Abstract | BACKGROUND:
Antiepileptic treatment response has been suggested to be modulated by genetic polymorphisms of drug efflux transporters, in particular ABCB1. Recently, we found a significant association of ABCC2 -24C>T with nonresponse, primarily in the context of generalized epilepsy. Moreover, ABCC2 1249G>A was reported to alter transmembranal carbamazepine transport. Therefore, we aimed to confirm the association of ABCC2 variants with pharmacotherapy-resistance in Caucasians mainly affected by partial epilepsy. PATIENTS AND METHODS: A total of 208 patients (114 male; age: 11.3±5.9 years) were genotyped for three putatively functionally relevant polymorphisms of ABCC2 (-24C>T, 1249G>A, 3972C>T). Genotype and haplotype frequencies were compared between responders and nonresponders to first-line antiepileptic treatment. RESULTS: Carriers of the ABCC2 1249G>A variant (417V>I) were more frequent among responders [odds ratio (OR)=2.68 (1.25-5.78); P=0.010]. This association remained significant after adjusting for age, sex and seizure type, [OR=2.88 (1.23-6.73); P=0.015]. The impact of 1249G>A was more pronounced among 64 patients receiving carbamazepine or oxcarbazepine (P=0.005), but nonsignificant in patients receiving other anticonvulsants. ABCC2 -24C>T and 3972C>T showed lack of association to therapy response. Haplotype analyses revealed that haplotype H2 containing solely the 1249A variant allele was more frequent in the responder group [OR=2.98 (1.38-6.44); P=0.004]. DISCUSSION: These data argue for a greater probability of antiepileptic drug response among carriers of the ABCC2 1249A variant that is associated with reduced carbamazepine transport. Although we could not confirm an impact of ABCC2 -24C>T, these results suggest that ABCC2 genotype may also modulate the response to anticonvulsants besides the extensively studied ABCB1 ( P-glycoprotein).
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Authors | Mike Ufer, Celina von Stülpnagel, Hiltrud Muhle, Sierk Haenisch, Cornelia Remmler, Amani Majed, Herbert Plischke, Ulrich Stephani, Gerhard Kluger, Ingolf Cascorbi |
Journal | Pharmacogenetics and genomics
(Pharmacogenet Genomics)
Vol. 21
Issue 10
Pg. 624-30
(Oct 2011)
ISSN: 1744-6880 [Electronic] United States |
PMID | 21799461
(Publication Type: Journal Article)
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Chemical References |
- ABCC2 protein, human
- Anticonvulsants
- Biomarkers, Pharmacological
- Multidrug Resistance-Associated Protein 2
- Multidrug Resistance-Associated Proteins
- Carbamazepine
- Valproic Acid
- Oxcarbazepine
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Topics |
- Adolescent
- Alleles
- Anticonvulsants
(therapeutic use)
- Biomarkers, Pharmacological
- Carbamazepine
(analogs & derivatives, therapeutic use)
- Child
- Drug Resistance
(genetics)
- Epilepsies, Partial
(drug therapy)
- Female
- Genetic Association Studies
- Genotype
- Haplotypes
- Humans
- Male
- Multidrug Resistance-Associated Protein 2
- Multidrug Resistance-Associated Proteins
(genetics)
- Oxcarbazepine
- Polymorphism, Single Nucleotide
- Valproic Acid
(therapeutic use)
- White People
(genetics)
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