queensland, Translational Research Institute, Woolloongabba, QLD 4102, Australia.,Basil Hetzel Institute for Translational Medical Research, The Queen Elizabeth Hospital, 28 Woodville Rd, Woodville, SA 5011, Australia
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7
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Wagner JB, Ruggiero M, Leeder JS, Hagenbuch B. Functional Consequences of Pravastatin Isomerization on OATP1B1-Mediated Transport. Drug Metab Dispos 2020; 48:1192-1198. [PMID: 32892153 PMCID: PMC7589943 DOI: 10.1124/dmd.120.000122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022] Open
Abstract
Pravastatin acid (PVA) can be isomerized to its inactive metabolite 3'α-iso-pravastatin acid (3αPVA) under acidic pH conditions. Previous studies reported interindividual differences in circulating concentrations of PVA and 3αPVA. This study investigated the functional consequences of PVA isomerization on OATP1B1-mediated transport. We characterized 3αPVA inhibition of OATP1B1-mediated PVA uptake into human embryonic kidney 293 cells expressing the four different OATP1B1 proteins (*1a, *1b, *5, and *15). 3αPVA inhibited OATP1B1-mediated PVA uptake in all four OATP1B1 gene products but with lower IC50/Ki values for OATP1B1*5 and *15 than for the reference proteins (*1a and *1b). PVA and 3αPVA were transported by all four OATP1B1 proteins. Kinetic experiments revealed that maximal transport rates (Vmax values) for OATP1B1 variants *5 and *15 were lower than for *1a and *1b for both substrates. Apparent affinities for 3αPVA transport were similar for all four variants. However, the apparent affinity of OATP1B1*5 for 3αPVA was higher (lower Km value) than for PVA. These data confirm that PVA conversion to 3αPVA can have functional consequences on PVA uptake and impacts OATP1B1 variants more than the reference protein, thus highlighting another source variation that must be taken into consideration when optimizing the PVA dose-exposure relationship for patients. SIGNIFICANCE STATEMENT: 3'α-iso-pravastatin acid inhibits pravastatin uptake for all OATP1B1 protein types; however, the IC50 values were significantly lower in OATP1B1*5 and *15 transfected cells. This suggests that a lower concentration of 3'α-iso-pravastatin is needed to disrupt OATP1B1-mediated pravastatin uptake, secondary to decreased cell surface expression of functional OATP1B1 in variant-expressing cells. These data will refine previous pharmacokinetic models that are utilized to characterize pravastatin interindividual variability with an ultimate goal of maximizing efficacy at the lowest possible risk for toxicity.
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Affiliation(s)
- Jonathan B Wagner
- Ward Family Heart Center (J.B.W.) and Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation (J.B.W., J.S.L.), Children's Mercy, Kansas City, Missouri; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri (J.B.W., J.S.L.); and Department of Pharmacology, Toxicology, and Therapeutics, The University of Kansas Medical Center, Kansas City, Kansas (M.R., B.H.)
| | - Melissa Ruggiero
- Ward Family Heart Center (J.B.W.) and Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation (J.B.W., J.S.L.), Children's Mercy, Kansas City, Missouri; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri (J.B.W., J.S.L.); and Department of Pharmacology, Toxicology, and Therapeutics, The University of Kansas Medical Center, Kansas City, Kansas (M.R., B.H.)
| | - J Steven Leeder
- Ward Family Heart Center (J.B.W.) and Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation (J.B.W., J.S.L.), Children's Mercy, Kansas City, Missouri; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri (J.B.W., J.S.L.); and Department of Pharmacology, Toxicology, and Therapeutics, The University of Kansas Medical Center, Kansas City, Kansas (M.R., B.H.)
| | - Bruno Hagenbuch
- Ward Family Heart Center (J.B.W.) and Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation (J.B.W., J.S.L.), Children's Mercy, Kansas City, Missouri; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri (J.B.W., J.S.L.); and Department of Pharmacology, Toxicology, and Therapeutics, The University of Kansas Medical Center, Kansas City, Kansas (M.R., B.H.)
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Abstract
Pro-protein convertase subtilisin/Kexin type 9 (PCSK9) inhibitors are relatively new, non-statin, lipid-lowering drugs that reduce low-density lipoprotein cholesterol (LDL-C) by 60%. PCSK9 inhibitors reduce the blood concentrations of cholesterol by the degradation of LDL receptors, which subsequently extracts cholesterol from cells. This leads to cardiovascular risk reduction in various at-risk populations, including atherosclerotic coronary artery disease. Despite their promise for advanced lipid-lowering ability, cost-effectiveness is a barrier to their routine use. While searching PubMed, we extracted land-mark trials on two of the anti-PCSK9 monoclonal antibodies, alirocumab and evolocumab. When combined with statins or ezetimibe, they show an exponential fall in LDL-C levels, helping achieve target values in high-risk populations and decreasing cardiovascular adverse events. Ongoing research is exploring the long-term efficacy of these antibodies in established coronary artery disease and familial hypercholesterolemia with more prospects for this novel lipid-lowering therapy.
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Affiliation(s)
- Jahanzeb Malik
- Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK
| | - Hassan Shabeer
- Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK
| | - Uzma Ishaq
- Hematology and Medical Oncology, Fauji Foundation Hospital, Rawalpindi, PAK
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10
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Loisios-Konstantinidis I, Paraiso RLM, Fotaki N, McAllister M, Cristofoletti R, Dressman J. Application of the relationship between pharmacokinetics and pharmacodynamics in drug development and therapeutic equivalence: a PEARRL review. J Pharm Pharmacol 2019; 71:699-723. [DOI: 10.1111/jphp.13070] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/19/2019] [Indexed: 12/18/2022]
Abstract
Abstract
Objectives
The objective of this review was to provide an overview of pharmacokinetic/pharmacodynamic (PK/PD) models, focusing on drug-specific PK/PD models and highlighting their value added in drug development and regulatory decision-making.
Key findings
Many PK/PD models, with varying degrees of complexity and physiological understanding have been developed to evaluate the safety and efficacy of drug products. In special populations (e.g. paediatrics), in cases where there is genetic polymorphism and in other instances where therapeutic outcomes are not well described solely by PK metrics, the implementation of PK/PD models is crucial to assure the desired clinical outcome. Since dissociation between the pharmacokinetic and pharmacodynamic profiles is often observed, it is proposed that physiologically based pharmacokinetic and PK/PD models be given more weight by regulatory authorities when assessing the therapeutic equivalence of drug products.
Summary
Modelling and simulation approaches already play an important role in drug development. While slowly moving away from ‘one-size fits all’ PK methodologies to assess therapeutic outcomes, further work is required to increase confidence in PK/PD models in translatability and prediction of various clinical scenarios to encourage more widespread implementation in regulatory decision-making.
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Affiliation(s)
| | - Rafael L M Paraiso
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt am Main, Germany
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, Faculty of Science, University of Bath, Bath, UK
| | | | - Rodrigo Cristofoletti
- Division of Therapeutic Equivalence, Brazilian Health Surveillance Agency (ANVISA), Brasilia, Brazil
| | - Jennifer Dressman
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt am Main, Germany
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11
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Lam YWF. Principles of Pharmacogenomics. Pharmacogenomics 2019. [DOI: 10.1016/b978-0-12-812626-4.00001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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12
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Liu N, Yang G, Hu M, Cai Y, Hu Z, Jia C, Zhang M. Association of ABCC2 polymorphism and gender with high-density lipoprotein cholesterol response to simvastatin. Pharmacogenomics 2018; 19:1125-1132. [PMID: 30024814 DOI: 10.2217/pgs-2018-0084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Aim: The clinical benefits of lipid-lowering therapy with statins are widely recognized. However, the lipid-lowering efficacy of statins shows significant differences between individuals. ABCC2 has been demonstrated to contribute to the transmembrane transport of the substrate compounds. The ABCC2 SNPs may be important factors that affect individual differences in clinical drug response. The aim of this study was to evaluate the association of rs717620 of ABCC2 with treatment response to simvastatin in a Chinese Han population. Methods: A total of 318 subjects were medicated with simvastatin 20 mg/day for 12 weeks after enrollment. Venous blood was obtained before and after simvastatin treatment for measurement of blood lipid profile. Subjects were classified into high-response and low-response groups depending on whether their lipid profile change was higher or lower than median change values. The ABCC2 SNP rs717620 was genotyped from blood samples with a snapshot assay. Results: A total of 12 weeks of treatment with simvastatin significantly decreased low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TGs) and significantly increased high-density lipoprotein cholesterol (HDL-C; p < 0.05). In multivariate analysis, there were no significant genetic effects of SNP rs717620 on the incidence of high- or low-response patients among TC, TG and LDL-C groups. However, rs717620 A-allele and female gender are significantly associated with the risk of low-response of HDL-C elevation after simvastatin treatment. Conclusion: ABCC2 rs717620 and female gender may be related to the low-effect of simvastatin treatment on the HDL-C level in the Chinese Han population. Female Chinese patients with hyperlipidemia carrying rs717620 GA/AA genotypes might have reduced benefit from simvastatin treatment.
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Affiliation(s)
- Na Liu
- Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
- Clinical Laboratory Medicine, Peking University Ninth School of Clinical Medicine, Beijing, PR China
- Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Guihua Yang
- Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
- Clinical Laboratory Medicine, Peking University Ninth School of Clinical Medicine, Beijing, PR China
- Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Mei Hu
- Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
- Clinical Laboratory Medicine, Peking University Ninth School of Clinical Medicine, Beijing, PR China
- Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Yuyu Cai
- Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
- Clinical Laboratory Medicine, Peking University Ninth School of Clinical Medicine, Beijing, PR China
- Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Zhiying Hu
- Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
- Clinical Laboratory Medicine, Peking University Ninth School of Clinical Medicine, Beijing, PR China
- Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Chundi Jia
- Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
- Clinical Laboratory Medicine, Peking University Ninth School of Clinical Medicine, Beijing, PR China
- Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
| | - Man Zhang
- Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
- Clinical Laboratory Medicine, Peking University Ninth School of Clinical Medicine, Beijing, PR China
- Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics, Beijing Shijitan Hospital, Capital Medical University, Beijing, PR China
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13
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Zhong Z, Wu H, Li B, Li C, Liu Z, Yang M, Zhang Q, Zhong W, Zhao P. Analysis of SLCO1B1 and APOE genetic polymorphisms in a large ethnic Hakka population in southern China. J Clin Lab Anal 2018; 32:e22408. [PMID: 29424099 PMCID: PMC6817202 DOI: 10.1002/jcla.22408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/21/2018] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Statins are the most widely used lipid-lowering drugs, which have a significant effect on the inhibition of cardiovascular disease. The efficacy and side effects of statins are associated with the polymorphisms of SLCO1B1 and APOE genes. The purpose of this study was to analyze the SLCO1B1 and APOE gene polymorphisms in the Hakka population of southern China. METHODS A total of 3249 subjects including 2019 males and 1230 females participated in this study. Polymerase chain reaction (PCR)-fluorescence probe technique for polymorphisms analysis and analyzed the genotypes frequencies of SLCO1B1 and APOE genes. RESULTS The frequencies of SLCO1B1 521T>C between men and women were statistically significant (SLCO1B1 521TT, χ2 = 8.431, P = .004; SLCO1B1 521TC, χ2 = 7.436, P = .007). The frequencies of haplotypes *1b/*1b (40.07%) and *1a/*1b (32.56%) of SLCO1B1 gene accounted for 72.63%, followed by *1b/*15(14.40%), *1a/*1a (5.82%), *1a/*15 (5.57%), *15/*15 (1.45%), and *1a/*5 (0.12%). The frequencies of haplotypes *1a/*15 and *1b/*1b of SLCO1B1 gene between men and women were statistically significant (*1a/*15, χ2 = 6.789, P = .009; *1b/*1b, χ2 = 3.998, P = .004). In this study, genotype ɛ3/ɛ3 accounted for 69.04%, followed by ɛ3/ɛ4 (16.19%), ɛ2/ɛ3 (11.60%), ɛ2/ɛ4 (1.35%), ɛ4/ɛ4 (1.08%), and ɛ2/ɛ2 (0.74%) in all subjects, in which ɛ3 had the greatest allele frequency (82.93%), followed by ɛ4 (9.85%) and ɛ2 (7.22%). We found that 47 subjects carrying the SLCO1B1 521 (CC) polymorphism who had not any myopathy caused by statins. CONCLUSIONS We analyzed the SLCO1B1 and APOE gene polymorphisms in the Hakka population of southern China. This study provides a reference for the individualized meditation for Hakka population in this area.
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Affiliation(s)
- Zhixiong Zhong
- Center for Cardiovascular DiseasesMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Heming Wu
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Center for Precision MedicineMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Bin Li
- Center for Cardiovascular DiseasesMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Cunren Li
- Center for Cardiovascular DiseasesMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Zhidong Liu
- Center for Cardiovascular DiseasesMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Min Yang
- Center for Cardiovascular DiseasesMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Qifeng Zhang
- Center for Cardiovascular DiseasesMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Wei Zhong
- Center for Cardiovascular DiseasesMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
| | - Pingsen Zhao
- Clinical Core LaboratoryMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
- Center for Precision MedicineMeizhou People's Hospital (Huangtang Hospital)Meizhou Hospital Affiliated to Sun Yat‐sen UniversityMeizhouChina
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14
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Chang JH, Zhang X, Messick K, Chen YC, Chen E, Cheong J, Ly J. Unremarkable impact of Oatp inhibition on the liver concentration of fluvastatin, lovastatin and pitavastatin in wild-type and Oatp1a/1b knockout mouse. Xenobiotica 2018; 49:602-610. [DOI: 10.1080/00498254.2018.1478167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Jae H. Chang
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc, South San Francisco, CA, USA
| | - Xiaolin Zhang
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc, South San Francisco, CA, USA
| | - Kirsten Messick
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc, South San Francisco, CA, USA
| | - Yi-Chen Chen
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc, South San Francisco, CA, USA
| | - Eugene Chen
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc, South San Francisco, CA, USA
| | - Jonathan Cheong
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc, South San Francisco, CA, USA
| | - Justin Ly
- Department of Drug Metabolism and Pharmacokinetics, Genentech Inc, South San Francisco, CA, USA
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15
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Kaewboonlert N, Thitisopee W, Sirintronsopon W, Porntadavity S, Jeenduang N. Lack of association between SLCO1B1 polymorphisms and lipid-lowering response to simvastatin therapy in Thai hypercholesterolaemic patients. J Clin Pharm Ther 2018; 43:647-655. [PMID: 29575099 DOI: 10.1111/jcpt.12682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 02/23/2018] [Indexed: 01/03/2023]
Abstract
WHAT IS KNOWN SLCO1B1 polymorphisms have been reported to affect the responses to statin therapy. However, the association of these polymorphisms and lipid-lowering responses has been inconsistent. OBJECTIVE To investigate the effect of SLCO1B1 c.388A>G, c.521T>C and g.89595T>C polymorphisms on the lipid-lowering response to simvastatin therapy in Thai hypercholesterolaemic patients. METHODS Three hundred and 91 hypercholesterolaemic patients in Southern Thailand were enrolled and treated with simvastatin 20 or 40 mg per day. Among them, 191 and 200 patients were treated for 3 and 12 months, respectively. Serum lipids were measured before and after the treatment. SLCO1B1 c.388A>G, c.521T>C and g.89595T>C polymorphisms were analysed using polymerase chain reaction-high-resolution melting (PCR-HRM). RESULTS The allele frequencies of the SLCO1B1 c.388A>G, c.521T>C and g.89595T>C polymorphisms in Thai hypercholesterolaemic patients were 74.9%, 11.8% and 37.2%, respectively. After treatment with 20-40 mg simvastatin daily for 3 and 12 months, TC, TG and LDL-C concentrations were significantly lower than at baseline (P < .05). However, there was no a significant change in serum HDL-C after simvastatin treatment for 3 and 12 months (P > .05). Moreover, there was no association between SLCO1B1 c.388A>G, c.521T>C and g.89595T>C polymorphisms and lipid-lowering response to 3 and 12 months of either 20 or 40 mg/day simvastatin treatment. WHAT IS NEW AND CONCLUSION SLCO1B1 c.388A>G, c.521T>C and g.89595T>C polymorphisms may not be useful as genetic markers of lipid-lowering response to simvastatin therapy in Thai hypercholesterolaemic patients.
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Affiliation(s)
- N Kaewboonlert
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - W Thitisopee
- Department of Medicine, Thasala Hospital, Nakhon Si Thammarat, Thailand
| | | | - S Porntadavity
- Faculty of Medical Technology, Department of Clinical Chemistry, Mahidol University, Bangkok, Thailand
| | - N Jeenduang
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
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16
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Wagner JB, Abdel-Rahman S, Van Haandel L, Gaedigk A, Gaedigk R, Raghuveer G, Kauffman R, Leeder JS. Impact of SLCO1B1 Genotype on Pediatric Simvastatin Acid Pharmacokinetics. J Clin Pharmacol 2018; 58:823-833. [PMID: 29469964 DOI: 10.1002/jcph.1080] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/21/2017] [Indexed: 11/08/2022]
Abstract
This study investigated the impact of allelic variation in SLCO1B1, a gene encoding for the liver-specific solute carrier organic anion transporter family member 1B1 protein (SLCO1B1), on simvastatin and simvastatin acid (SVA) systemic exposure in children and adolescents. Participants (8-20 years old) with at least 1 variant SLCO1B1 c.521T>C allele (521TC, n = 15; 521CC, n = 2) and 2 wild-type alleles (521TT, n = 15) completed a single oral dose pharmacokinetic study. At equivalent doses, SVA exposure was 6.3- and 2.5-fold greater in 521CC and TC genotypes relative to 521TT (Cmax , 2.1 ± 0.2 vs 1.0 ± 0.5 vs 0.4 ± 0.3 ng/mL; P < .0001; and AUC, 12.1 ± 0.3 vs 4.5 ± 2.5 vs 1.9 ± 1.8 ng·h/mL; P < .0001). The impact of the SLCO1B1 c.521 genotype was more pronounced in children, although considerable interindividual variability in SVA exposure was observed within genotype groups. In addition, SVA systemic exposure was negligible in 25% of pediatric participants. Further investigation of the ontogeny and genetic variation of SVA formation and SLCO1B1-mediated hepatic uptake is necessary to better understand the variability in SVA exposure in children and its clinical consequences.
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Affiliation(s)
- Jonathan B Wagner
- Ward Family Heart Center, Medical Toxicology and Therapeutic Innovation, Children's Mercy, Kansas City, MO, USA.,Division of Clinical Pharmacology, Medical Toxicology and Therapeutic Innovation, Children's Mercy, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Susan Abdel-Rahman
- Division of Clinical Pharmacology, Medical Toxicology and Therapeutic Innovation, Children's Mercy, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Leon Van Haandel
- Division of Clinical Pharmacology, Medical Toxicology and Therapeutic Innovation, Children's Mercy, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Andrea Gaedigk
- Division of Clinical Pharmacology, Medical Toxicology and Therapeutic Innovation, Children's Mercy, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Roger Gaedigk
- Division of Clinical Pharmacology, Medical Toxicology and Therapeutic Innovation, Children's Mercy, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Geetha Raghuveer
- Ward Family Heart Center, Medical Toxicology and Therapeutic Innovation, Children's Mercy, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Ralph Kauffman
- Division of Clinical Pharmacology, Medical Toxicology and Therapeutic Innovation, Children's Mercy, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - J Steven Leeder
- Division of Clinical Pharmacology, Medical Toxicology and Therapeutic Innovation, Children's Mercy, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
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17
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Maxwell WD, Ramsey LB, Johnson SG, Moore KG, Shtutman M, Schoonover JH, Kawaguchi-Suzuki M. Impact of Pharmacogenetics on Efficacy and Safety of Statin Therapy for Dyslipidemia. Pharmacotherapy 2017; 37:1172-1190. [DOI: 10.1002/phar.1981] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Whitney D. Maxwell
- Department of Clinical Pharmacy and Outcomes Sciences; University of South Carolina College of Pharmacy; Columbia South Carolina
| | - Laura B. Ramsey
- Division of Research in Patient Services-Pharmacy Research; Cincinnati Children's Hospital Medical Center; Cincinnati Ohio
| | - Samuel G. Johnson
- American College of Clinical Pharmacy; Washington District of Columbia
- Virginia Commonwealth University; Richmond Virginia
| | - Kate G. Moore
- Department of Pharmacy Practice; Presbyterian College School of Pharmacy; Clinton South Carolina
| | - Michael Shtutman
- Department of Drug Discovery and Biomedical Sciences; University of South Carolina College of Pharmacy; Columbia South Carolina
| | - John H. Schoonover
- Department of Clinical Pharmacy and Outcomes Sciences; University of South Carolina College of Pharmacy; Columbia South Carolina
| | - Marina Kawaguchi-Suzuki
- School of Pharmacy; Pacific University College of Health Professions; Hillsboro Oregon
- Clinical Pharmacy Services; Kaiser Permanente Northwest; Portland Oregon
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18
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Du X, Kou H, Fu Q, Li Y, Zhu Z, Li T. Steady-state pharmacokinetics of tenofovir disoproxil fumarate in human immunodeficiency virus-infected Chinese patients. Expert Rev Clin Pharmacol 2017; 10:783-788. [PMID: 28480762 DOI: 10.1080/17512433.2017.1321480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The pharmacokinetic (PK) profile of tenofovir disoproxil fumarate in Chinese adults infected with HIV is unknown. METHODS A pilot, prospective, open-label study was performed to investigate the steady-state PK profile of tenofovir disoproxil fumarate in 15 Chinese HIV-infected patients among whom eight patients were treated with 300 mg tenofovir disoproxil fumarate, 300 mg lamivudine and 400/100 mg lopinavir/ritonavir, and seven with 300 mg tenofovir disoproxil fumarate, 300 mg lamivudine and 400 mg nevirapine. The plasma concentrations of tenofovir over the 24-h dosing interval were determined by HPLC. The PK parameters were calculated using the non-compartmental model in WinNonlin software. RESULTS The PK parameters of tenofovir in the 15 patients were determined as follows (mean ± SD): AUC(0-24 h), 4074.7 ± 1551.9 ng•h/mL; Cmax,ss, 447.1 ± 217.4 ng/mL; Ctrough,ss, 98.7 ± 36.7 ng/mL; tmax,ss, 1.3 ± 0.4 h; plasma t1/2, 21.8 ± 7.6 h; and CLss/F, 45.8 ± 13.0 L/h. CONCLUSION Tenofovir demonstrated slower elimination rate and increased plasma concentration in Chinese patients compared to previously published data from Caucasian or African subjects, which may be associated with the higher incidences of renal and bone resorption dysfunction observed in our patient population. Clinicians should be cautious of the differing PK characteristics of tenofovir among people of different races.
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Affiliation(s)
- Xiaoli Du
- a Department of Pharmacy, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences , Beijing , China
| | - Huijuan Kou
- b AIDS Diagnosis and Treatment Center, Department of Infectious Diseases, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences , Beijing , China
| | - Qiang Fu
- a Department of Pharmacy, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences , Beijing , China
| | - Yanling Li
- b AIDS Diagnosis and Treatment Center, Department of Infectious Diseases, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences , Beijing , China
| | - Zhu Zhu
- a Department of Pharmacy, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences , Beijing , China
| | - Taisheng Li
- b AIDS Diagnosis and Treatment Center, Department of Infectious Diseases, Peking Union Medical College Hospital , Chinese Academy of Medical Sciences , Beijing , China
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19
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Feasibility of the functional expression of the human organic anion transporting polypeptide 1B1 (OATP1B1) and its genetic variant 521T/C in the mouse liver. Eur J Pharm Sci 2017; 96:28-36. [PMID: 27619346 DOI: 10.1016/j.ejps.2016.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/16/2016] [Accepted: 09/09/2016] [Indexed: 11/22/2022]
Abstract
The objective of this study was to examine the feasibility of functional expression of the human organic anion transporting polypeptide 1B1 (hOATP1B1) forms in the liver of the mouse. After the mouse received the gene of interest (i.e., luciferase as the reporter or hOATP1B1) via hydrodynamic gene delivery (HGD) method, the expression was found to be liver-specific while alterations in the serum biochemistry and hepatocyte histology were apparently transient and reversible. The reporter activity was also detected in the plasma, but not in the blood cell in mice that received HGD, suggesting that the protein is probably released due to transiently increased permeability in hepatocytes by HGD. Using this delivery condition, the expression of hOATP1B1 was readily detected in the liver, but not in other tissues, of the mice receiving HGD for the transporter gene. Compared with the sham control mice, the uptake of pravastatin into the liver increased significantly in mice receiving hOATP1B1 wild type; the uptake parameters decreased consistently in mice expressing the 521T>C variant compared with that of the wild type control. These observations suggest that the functional expression of human transporter gene in mice is feasible, further suggesting that this treatment is practically useful in the pharmacokinetic studies for hOATP1B1 substrates.
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20
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Clinical Pharmacogenetics of the Major Adenosine Triphosphate−Binding Cassette and Solute Carrier Drug Transporters. J Pharm Pract 2016. [DOI: 10.1177/0897190007304823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Interindividual variability in drug response is a significant problem in clinical practice, and it is likely that genetic variation among the drug transport genes are major contributors to such variability. Numerous genetic alterations affecting the members of the adenosine triphosphate-binding cassette (ABC) and solute carrier (SLC) families of transporters have been identified. Considerable data exist regarding how mutations in the ABCB1 gene that encodes p-glycoprotein impact drug disposition and response in vivo, but many study reports are conflicting on both the direction of any effect as well as the significance of any alteration. Many possible reasons for such discrepant study results have been identified, and efforts to improve the quality of such pharmacogenetic clinical association studies are ongoing. For most other clinically important transporters relatively, little clinical data exist regarding the significance of known genetic variants despite in vitro evidence of altered function for many of these transporters. What clinical data do exist suggest that certain mutations in ABCG2 and SLCO1B1 may be of importance clinically. Until the current uncertainties regarding the importance of genetic variants in drug transporter genes are clarified, the clinical application of existing pharmacogenetic data should be done with caution.
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21
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Sychev DA, Shuev GN, Chertovskih JV, Maksimova NR, Grachev AV, Syrkova OA. The frequency of SLCO1B1*5 polymorphism genotypes among Russian and Sakha (Yakutia) patients with hypercholesterolemia. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2016; 9:59-63. [PMID: 27307760 PMCID: PMC4889090 DOI: 10.2147/pgpm.s99634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Introduction Statins are the most commonly prescribed medicines for treatment of hypercholesterolemia. At the same time, up to 25% of patients cannot tolerate or have to discontinue the statin therapy due to statin-induced myopathy. In a majority of cases, statin-induced myopathy is attributed to SLCO1B1 gene polymorphism. The strongest association between statin-induced myopathy and SLCO1B1 gene polymorphism was described for simvastatin. Our research was focused on the frequency of SLCO1B1*5 genetic variant in the Russian population and in the native population of Sakha (Yakutia). Materials and methods A total of 1,071 hyperlipidemic Russian and 76 hyperlipidemic Sakha (Yakutian) patients were included in the study. Genotypes of SLCO1B1*5 (c.521T>C, rs4149056) were determined with polymerase chain reaction amplification. The results of our study were compared with data about hyperlipidemic patients in available publications. Results In the Russian population 665 (62%) patients had TT genotype of SLCO1B1*5, 346 (32%) patients had TC genotype, and in 60 patients (6%) CC variant was found (Hardy–Weinberg’s chi-square test was 3.1 P=0.21). In comparison with Brazil, France, the People’s Republic of China, Japan, and the native population of Sakha (Yakutia), C-allele, which causes an increased risk of statin-induced myopathy, was found significantly more often in the Russian population. In the native population of Sakha (Yakutia) SLCO1B1 polymorphism was TT – 62 (82%), TC – 11 (14%), CC – 3 (4%) (Hardy–Weinberg’s chi-square test was 5.13 P=0.077). In comparison with data from Brazil, France, the People’s Republic of China, and Japan, C-allele frequency in the Sakha (Yakutian) population was not significantly different. Conclusion Thus, we have studied the incidence of pathologic SLCO1B1 c.521C-allele in Russian and Sakha hyperlipidemic patients. The presence of SLCO1B1 C-allele in patients with hyperlipidemia forces us to be more careful in hypolipidemic drug prescription, especially statins, according to a higher risk of statin-induced myopathy development. The fact that SLCO1B1 C-allele is rarer among Sakha patients, could be interesting from the point of studying adverse drug effects frequency and statins’ effectiveness.
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Affiliation(s)
- Dmitrij Alekseevitch Sychev
- Department of Internal Medicine and Clinical Pharmacology, Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation
| | | | | | | | - Andrej Vladimirovich Grachev
- Department of Internal Medicine and Clinical Pharmacology, Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation
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22
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Cárdenas-Rojas MI, Delgado-Enciso I, Baltazar-Rodríguez LM, Guzmán-Esquivel J, Ramírez-Flores M. Effects of the SLCO1B1 *1 and SLCO1B1 *5 polymorphisms on IL-6 and IL-10 levels in patients under pravastatin treatment prior to inguinal hernia repair. Int J Surg 2016; 27:105-109. [PMID: 26826613 DOI: 10.1016/j.ijsu.2016.01.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/16/2015] [Accepted: 01/03/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Different genetic variants in the SLCO1B1 gene have been shown to have functional importance in individual variability in pravastatin pharmacokinetics, resulting in different inflammatory responses to surgical inguinal hernia repair. The aim of this study was to determine IL-6 and IL-10 serum concentrations in the presence and absence of the SLCO1B1*1 and SLCO1B1*5 polymorphisms in patients under pravastatin treatment that underwent inguinal hernia repair. METHODS The study included 26 subjects that were under pravastatin treatment (40 mg/day) at least 1 month prior to inguinal hernia repair open technique. All the subjects were genotyped for the SLCO1B1*1 and SLCO1B1*5 polymorphisms through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and their preoperative and postoperative serum IL-6 and IL-10 levels were quantified through the ELISA technique. The IL-6 and IL-10 levels were analyzed in the presence or absence of the mutated polymorphism for SLCO1B1*1 and SLCO1B1*5. RESULTS The SLCO1B1*1 polymorphism had a frequency of 38.5% and the SLCO1B1*5 polymorphism had a frequency of 19.2%. The preoperative and postoperative serum concentrations of IL-6 were 0.252 pg/ml ± 0.19 and 0.206 pg/ml ± 0.20, respectively, with a p = 0.525, whereas the preoperative and postoperative serum concentrations for IL-10 were 4.943 pg/ml ± 3.13 and 4.611 pg/ml ± 3.01, respectively, with a p = 0.004. CONCLUSIONS The patients under pravastatin treatment presented with lower postoperative IL-10 levels with respect to the baseline concentration (p = 0.004), regardless of the presence or absence of the two polymorphisms.
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Affiliation(s)
| | | | | | | | - Mario Ramírez-Flores
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Colima, Mexico.
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Leusink M, Onland-Moret NC, de Bakker PIW, de Boer A, Maitland-van der Zee AH. Seventeen years of statin pharmacogenetics: a systematic review. Pharmacogenomics 2015; 17:163-80. [PMID: 26670324 DOI: 10.2217/pgs.15.158] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
AIM We evaluated the evidence of pharmacogenetic associations with statins in a systematic review. METHODS Two separate outcomes were considered of interest: modification of low-density lipoprotein cholesterol (LDL-C) response and modification of risk for cardiovascular events. RESULTS In candidate gene studies, 141 loci were claimed to be associated with LDL-C response. Only 5% of these associations were positively replicated. In addition, six genome-wide association studies of LDL-C response identified common SNPs in APOE, LPA, SLCO1B1, SORT1 and ABCG2 at genome-wide significance. None of the investigated SNPs consistently affected the risk reduction for cardiovascular events. CONCLUSION Only five genetic loci were consistently associated with LDL-C response. However, as effect sizes are modest, there is no evidence for the value of genetic testing in clinical practice.
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Affiliation(s)
- Maarten Leusink
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul I W de Bakker
- Julius Center for Health Sciences & Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Medical Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Anthonius de Boer
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Anke H Maitland-van der Zee
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
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Function-impairing polymorphisms of the hepatic uptake transporter SLCO1B1 modify the therapeutic efficacy of statins in a population-based cohort. Pharmacogenet Genomics 2015; 25:8-18. [PMID: 25379722 DOI: 10.1097/fpc.0000000000000098] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The efficacy of statins, which are used commonly in primary and secondary prevention of cardiovascular diseases, shows a wide range of interindividual variability. Genetic variants of OATP1B1, a hepatic uptake transporter, can modify access of statins to its therapeutic target, thereby potentially altering drug efficacy. We studied the impact of genetic variants of OATP1B1 on the lipid-lowering efficacy of statins in a population-based setting. MATERIALS AND METHODS The basis of the analysis was the Study of Health in Pomerania, a cohort of 2732 men and women aged 20-81 years. Included in the statistical analysis to evaluate the impact of OATP1B1 on therapeutic efficacy of statins were 214 individuals diagnosed with dyslipidaemia during initial recruitment and receiving statins during the 5-year follow-up. RESULTS Analysing the impact of the OATP1B1 genotype, we observed a trend for lower statin-induced total cholesterol reduction in carriers of the SLCO1B1 512C variant. Restricting the analysis to patients receiving simvastatin, pravastatin, lovastatin and fluvastatin indicated a statistically significant association of the OATP1B1 genotype on lipid parameters at the 5-year follow-up. No such effect was observed for atorvastatin. Calculation of achievement of treatment goals according to the NCEP-ATPIII guidelines showed a lower rate of successful treatment when harbouring the mutant allele for patients taking simvastatin (46.7 vs. 73.9%). A similar trend was observed for pravastatin (34.4 vs. 70.4%). CONCLUSION Genetic variants of OATP1B1 leading to impaired hepatic uptake of statins translated into reduced drug efficacy in a population-based cohort.
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Testa A, Zanda M, Elmore CS, Sharma P. PET Tracers To Study Clinically Relevant Hepatic Transporters. Mol Pharm 2015; 12:2203-16. [DOI: 10.1021/acs.molpharmaceut.5b00059] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Andrea Testa
- Kosterlitz
Centre for Therapeutics, School of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, U.K
| | - Matteo Zanda
- Kosterlitz
Centre for Therapeutics, School of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, U.K
| | | | - Pradeep Sharma
- AstraZeneca R&D, Cambridge Science Park, Milton Road, Cambridge CB4 0WG, U.K
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Delang L, Scheers E, Grabner M, Verpaalen B, Helsen N, Vanstreels E, Daelemans D, Verfaillie C, Neyts J. Understanding the molecular mechanism of host-based statin resistance in hepatitis C virus replicon containing cells. Biochem Pharmacol 2015; 96:190-201. [PMID: 26070251 DOI: 10.1016/j.bcp.2015.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/02/2015] [Indexed: 12/16/2022]
Abstract
A number of statins, the cholesterol-lowering drugs, inhibit the in vitro replication of hepatitis C virus (HCV). In HCV-infected patients, addition of statins to the earlier standard of care therapy (pegIFN-α and ribavirin) resulted in increased sustained virological response rates. The mechanism by which statins inhibit HCV replication has not yet been elucidated. In an attempt to gain insight in the underlying mechanism, hepatoma cells carrying an HCV replicon were passaged in the presence of increasing concentrations of fluvastatin. Fluvastatin-resistant replicon containing cells could be generated and proved ∼8-fold less susceptible to fluvastatin than wild-type cultures. The growth efficiency of the resistant replicon containing cells was comparable to that of wild-type replicon cells. The fluvastatin-resistant phenotype was not conferred by mutations in the viral genome but is caused by cellular changes. The resistant cell line had a markedly increased HMG-CoA reductase expression upon statin treatment. Furthermore, the expression of the efflux transporter P-gp was increased in fluvastatin-resistant replicon cells (determined by qRT-PCR and flow cytometry). This increased expression resulted also in an increased functional transport activity as measured by the P-gp mediated efflux of calcein AM. In conclusion, we demonstrate that statin resistance in HCV replicon containing hepatoma cells is conferred by changes in the cellular environment.
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Affiliation(s)
- Leen Delang
- Rega Institute for Medical Research, University of Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium.
| | - Els Scheers
- Rega Institute for Medical Research, University of Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium.
| | - Mareike Grabner
- Rega Institute for Medical Research, University of Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium.
| | - Ben Verpaalen
- Rega Institute for Medical Research, University of Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium.
| | - Nicky Helsen
- Stem Cell Biology and Embryology, University of Leuven, O&N IV Herestraat 49 - bus 804, 3000 Leuven, Belgium.
| | - Els Vanstreels
- Rega Institute for Medical Research, University of Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium.
| | - Dirk Daelemans
- Rega Institute for Medical Research, University of Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium.
| | - Catherine Verfaillie
- Stem Cell Biology and Embryology, University of Leuven, O&N IV Herestraat 49 - bus 804, 3000 Leuven, Belgium.
| | - Johan Neyts
- Rega Institute for Medical Research, University of Leuven, Minderbroedersstraat 10, 3000 Leuven, Belgium.
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Dou Y, Zhu X, Wang Q, Tian X, Cheng J, Zhang E. Meta-Analysis of the SLCO1B1 c.521T>C Variant Reveals Slight Influence on the Lipid-Lowering Efficacy of Statins. Ann Lab Med 2015; 35:329-35. [PMID: 25932441 PMCID: PMC4390701 DOI: 10.3343/alm.2015.35.3.329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/16/2014] [Accepted: 03/09/2015] [Indexed: 01/11/2023] Open
Abstract
Background Several studies have focused on the association between the lipid-lowering efficacy of statins and the SLCO1B1 c.521T>C polymorphism; however, the results are conflicting. The effects of statins show significant variability between individuals. This meta-analysis aimed to investigate the effects of the SLCO1B1 c.521T>C polymorphism on the lipid-lowering effects of statins. Methods We systematically searched PubMed and Web of Science to screen relevant studies. Meta-analysis was performed to identify the association between SLCO1B1 c.521 polymorphisms and the lipid-lowering effects of statinson the basis of the standard mean difference (SMD) and 95% confidence intervals (CIs). Additionally, we checked for heterogeneity (I2) among studies and evidence of publication bias. We obtained eight studies including 2,012 wild genotype (T/T) and 526 variant genotype (T/C and C/C) cases. Results No significant difference was observed in the lipid-lowering efficacy of statins between the wildand variant genotypes of SLCO1B1, with a pooled SMD of 0.03 (95% CI: -0.07-0.13). Furthermore, there was no significant effect in the meta-analyses of the variant heterozygote, homozygote, and Chinese populations. Subgroup meta-analysis indicated that the timerequired for the statin to take effectdid notsignificantly affect the association between lipid-lowering efficacy of statins and SLCO1B1 c.521T>C polymorphism. However, thewild genotype improved the lipid-lowering efficacy of simvastatin with a pooled SMD of -0.26 (95% CI: -0.47- -0.05). Conclusions No significant association was detected between the lipid-lowering efficacy of statins and the SLCO1B1 c.521T>C polymorphism, with the exception of simvastatin.
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Affiliation(s)
- Ye Dou
- Key Laboratory of Biomedical Engineering & Technology of Shandong High School, Shandong Wanjie Medical College, Zibo, China
| | - Xiaohai Zhu
- Key Laboratory of Biomedical Engineering & Technology of Shandong High School, Shandong Wanjie Medical College, Zibo, China
| | - Qinglu Wang
- Key Laboratory of Biomedical Engineering & Technology of Shandong High School, Shandong Wanjie Medical College, Zibo, China
| | - Xuewen Tian
- Sports Science Research Center of Shandong Province, Jinan, China
| | - Jingjing Cheng
- Sports Science Research Center of Shandong Province, Jinan, China
| | - Enying Zhang
- College of Agronomy and Plant Protection, Qingdao Agricultural University, Qingdao, Shandong, China
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Dai R, Feng J, Wang Y, Yang Y, Deng C, Tang X, Zhao Y, Zhou H, Zhang F. Association between SLCO1B1 521 T>C and 388 A>G Polymorphisms and Statins Effectiveness: A Meta-Analysis. J Atheroscler Thromb 2015; 22:796-815. [PMID: 25832498 DOI: 10.5551/jat.26856] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Previous studies on the association between the SLCO1B1 521 T>C and 388 A>G polymorphisms and statin effectiveness have been inconsistent. We performed this meta-analysis to provide a more comprehensive estimation of this issue. METHODS Multiple electronic literatues databases were searched on March 5th 2014. A quality assessment was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. A meta-analysis, sub-group analysis, sensitivity analysis (RevMan 5.2), publication bias measuring and meta-regression analysis were conducted utilizing the Stata software program (version 12.0). RESULTS A total of 13 studies were included in the final meta-analysis, which included 7,079 participants. Overall, there was no statistically significant association in the four genetic models of hypolipidemic effect. For the 521 T>C polymorphism, significant associations were found for the long-term effectiveness of lowering the low-density lipoprotein cholesterol (LDL-C) and in non-Asian populations in the dominant model [(CC+TC vs. TT: mean difference (MD)=1.44, 95% CI: 0.25-2.64,p=0.02) and (CC+TC vs. TT: MD=1.38, 95% CI: 0.28-2.49, p=0.01)], the recessive model [(CC vs. TT+TC: MD=3.31, 95% CI: 0.09-6.54, p=0.04) and (CC vs. TT+TC: MD=2.83, 95% CI: 0.26-5.41, p=0.03)], and the homozygote comparison [(CC vs. TT: MD=3.68, 95% CI: 0.42-6.94,p=0.03) and (CC vs. TT: MD=3.33, 95% CI: 0.67-5.99, p=0.01)], respectively. There were no significant differences for the other analyses of the 521 T>C polymorphism or all the analyses of the 388 A>G polymorphism. CONCLUSIONS The overall results suggest that the SLCO1B1 521 T>C and 388 A>G polymorphisms do not affect the lipid-lowering effectiveness of statins. However, allele C of the SLCO1B1 521 T>C polymorphism leads to an attenuated effect on lowering the LDL-C in non-Asian populations and the long-term effectiveness of statin treatment.
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Affiliation(s)
- Rong Dai
- School of Public Health and Management, Research Center for Medicine and Social Development, The Innovation Center for Social Risk Government in Health
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Application of a Physiologically Based Pharmacokinetic Model to Predict OATP1B1-Related Variability in Pharmacodynamics of Rosuvastatin. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2014; 3:e124. [PMID: 25006781 PMCID: PMC4120018 DOI: 10.1038/psp.2014.24] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 04/16/2014] [Indexed: 12/11/2022]
Abstract
Typically, pharmacokinetic–pharmacodynamic (PK/PD) models use plasma concentration as the input that drives the PD model. However, interindividual variability in uptake transporter activity can lead to variable drug concentrations in plasma without discernible impact on the effect site organ concentration. A physiologically based PK/PD model for rosuvastatin was developed that linked the predicted liver concentration to the PD response model. The model was then applied to predict the effect of genotype-dependent uptake by the organic anion-transporting polypeptide 1B1 (OATP1B1) transporter on the pharmacological response. The area under the plasma concentration–time curve (AUC0–∞) was increased by 63 and 111% for the c.521TC and c.521CC genotypes vs. the c.521TT genotype, while the PD response remained relatively unchanged (3.1 and 5.8% reduction). Using local concentration at the effect site to drive the PD response enabled us to explain the observed disconnect between the effect of the OATP1B1 c521T>C polymorphism on rosuvastatin plasma concentration and the cholesterol synthesis response.
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Clarke JD, Hardwick RN, Lake AD, Lickteig AJ, Goedken MJ, Klaassen CD, Cherrington NJ. Synergistic interaction between genetics and disease on pravastatin disposition. J Hepatol 2014; 61:139-47. [PMID: 24613363 PMCID: PMC4065643 DOI: 10.1016/j.jhep.2014.02.021] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 01/31/2014] [Accepted: 02/25/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS A genome wide association study and multiple pharmacogenetic studies have implicated the hepatic uptake transporter organic anion transporting polypeptide-1B1 (OATP1B1) in the pharmacokinetics and musculoskeletal toxicity of statin drugs. Other OATP uptake transporters can participate in the transport of pravastatin, partially compensating for the loss of OATP1B1 in patients carrying the polymorphism. Non-alcoholic steatohepatitis (NASH) in humans and in a diet-induced rodent model alter the expression of multiple OATP transporters. METHODS To determine how genetic alteration in one Oatp transporter can interact with NASH-associated changes in Oatp expression we measured the disposition of intravenously administered pravastatin in Slco1b2 knockout (Slco1b2(-/-)) and wild-type (WT) mice fed either a control or a methionine and choline deficient (MCD) diet to induce NASH. RESULTS Genetic loss of Oatp1b2, the rodent ortholog of human OATP1B transporters, caused a modest increase in pravastatin plasma concentrations in mice with healthy livers. Although a diet-induced model of NASH decreased the expression of multiple hepatic Oatp transporters, it did not alter the disposition of pravastatin compared to WT control mice. In contrast, the combination of NASH-associated decrease in compensatory Oatp transporters and Oatp1b2 genetic loss caused a synergistic increase in plasma area under the curve (AUC) and tissue concentrations in kidney and muscle. CONCLUSIONS Our data show that NASH alters the expression of multiple hepatic uptake transporters which, due to overlapping substrate specificity among the OATP transporters, may combine with the pharmacogenetic loss of OATP1B1 to increase the risk of statin-induced adverse drug reactions.
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Affiliation(s)
- John D. Clarke
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, AZ 85721
| | - Rhiannon N. Hardwick
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, AZ 85721
| | - April D. Lake
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, AZ 85721
| | - Andrew J. Lickteig
- Department of Internal Medicine (Division of Gastroenterology and Hepatology), University of Kansas Medical Center, Kansas City, KS 66160
| | - Michael J. Goedken
- Department of Pharmacology and Toxicology, Rutgers University, Piscataway, NJ 08854
| | - Curtis D. Klaassen
- Department of Internal Medicine (Division of Gastroenterology and Hepatology), University of Kansas Medical Center, Kansas City, KS 66160
| | - Nathan J. Cherrington
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, AZ 85721
,Corresponding author. Nathan J. Cherrington, 1703 E. Mabel Street, Tucson, AZ 85721; Phone: 520 626-0219; Fax: 520 626-2466, Nathan Cherrington :
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A Current Approach to Statin Intolerance. Clin Pharmacol Ther 2014; 96:74-80. [DOI: 10.1038/clpt.2014.84] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 04/07/2014] [Indexed: 11/09/2022]
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Giannakopoulou E, Ragia G, Kolovou V, Tavridou A, Tselepis AD, Elisaf M, Kolovou G, Manolopoulos VG. No impact of SLCO1B1 521T>C, 388A>G and 411G>A polymorphisms on response to statin therapy in the Greek population. Mol Biol Rep 2014; 41:4631-8. [DOI: 10.1007/s11033-014-3334-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 03/14/2014] [Indexed: 11/30/2022]
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Stoll F, Burhenne J, Lausecker B, Weiss J, Thomsen T, Haefeli WE, Mikus G. Reduced exposure variability of the CYP3A substrate simvastatin by dose individualization to CYP3A activity. J Clin Pharmacol 2013; 53:1199-204. [PMID: 23939663 DOI: 10.1002/jcph.161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/02/2013] [Indexed: 01/03/2023]
Abstract
This study aimed to demonstrate that the dose of a CYP3A substrate (simvastatin) can be adapted individually on the basis of CYP3A activity as assessed by midazolam metabolic clearance. In 18 healthy participants individual CYP3A activity was quantified using midazolam metabolic clearance both alone and during CYP3A inhibition with 40 mg ritonavir. Thereafter, simvastatin acid exposure was determined after a simvastatin standard dose (40 mg) and doses adapted to individual CYP3A activity at baseline and during CYP3A inhibition. Interindividual variability of CYP3A activity and simvastatin acid AUC0-24 was large and both correlated (r(2) = 0.745, P < .001). The adapted simvastatin doses ranged from 25 to 80 mg and their administration reduced simvastatin variability fivefold. Despite the low adapted simvastatin dose of 12 mg during CYP3A inhibition with ritonavir, exposure increased (point estimate of 4.2 [90% CI: 3.15-5.61]) probably caused by additional OATP1B1 inhibition. CYP3A activity-based dose adaptation can be used to reduce interindividual variability in simvastatin exposure.
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Affiliation(s)
- Felicitas Stoll
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, 69120, Heidelberg, Germany
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Danik JS, Chasman DI, MacFadyen JG, Nyberg F, Barratt BJ, Ridker PM. Lack of association between SLCO1B1 polymorphisms and clinical myalgia following rosuvastatin therapy. Am Heart J 2013; 165:1008-14. [PMID: 23708174 DOI: 10.1016/j.ahj.2013.01.025] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 01/17/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Carriers of the rs4363657C and rs4149056C alleles in SLCO1B1 have increased myopathic complaints when taking simvastatin. Whether rosuvastatin has a similar effect is uncertain. This study assesses whether SLCO1B1 polymorphisms relate to clinical myalgia after rosuvastatin therapy. METHODS In the JUPITER trial, participants without prior cardiovascular disease or diabetes who had low-density lipoprotein cholesterol <130 mg/dL and C-reactive protein ≥2 mg/L were randomly allocated to rosuvastatin 20 mg or placebo and followed for the first cardiovascular disease events and adverse effects. We evaluated the effect of rs4363657 and rs4149056 in SLCO1B1, which encodes organic anion-transporting polypeptide OATP1B1, a regulator of hepatic statin uptake, on clinically reported myalgia. RESULTS Among 4,404 participants allocated to rosuvastatin, clinical myalgia occurred with a rate of 4.1 events per 100 person-years as compared with 3.7 events per 100 person-years among 4,378 participants allocated to placebo (hazard ratio [HR] 1.13, 95% CI 0.98-1.30). Among those on rosuvastatin, there were no differences in the rate of myalgia among those with the rs4363657C (HR 0.95, 95% CI 0.79-1.14 per allele) or the rs4149056C allele (HR 0.95, 95% CI 0.79-1.15 per allele) compared with those without the C allele. Similar null data were observed when the myalgia definition was broadened to include muscle weakness, stiffness, or pain. None of the 3 participants on rosuvastatin or the 3 participants on placebo with frank myopathy had the minor allele at either polymorphism. CONCLUSION There appears to be no increased risk of myalgia among users of rosuvastatin who carry the rs4363657C or the rs4149056C allele in SLCO1B1.
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Affiliation(s)
- Jacqueline S Danik
- Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA.
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Gong IY, Kim RB. Impact of Genetic Variation in OATP Transporters to Drug Disposition and Response. Drug Metab Pharmacokinet 2013; 28:4-18. [DOI: 10.2133/dmpk.dmpk-12-rv-099] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Miki T. [The deal with the super-aged society ~to anti-aging research and epidemiological studies from genomic medicine~]. Nihon Ronen Igakkai Zasshi 2013; 50:608-614. [PMID: 24622125 DOI: 10.3143/geriatrics.50.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Lack of association between SLCO1B1 polymorphism and the lipid-lowering effects of atorvastatin and simvastatin in Chinese individuals. Eur J Clin Pharmacol 2012; 69:1269-74. [PMID: 23263738 DOI: 10.1007/s00228-012-1453-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 11/07/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE There is significant inter-individual variability in the lipid-lowering effects of atorvastatin and simvastatin. Our goal was to investigate the impact of SLCO1B1 genetic polymorphism on the lipid-lowering effects of atorvastatin and simvastatin. METHODS We recruited 363 unrelated hyperlipidemic patients with the CYP3A4 1/1, CYP3A5 1/1, and CYP3AP1 1/1 genotypes: 189 of these were treated with atorvastatin and 174 were treated with simvastatin as a single-agent therapy (20 mg day(-1) orally) for 4 weeks. The genotyping of SLCO1B1 c.521T > C (p.V174A, OATP-C5) was performed with allele-specific polymerase chain reaction (AS-PCR), and PCR restriction fragment length polymorphism (RFLP) was performed to detect the carriers of SLCO1B1 c.388A > G (p.N130D, OATP-C1b). Serum triglyceride (TGs), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were determined before and after treatment. RESULTS The frequencies of the SLCO1B1 521T > C and 388A > G variant alleles in Chinese hyperlipidemic patients were found to be 16.2% and 72.1% respectively. After treatment with 20 mg simvastatin or atorvastatin daily for 4 weeks, TC, TG, and LDL-C concentrations were lower than at baseline, on average, by 18.1 ± 3.7%, 25.8 ± 9.7%, 27.7 ± 5.4% in the simvastatin-treated group, and 17.5 ± 3.7%, 22.6 ± 8.6%, 27.5 ± 5.5% in the atorvastatin-treated group respectively, and the mean relative reduction in serum HDL cholesterol did not reach statistical significance (-1.0 ± 10.9%, 0.5 ± 9.3%). However, no significant differences were observed in the lipid-lowering effects of atorvastatin and simvastatin between subjects with different SLCO1B1 genotypes. CONCLUSION The SLCO1B1 521T > C and 388A > G variants were found to be relatively common in Chinese patients with essential hyperlipidemia. These frequencies were found to be similar to those observed in healthy Chinese and Japanese individuals, but significantly different from Caucasians and blacks. SLCO1B1 521T > C and 388A > G polymorphisms may not be associated with the lipid-lowering effects of atorvastatin and simvastatin.
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Oh ES, Kim CO, Cho SK, Park MS, Chung JY. Impact of ABCC2, ABCG2 and SLCO1B1 polymorphisms on the pharmacokinetics of pitavastatin in humans. Drug Metab Pharmacokinet 2012; 28:196-202. [PMID: 23007012 DOI: 10.2133/dmpk.dmpk-12-rg-068] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Pitavastatin, a 3-hydroxyl-3-methylglutaryl-coenzyme A reductase inhibitor is distributed to the liver, a target organ of action and excreted mainly into the bile. To investigate the impact of influx (OATP1B1) and efflux (MRP2, BCRP) transporter alleles on its disposition, the pharmacokinetic (PK) parameters were compared among the following groups: SLCO1B1 (*15 carrier and non-carrier), ABCC2 (G1249A, C3972T, C-24T, G1549A, and G1774T), and ABCG2 (C421A) single nucleotide polymorphisms in 45 healthy Korean volunteers. Pitavastatin AUC(last) was higher in individuals carrying the SLCO1B1*15 allele than those not carrying it (144.1 ± 55.3 vs. 84.7 ± 25.7 h·ng/mL [mean ± SD], p = 0.002). The AUC(last) varied significantly according to the ABCC2 C-24T allele (103.4 ± 42.2, 80.2 ± 23.8, and 39.0 h·ng/mL in CC, CT and TT, respectively; p = 0.027). Other SNPs of ABCC2 and ABCG2 were not significant. The effect of these transporters and body weight on the AUC(last) and C(max) were tested, and only SLCO1B1 and ABCC2 C-24T genotypes were significant factors by analysis of covariance. These variants accounted for almost 50% of the variation in AUC(last) and C(max) of pitavastatin. Therefore, ABCC2 C-24T was significantly associated with pitavastatin human PK when the known effect of SLCO1B1*15 was also considered.
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Affiliation(s)
- Eun Sil Oh
- Department of Clinical Pharmacology, Yonsei University Severance Hospital, Seoul, Korea
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Roth M, Obaidat A, Hagenbuch B. OATPs, OATs and OCTs: the organic anion and cation transporters of the SLCO and SLC22A gene superfamilies. Br J Pharmacol 2012; 165:1260-87. [PMID: 22013971 DOI: 10.1111/j.1476-5381.2011.01724.x] [Citation(s) in RCA: 532] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The human organic anion and cation transporters are classified within two SLC superfamilies. Superfamily SLCO (formerly SLC21A) consists of organic anion transporting polypeptides (OATPs), while the organic anion transporters (OATs) and the organic cation transporters (OCTs) are classified in the SLC22A superfamily. Individual members of each superfamily are expressed in essentially every epithelium throughout the body, where they play a significant role in drug absorption, distribution and elimination. Substrates of OATPs are mainly large hydrophobic organic anions, while OATs transport smaller and more hydrophilic organic anions and OCTs transport organic cations. In addition to endogenous substrates, such as steroids, hormones and neurotransmitters, numerous drugs and other xenobiotics are transported by these proteins, including statins, antivirals, antibiotics and anticancer drugs. Expression of OATPs, OATs and OCTs can be regulated at the protein or transcriptional level and appears to vary within each family by both protein and tissue type. All three superfamilies consist of 12 transmembrane domain proteins that have intracellular termini. Although no crystal structures have yet been determined, combinations of homology modelling and mutation experiments have been used to explore the mechanism of substrate recognition and transport. Several polymorphisms identified in members of these superfamilies have been shown to affect pharmacokinetics of their drug substrates, confirming the importance of these drug transporters for efficient pharmacological therapy. This review, unlike other reviews that focus on a single transporter family, briefly summarizes the current knowledge of all the functionally characterized human organic anion and cation drug uptake transporters of the SLCO and the SLC22A superfamilies.
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Affiliation(s)
- Megan Roth
- Department of Pharmacology, Toxicology and Therapeutics, The University of Kansas Medical Center, Kansas City, KS 66160, USA
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Sirtori CR, Mombelli G, Triolo M, Laaksonen R. Clinical response to statins: mechanism(s) of variable activity and adverse effects. Ann Med 2012; 44:419-32. [PMID: 21623698 DOI: 10.3109/07853890.2011.582135] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Statins represent a major advance in the treatment of hypercholesterolemia, a significant risk factor for atherosclerosis. There is, however, notable interindividual variation in the cholesterolemic response to statins, and the origin of this variability is poorly understood; pharmacogenetics has attempted to determine the role of genetic factors. Myopathy, further, has been reported in a considerable percentage of patients, but the mechanisms underlying muscle injury have yet to be fully characterized. Most statins are the substrates of several cytochrome P450s (CYP). CYP polymorphisms may be responsible for variations in hypolipidemic activity; inhibitors of CYPs, e.g. of CYP3A4, can significantly raise plasma concentrations of several statins, but consequences in terms of clinical efficacy are not uniform. Pravastatin and rosuvastatin are not susceptible to CYP inhibition but are substrates of the organic anion-transporting polypeptide (OATP) 1B1, encoded by the SLCO1B1 gene. Essentially all statins are, in fact, substrates of membrane transporters: SLCO1B1 polymorphisms can decrease the liver uptake, as well as the therapeutic potential of these agents, and may be linked to their muscular side-effects. A better understanding of the mechanisms of statin handling will help to minimize adverse effects and interactions, as well as to improve their lipid-lowering efficiency.
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Georgitsi M, Zukic B, Pavlovic S, Patrinos GP. Transcriptional regulation and pharmacogenomics. Pharmacogenomics 2012; 12:655-73. [PMID: 21619428 DOI: 10.2217/pgs.10.215] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Interindividual variable drug response is correlated with sequence alterations in genes encoding drug-metabolizing enzymes and transporters, affecting drug absorption, distribution, metabolism and excretion. This variable drug response may have an impact on disease therapeutic outcomes, tolerance to adverse drug reactions and even survival. Sequence alterations may occur not only within the coding region of a gene, but in its regulatory elements too, affecting gene transcription and gene-expression levels. Here, we provide a compilation of the current knowledge of pharmacogenomics related to transcription, with a focus on the effect of SNPs and short tandem repeats residing in cis-regulatory elements of 11 genes encoding for drug-metabolizing enzymes and drug transporters. In addition, we comment on two genes encoding enzymes that are drug targets themselves. Finally, we briefly discuss the currently available methodologies for clinically assessing pharmacogenomic profiles, which could potentially in the future facilitate drug treatment-individualization via the identification of molecular signatures in specific patient groups.
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Affiliation(s)
- Marianthi Georgitsi
- Department of Pharmacy, School of Health Sciences, University of Patras, 26504 Rion, Patras, Greece
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Lai Y, Varma M, Feng B, Stephens JC, Kimoto E, El-Kattan A, Ichikawa K, Kikkawa H, Ono C, Suzuki A, Suzuki M, Yamamoto Y, Tremaine L. Impact of drug transporter pharmacogenomics on pharmacokinetic and pharmacodynamic variability - considerations for drug development. Expert Opin Drug Metab Toxicol 2012; 8:723-43. [PMID: 22509796 DOI: 10.1517/17425255.2012.678048] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Drug transporter proteins are expressed on the cell membrane, regulating substrate exposure in systemic circulation and/or peripheral tissues. Genetic polymorphism of drug transporter genes encoding these proteins could alter the functional activity and/or protein expression, having effects on absorption, distribution, metabolism and excretion (ADME), efficacy and adverse effects. AREAS COVERED The authors provide the reader with an overview of the pharmacogenetics (PGx) of 12 membrane transporters. The clinical literature is summarized as to the quantitative significance on pharmacokinetics (PK) and implications on pharmacodynamics (PD) and adverse effects, due to transporter influence on intracellular drug concentrations. EXPERT OPINION Unlike polymorphisms for cytochrome P450s (CYPs) resulting in large magnitude of PK variation, genetic mutations for membrane transporters are typically less than threefold alteration in systemic PK for drugs with a few exceptions. However, substantially greater changes in intracellular drug levels may result. We are aware of 1880 exome variants in 12 of the best-studied transporters to date, and nearly 40% of these change the amino acid. However, the functional consequences of most of these variants remain to be determined, and have only been empirically evaluated for a handful. To the extent that genetic polymorphisms impact ADME, it is a variable that will contribute to ethnic differences due to substantial frequency differences for the known variants.
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Affiliation(s)
- Yurong Lai
- Pfizer Worldwide Research and Development, Department of Pharmacokinetics, Dynamics and Metabolism, Groton, CT 06340, USA
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Abstract
Historically the efficacy and safety of statins has mostly been studied in western populations. Few such studies have been carried out in Asians until recent years. These studies revealed interesting similarities and differences for statin use between Asians and Caucasians. One clinically important question subsequently raised is whether Asians need lower statin doses compared with Caucasians. Many practicing physicians believe that statin doses are lower in Asians because of the generally lower bodyweight and BMI. Whether this belief is based on sound scientific evidence needs to be reviewed. Furthermore, since the decision of optimal dose is based on both efficacy and safety, both of which may be impacted by genetic factors, one may ask whether pharmacogenetics plays a role in the dose difference, if such a difference exists. There is a clinical need to critically and comprehensively article the literature to answer these questions, and summarize future directions of research in the field. This article serves the above purpose.
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Affiliation(s)
- Ping Wang
- Department of Pathology & Laboratory Medicine, The Methodist Hospital & The Methodist Hospital Research Institute, Houston, TX 77030, USA.
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Akao H, Polisecki E, Kajinami K, Trompet S, Robertson M, Ford I, Jukema JW, de Craen AJ, Westendorp RG, Shepherd J, Packard C, Buckley BM, Schaefer EJ. Genetic variation at the SLCO1B1 gene locus and low density lipoprotein cholesterol lowering response to pravastatin in the elderly. Atherosclerosis 2012; 220:413-7. [DOI: 10.1016/j.atherosclerosis.2011.09.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 09/06/2011] [Accepted: 09/14/2011] [Indexed: 10/17/2022]
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Clarke JD, Cherrington NJ. Genetics or environment in drug transport: the case of organic anion transporting polypeptides and adverse drug reactions. Expert Opin Drug Metab Toxicol 2012; 8:349-60. [PMID: 22280100 DOI: 10.1517/17425255.2012.656087] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Organic anion transporting polypeptide (OATP) uptake transporters are important for the disposition of many drugs and perturbed OATP activity can contribute to adverse drug reactions (ADRs). It is well documented that both genetic and environmental factors can alter OATP expression and activity. Genetic factors include single nucleotide polymorphisms (SNPs) that change OATP activity and epigenetic regulation that modify OATP expression levels. SNPs in OATPs contribute to ADRs. Environmental factors include the pharmacological context of drug-drug interactions and the physiological context of liver diseases. Liver diseases such as non-alcoholic fatty liver disease, cholestasis and hepatocellular carcinoma change the expression of multiple OATP isoforms. The role of liver diseases in the occurrence of ADRs is unknown. AREAS COVERED This article covers the roles OATPs play in ADRs when considered in the context of genetic or environmental factors. The reader will gain a greater appreciation for the current evidence regarding the salience and importance of each factor in OATP-mediated ADRs. EXPERT OPINION A SNP in a single OATP transporter can cause changes in drug pharmacokinetics and contribute to ADRs but, because of overlap in substrate specificities, there is potential for compensatory transport by other OATP isoforms. By contrast, the expression of multiple OATP isoforms is decreased in liver diseases, reducing compensatory transport and thereby increasing the probability of ADRs. To date, most research has focused on the genetic factors in OATP-mediated ADRs while the impact of environmental factors has largely been ignored.
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Affiliation(s)
- John D Clarke
- University of Arizona, Department of Pharmacology and Toxicology, 1703 E. Mabel Street, Tucson, AZ 85721, USA
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ENT1, a ribavirin transporter, plays a pivotal role in antiviral efficacy of ribavirin in a hepatitis C virus replication cell system. Antimicrob Agents Chemother 2012; 56:1407-13. [PMID: 22232287 DOI: 10.1128/aac.05762-11] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
We previously showed that equilibrative nucleoside transporter 1 (ENT1) is a primary ribavirin transporter in human hepatocytes. However, because the role of this transporter in the antiviral mechanism of the drug remains unclear, the present study aimed to elucidate the role of ENT1 in ribavirin antiviral action. OR6 cells, a hepatitis C virus (HCV) replication system, were used to evaluate both ribavirin uptake and efficacy. The ribavirin transporter in OR6 cells was identified by mRNA expression analyses and transport assays. Nitrobenzylmercaptopurine riboside (NBMPR) and micro-RNA targeted to ENT1 mRNA (miR-ENT1) were used to reduce the ribavirin uptake level in OR6 cells. Our results showed that ribavirin antiviral activity was associated with its accumulation in OR6 cells, which was also closely associated with the uptake of the drug. It was found that the primary ribavirin transporter in OR6 cells was ENT1 and that inhibition of ENT1-mediated ribavirin uptake by NBMPR significantly attenuated the antiviral activity of the drug as well as its accumulation in OR6 cells. The results also showed that even a small reduction in the ENT1-mediated ribavirin uptake, achieved in this case using miR-ENT1, caused a significant decrease in its antiviral activity, thus indicating that the ENT1-mediated ribavirin uptake level determined its antiviral activity level in OR6 cells. In conclusion, our results show that by facilitating its uptake and accumulation in OR6 cells, ENT1 plays a pivotal role in the antiviral effectiveness of ribavirin and therefore provides an important insight into the efficacy of the drug in anti-HCV therapy.
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Chae YJ, Lee KR, Noh CK, Chong S, Kim DD, Shim CK, Chung SJ. Functional consequences of genetic variations in the human organic anion transporting polypeptide 1B3 (OATP1B3) in the Korean population. J Pharm Sci 2011; 101:1302-13. [PMID: 22147445 DOI: 10.1002/jps.23005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Revised: 10/18/2011] [Accepted: 11/11/2011] [Indexed: 01/09/2023]
Abstract
The objectives of this study were to investigate the allele frequencies and linkage disequilibrium (LD) in the organic anion transporting polypeptide 1B3 (OATP1B3) in the Korean population and to examine the functional consequences. Using samples from 48 Koreans, direct sequencing was carried out to determine the allele frequencies and LD of OATP1B3 in a representative Korean population. Thirty-six genetic variations in the transporter were found in Koreans; among them, five undocumented variations (i.e.,-6436G>C in the 5'-upstream region, 26A>C and 586A>G in the protein coding region, and IVS6-72A>T and IVS12-80A>T in intron regions) were identified. In the upstream region, -5035G>A was found to have lowered gene expression, as determined by a reporter gene assay, suggesting that this variation reduces the expression of OATP1B3 in humans. The functional relevance of the genetic variations in the protein coding region was determined by an uptake study involving representative substrates in human embryonic kidney 293 cells expressing wild type or variant forms. Variations involving 699G>A showed a reduced uptake activity for testosterone, but not for estradiol 17β-d-glucuronide or methotrexate, indicating that the functional impact of the variations is substrate specific. Considering the kinetic relevance of OATP1B3, the functionally affected variations may be therapeutically important.
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Affiliation(s)
- Yoon-Jee Chae
- Department of Pharmaceutics, College of Pharmacy, Seoul National University, Gwanak-gu, Seoul 151-742, Korea
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Abstract
Drug transporters are now widely acknowledged as important determinants governing drug absorption, excretion, and, in many cases, extent of drug entry into target organs. There is also a greater appreciation that altered drug transporter function, whether due to genetic polymorphisms, drug-drug interactions, or environmental factors such as dietary constituents, can result in unexpected toxicity. Such effects are in part due to the interplay between various uptake and efflux transporters with overlapping functional capabilities that can manifest as marked interindividual variability in drug disposition in vivo. Here we review transporters of the solute carrier (SLC) and ATP-binding cassette (ABC) superfamilies considered to be of major importance in drug therapy and outline how understanding the expression, function, and genetic variation in such drug transporters will result in better strategies for optimal drug design and tissue targeting as well as reduce the risk for drug-drug interactions and adverse drug responses.
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Affiliation(s)
- M K DeGorter
- Division of Clinical Pharmacology, University of Western Ontario, London, Canada N6A 5A5
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Srivastava A, Srivastava A, Srivastava N, Choudhuri G, Mittal B. Organic anion transporter 1B1 (SLCO1B1) polymorphism and gallstone formation: High incidence of Exon4 CA genotype in female patients in North India. Hepatol Res 2011; 41:71-8. [PMID: 20973885 DOI: 10.1111/j.1872-034x.2010.00736.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM Gallstone disease is an important cause of abdominal morbidity Organic anion transport protein 1B1 (OATP1B1) (encoded by SLCO1B1) is a major transporter protein for bile salt uptake in enterohepatic circulation of bile salts. Disturbance in this pathway can decrease relative concentration of bile salts in gallbladder and may lead to formation of gallstones. We investigated role of SLCO1B1 polymorphisms [(Exon4 C > A (Pro155Thr; rs11045819) and Ex6 + 40T > C (Val174Ala; rs4149056)] in conferring interindividual susceptibility to gallstone disease. METHODS A total of 173 healthy controls and 226 gallstone patients (USG positive) were recruited. Genotyping was done by using standard polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method. RESULTS The observed control frequencies of both polymorphisms of SLCO1B1 gene [(Exon4 C > A (Pro155Thr; rs11045819) and Ex6 + 40T > C (Val174Ala; rs4149056)] were in agreement with Hardy-Weinberg equilibrium. The frequency CA genotype and A allele of Exon4 C > A polymorphism was higher in gallstones patients (12.4% and 6.2%) as compared to controls (5.2% and 2.6%) which was statistically significant [(P = 0.029; OR = 2.31; 95% CI = 1.1-5.0); (P = 0.034; OR = 2.22; 95% CI = 1.1-4.8)], respectively). However, distribution of genotypes and alleles of Ex6 + 40T > C polymorphism was almost similar between gallstone patients and controls. Haplotype analysis showed frequency of A,T haplotype consisting of was significantly higher in gallstone patients as compared to controls and was imposing risk for the disease (P = 0.036; OR = 2.34; 95% CI = 1.0-5.1). CONCLUSION These results suggest that SLCO1B1 Exon4 C > A polymorphism confers increased risk for gallstone disease in North Indian population.
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Affiliation(s)
- Anshika Srivastava
- Departments of Genetics Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) Department of Physiology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India
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