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Noorizhab MNF, Zainal Abidin N, Teh LK, Tang TH, Onyejepu N, Kunle-Ope C, Tochukwu NE, Sheshi MA, Nwafor T, Akinwale OP, Ismail AI, Nor NM, Salleh MZ. Exploration of the diversity of multi-drug resistant Mycobacterium tuberculosis complex in Lagos, Nigeria using WGS: Distribution of lineages, drug resistance patterns and genetic mutations. Tuberculosis (Edinb) 2023; 140:102343. [PMID: 37080082 DOI: 10.1016/j.tube.2023.102343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/19/2023] [Accepted: 04/12/2023] [Indexed: 04/22/2023]
Abstract
Multidrug-resistant (MDR) or extensively drug-resistant (XDR) Tuberculosis (TB) is a major challenge to global TB control. Therefore, accurate tracing of in-country MDR-TB transmission are crucial for the development of optimal TB management strategies. This study aimed to investigate the diversity of MTBC in Nigeria. The lineage and drug-resistance patterns of the clinical MTBC isolates of TB patients in Southwestern region of Nigeria were determined using the WGS approach. The phenotypic DST of the isolates was determined for nine anti-TB drugs. The sequencing achieved average genome coverage of 65.99X. The most represented lineages were L4 (n = 52, 83%), L1 (n = 8, 12%), L2 (n = 2, 3%) and L5 (n = 1, 2%), suggesting a diversified MTB population. In term of detection of M/XDR-TB, while mutations in katG and rpoB genes are the strong predictors for the presence of M/XDR-TB, the current study also found the lack of good genetic markers for drug resistance amongst the MTBC in Nigeria which may pose greater problems on local tuberculosis management efforts. This high-resolution molecular epidemiological data provides valuable insights into the mechanistic for M/XDR TB in Lagos, Nigeria.
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Affiliation(s)
- Mohd Nur Fakhruzzaman Noorizhab
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia; Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
| | - Norzuliana Zainal Abidin
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
| | - Lay Kek Teh
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia; Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
| | - Thean Hock Tang
- Advance Medical & Dental Institute (AMDI), Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, Malaysia
| | - Nneka Onyejepu
- Microbiology Department, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | - Chioma Kunle-Ope
- Microbiology Department, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | - Nwanneka E Tochukwu
- Microbiology Department, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | | | - Timothy Nwafor
- Public Health and Epidemiology Department, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria
| | - Olaoluwa P Akinwale
- Public Health and Epidemiology Department, Nigerian Institute of Medical Research (NIMR), Lagos, Nigeria.
| | | | - Norazmi Mohd Nor
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Zaki Salleh
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Selangor, Malaysia.
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Zaman NIU, Kek TL, Ahmad R, Noorizhab MNF, Rofiee MS, James RJ, Nor NM, Mohamed M, Hoon TS, Singh PSA, Janor RM, Bakar SHA, Salleh MZ. Signatory metabolomics biomarkers of stress, anxiety, and depression: a proof of concept for precision health among university students: A cross-sectional study. Precis Future Med 2023. [DOI: 10.23838/pfm.2022.00128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Purpose: The highly competitive nature of tertiary education and the pressure to perform academically have increased psychological morbidity like emotional distress. Untargeted metabolomics was used to analyze serum samples of university students for biomarkers and perturbated metabolism due to stress, anxiety, and depression (SAD).Methods: Depression, Anxiety, Stress Scale 21 (DASS-21) was used to assess the severity of SAD in university students. The metabolite fingerprint of each subject was obtained using liquid chromatography-mass spectrometry quadrupole time-of-flight (LC/MS QTOF). The signature metabolites for each trait were determined by projections to latent structures discriminant analysis (PLS-DA) with variable importance for the projection (VIP) score > 1.0 (P<0.05) and subjected to analysis using the area under the receiver operating characteristic curve (AUROC). Potential biomarkers with an area under the curve (AUC) value exceeding 0.65 were identified.Results: Various groups of glycerophospholipids were upregulated in the studied traits. On the other hand, metabolites such as glycocholic acid was upregulated in depression, while hypoxanthine was upregulated in anxiety, and PE-Cer(d14:1(4E)/22:1(13Z)) was upregulated in stress.Conclusion: To our knowledge, this is the first study to assess the relationship of the differentially expressed metabolites in university students of different categories of SAD using the DASS-21 screening tool in Malaysia as we move forward with precision health.
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Azami NAM, Perera D, Thayan R, AbuBakar S, Sam IC, Salleh MZ, Isa MNM, Ab Mutalib NS, Aik WK, Suppiah J, Tan KK, Chan YF, Teh LK, Azzam G, Rasheed ZBM, Chan JCJ, Kamel KA, Tan JY, Khalilur Rahman O, Lim WF, Johari NA, Ishak M, Yunos RIM, Anasir MI, Wong JE, Fu JYL, Noorizhab MNF, Sapian IS, Mokhtar MFM, Md Shahri NAA, Ghafar K, Yusuf SNHM, Noor YM, Jamal R. SARS-CoV-2 genomic surveillance in Malaysia: displacement of B.1.617.2 with AY lineages as the dominant Delta variants and the introduction of Omicron during the fourth epidemic wave. Int J Infect Dis 2022; 125:216-226. [PMID: 36336246 PMCID: PMC9632236 DOI: 10.1016/j.ijid.2022.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/25/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES This study reported SARS-CoV-2 whole genome sequencing results from June 2021 to January 2022 from seven genome sequencing centers in Malaysia as part of the national surveillance program. METHODS COVID-19 samples that tested positive by reverse transcription polymerase chain reaction and with cycle threshold values <30 were obtained throughout Malaysia. Sequencing of SARS-CoV-2 complete genomes was performed using Illumina, Oxford Nanopore, or Ion Torrent platforms. A total of 6163 SARS-CoV-2 complete genome sequences were generated over the surveillance period. All sequences were submitted to the Global Initiative on Sharing All Influenza Data database. RESULTS From June 2021 to January 2022, Malaysia experienced the fourth wave of COVID-19 dominated by the Delta variant of concern, including the original B.1.617.2 lineage and descendant AY lineages. The B.1.617.2 lineage was identified as the early dominant circulating strain throughout the country but over time, was displaced by AY.59 and AY.79 lineages in Peninsular (west) Malaysia, and the AY.23 lineage in east Malaysia. In December 2021, pilgrims returning from Saudi Arabia facilitated the introduction and spread of the BA.1 lineage (Omicron variant of concern) in the country. CONCLUSION The changing trends of circulating SARS-CoV-2 lineages were identified, with differences observed between west and east Malaysia. This initiative highlighted the importance of leveraging research expertise in the country to facilitate pandemic response and preparedness.
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Affiliation(s)
- Nor Azila Muhammad Azami
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - David Perera
- Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | - Ravindran Thayan
- Virology Unit, Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Sazaly AbuBakar
- Tropical Infectious Diseases Research & Education Centre (TIDREC), Higher Institution Center of Excellence (HICoE), Universiti Malaya, Kuala Lumpur, Malaysia
| | - I-Ching Sam
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia; Department of Medical Microbiology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Mohd Zaki Salleh
- Integrative Pharmacogenomics Institute, Universiti Teknologi Mara (UiTM) Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
| | - Mohd Noor Mat Isa
- Malaysia Genome and Vaccine Institute, National Institutes of Biotechnology Malaysia, Selangor, Malaysia
| | - Nurul Syakima Ab Mutalib
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Wong Kiing Aik
- Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | - Jeyanthi Suppiah
- Virology Unit, Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Kim-Kee Tan
- Tropical Infectious Diseases Research & Education Centre (TIDREC), Higher Institution Center of Excellence (HICoE), Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yoke Fun Chan
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Lay Kek Teh
- Integrative Pharmacogenomics Institute, Universiti Teknologi Mara (UiTM) Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
| | - Ghows Azzam
- Malaysia Genome and Vaccine Institute, National Institutes of Biotechnology Malaysia, Selangor, Malaysia; School of Biological Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Jonathan Chia Jui Chan
- Institute of Health and Community Medicine, Universiti Malaysia Sarawak, Sarawak, Malaysia
| | - Khayri Azizi Kamel
- Virology Unit, Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Jia-Yi Tan
- Tropical Infectious Diseases Research & Education Centre (TIDREC), Higher Institution Center of Excellence (HICoE), Universiti Malaya, Kuala Lumpur, Malaysia
| | - Omar Khalilur Rahman
- Department of Medical Microbiology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Wai Feng Lim
- Integrative Pharmacogenomics Institute, Universiti Teknologi Mara (UiTM) Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
| | - Nor Azfa Johari
- Malaysia Genome and Vaccine Institute, National Institutes of Biotechnology Malaysia, Selangor, Malaysia
| | - Muhiddin Ishak
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Ryia Illani Mohd Yunos
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Mohd Ishtiaq Anasir
- Virology Unit, Infectious Diseases Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Selangor, Malaysia
| | - Jo-Ern Wong
- Tropical Infectious Diseases Research & Education Centre (TIDREC), Higher Institution Center of Excellence (HICoE), Universiti Malaya, Kuala Lumpur, Malaysia
| | - Jolene Yin Ling Fu
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mohd Nur Fakhruzzaman Noorizhab
- Integrative Pharmacogenomics Institute, Universiti Teknologi Mara (UiTM) Selangor Branch, Puncak Alam Campus, Selangor, Malaysia
| | - Irni Suhayu Sapian
- Malaysia Genome and Vaccine Institute, National Institutes of Biotechnology Malaysia, Selangor, Malaysia
| | | | | | - Khairun Ghafar
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | | | - Yusuf Muhammad Noor
- Malaysia Genome and Vaccine Institute, National Institutes of Biotechnology Malaysia, Selangor, Malaysia
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia.
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Khoruddin NA, Lim WF, Teh LK, Noorizhab MNF, Mohd Yusof FZ, Salleh MZ. Toward precision nutrition: A cross‐sectional study on the genetic risks of nutrients deficiencies and eating behaviors among the Orang Asli and Malays. Precision Medical Sciences 2022. [DOI: 10.1002/prm2.12081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Nurul Ain Khoruddin
- Integrative Pharmacogenomics Institute (iPROMISE) Universiti Teknologi MARA (UiTM) Selangor Bandar Puncak Alam Malaysia
- Faculty of Applied Sciences Universiti Teknologi MARA (UiTM) Selangor Shah Alam Malaysia
| | - Wai Feng Lim
- Integrative Pharmacogenomics Institute (iPROMISE) Universiti Teknologi MARA (UiTM) Selangor Bandar Puncak Alam Malaysia
| | - Lay Kek Teh
- Integrative Pharmacogenomics Institute (iPROMISE) Universiti Teknologi MARA (UiTM) Selangor Bandar Puncak Alam Malaysia
- Faculty of Pharmacy Universiti Teknologi MARA (UiTM) Selangor Bandar Puncak Alam Malaysia
| | - Mohd Nur Fakhruzzaman Noorizhab
- Integrative Pharmacogenomics Institute (iPROMISE) Universiti Teknologi MARA (UiTM) Selangor Bandar Puncak Alam Malaysia
- Faculty of Pharmacy Universiti Teknologi MARA (UiTM) Selangor Bandar Puncak Alam Malaysia
| | - Farida Zuraina Mohd Yusof
- Integrative Pharmacogenomics Institute (iPROMISE) Universiti Teknologi MARA (UiTM) Selangor Bandar Puncak Alam Malaysia
- Faculty of Applied Sciences Universiti Teknologi MARA (UiTM) Selangor Shah Alam Malaysia
| | - Mohd Zaki Salleh
- Integrative Pharmacogenomics Institute (iPROMISE) Universiti Teknologi MARA (UiTM) Selangor Bandar Puncak Alam Malaysia
- Faculty of Pharmacy Universiti Teknologi MARA (UiTM) Selangor Bandar Puncak Alam Malaysia
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Mohamed Noor NF, Salleh MZ, Mohd Zim MA, Bakar ZA, Fakhruzzaman Noorizhab MN, Zakaria NI, Lailanor MI, Teh LK. NAT2 polymorphism and clinical factors that increased antituberculosis drug-induced hepatotoxicity. Pharmacogenomics 2022; 23:531-541. [PMID: 35615896 DOI: 10.2217/pgs-2022-0022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Hepatotoxicity is a known adverse effect of antituberculosis drugs. The NAT2 gene polymorphism has been associated with an increased risk of antituberculosis drug-induced hepatotoxicity (ATDIH). Materials and methods: This study investigates the association of NAT2 polymorphism and clinical risk factors that may contribute to the development of ATDIH. The authors sequenced the NAT2 region of 33 tuberculosis patients who developed ATDIH and 100 tuberculosis patients who did not develop ATDIH during tuberculosis treatment. NAT2 haplotypes were inferred and NAT2 acetylator status was predicted from the combination of the inferred haplotypes. Multiple logistic regression was performed to identify possible factors that are associated with ATDIH. Results: The TT genotype of NAT2*13A and the AA genotype of NAT2*6B were found to be substantially linked with the risk of ATDIH, with odds ratios of 3.09 (95% CI: 1.37-6.95) and 3.07 (95% CI: 1.23-7.69), respectively. NAT2 slow acetylators are 3.39-times more likely to develop ATDIH. Factors that were associated with ATDIH include underlying diabetes mellitus (adjusted odds ratio [AOR] 2.96; 95% CI: 1.05-8.37), pre-treatment serum bilirubin (AOR 1.09; 95% CI: 1.02-1.16) and NAT2 slow acetylator (AOR 3.77; 95% CI: 1.51-9.44). Conclusion: Underlying diabetes mellitus, having a higher baseline bilirubin and being a slow acetylator are identified as the risk factors associated with ATDIH among patients in Malaysia.
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Affiliation(s)
- Nur Farhana Mohamed Noor
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA, Puncak Alam, Selangor, 42300, Malaysia
| | - Mohd Zaki Salleh
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA, Puncak Alam, Selangor, 42300, Malaysia.,Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Selangor, 42300, Malaysia
| | - Mohd Arif Mohd Zim
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, 47000, Malaysia
| | - Zamzurina Abu Bakar
- Respiratory Medicine Institute, Ministry of Health Malaysia, Kuala Lumpur, 53000, Malaysia
| | - Mohd Nur Fakhruzzaman Noorizhab
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA, Puncak Alam, Selangor, 42300, Malaysia.,Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Selangor, 42300, Malaysia
| | - Noor Izyani Zakaria
- Medical Department, Selayang Hospital, Ministry of Health Malaysia, Batu Caves, Selangor, 68100, Malaysia
| | | | - Lay Kek Teh
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA, Puncak Alam, Selangor, 42300, Malaysia.,Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Selangor, 42300, Malaysia
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Sukri A, Noorizhab MNF, Teh LK, Salleh MZ. Insight of the mitochondrial genomes of the Orang Asli and Malays: The heterogeneity and the disease-associated variants. Mitochondrion 2021; 62:74-84. [PMID: 34748985 DOI: 10.1016/j.mito.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 11/27/2022]
Abstract
Orang Asli are the oldest inhabitants in Peninsular Malaysia that forms as a national minority while the Malays are the majority. The study aimed to screen the mitochondrial genomes of the Orang Asli and the Malays to discover the disease-associated variants. A total of 99 Orang Asli from six tribes (Bateq, Cheq Wong, Orang Kanaq, Kensiu, Lanoh, and Semai) were recruited. Mitochondrial genome sequencing was conducted using a next-generation sequencing platform. Furthermore, we retrieved mitochondrial DNA sequences from the Malays for comparison. The clinical significance, pathogenicity prediction and frequency of variants were determined using online tools. Variants associated with mitochondrial diseases were detected in the 2 populations. A high frequency of variants associated with mitochondrial diseases, breast cancer, prostate cancer, and cervical cancer were detected in the Orang Asli and modern Malays. As medicine evolves to adopt prediction and prevention of diseases, this study highlights the need for intervention to adopt genomics medicine to strategise better healthcare management as a way forward for Precision Health.
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Affiliation(s)
- Asif Sukri
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, 42300 Puncak Alam, Selangor, Malaysia
| | - Mohd Nur Fakhruzzaman Noorizhab
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, 42300 Puncak Alam, Selangor, Malaysia; Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, 42300 Puncak Alam, Selangor, Malaysia
| | - Lay Kek Teh
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, 42300 Puncak Alam, Selangor, Malaysia; Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, 42300 Puncak Alam, Selangor, Malaysia
| | - Mohd Zaki Salleh
- Integrative Pharmacogenomics Institute, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, 42300 Puncak Alam, Selangor, Malaysia.
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Razali RH, Noorizhab MNF, Jamari H, James RJ, Teh KH, Ibrahim HM, Teh LK, Salleh MZ. Association of ABCC2 with levels and toxicity of methotrexate in Malaysian Childhood Acute Lymphoblastic Leukemia (ALL). Pediatr Hematol Oncol 2020; 37:185-197. [PMID: 31870219 DOI: 10.1080/08880018.2019.1705949] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Studies had shown that genetic polymorphism plays a significant role in the pharmacokinetics and pharmacodynamics variation of high dose methotrexate (MTX), 5000 mg/m2 regimen. The objective of this study was to investigate the genetic variations associated with the serum level and toxicity of MTX in Malaysian children with acute lymphoblastic leukemia (ALL). Thirty-eight patients were genotyped for rs717620 (ABCC2), rs4948496 (ARID5B), rs1801133 (MTHFR) and rs4149056 (SLCO1B1). Serum levels of MTX at 48 h post 24 h of intravenous infusion were analyzed by high-performance liquid chromatography-mass spectrometry. The ABCC2 genotype was significantly associated with the serum levels of MTX at 48 h after treatment (p = 0.017). Patients with CT and TT of rs717620 (ABCC2) and TC and CC of rs4948496 (ARID5B) were significantly associated with leukopenia grade I-IV (Fisher Exact Test; p = 0.03 and 0.02, respectively). The three most common MTX related toxicities were leukopenia (60.5%), increased alanine aminotransferase enzyme (47.4%), and thrombocytopenia (47.4%). Our results demonstrate that by prescreening of patients for ABCC2 and ARID5B associated with the serum levels and adverse effects of MTX would identify patients at risk and therefore help a pediatric oncologist to personalize chemotherapy drugs for precision health.
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Affiliation(s)
- Rizal Husaini Razali
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA Cawangan Selangor Kampus Puncak Alam, Selangor, Malaysia.,Faculty of Pharmacy Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia.,Pharmaceutical Services Programme, Ministry of Health, Petaling Jaya, Malaysia
| | - Mohd Nur Fakhruzzaman Noorizhab
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA Cawangan Selangor Kampus Puncak Alam, Selangor, Malaysia.,Faculty of Pharmacy Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia
| | - Hisyam Jamari
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA Cawangan Selangor Kampus Puncak Alam, Selangor, Malaysia
| | - Richard Johari James
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA Cawangan Selangor Kampus Puncak Alam, Selangor, Malaysia.,Faculty of Pharmacy Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia
| | - Kok Hoi Teh
- Paediatric Haematology and Oncology Unit, Women & Children's Hospital, Kuala Lumpur, Ministry of Health Malaysia
| | - Hishamshah Mohd Ibrahim
- Paediatric Haematology and Oncology Unit, Women & Children's Hospital, Kuala Lumpur, Ministry of Health Malaysia
| | - Lay Kek Teh
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA Cawangan Selangor Kampus Puncak Alam, Selangor, Malaysia.,Faculty of Pharmacy Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia
| | - Mohd Zaki Salleh
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA Cawangan Selangor Kampus Puncak Alam, Selangor, Malaysia.,Faculty of Pharmacy Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, Selangor, Malaysia
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