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Zhu J, Lu J, He Y, Shen X, Xia H, Li W, Zhang J, Fan X. Association of ABCB1 Polymorphisms with Efficacy and Adverse Drug Reactions of Valproic Acid in Children with Epilepsy. Pharmaceuticals (Basel) 2023; 16:1536. [PMID: 38004402 PMCID: PMC10675623 DOI: 10.3390/ph16111536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
Genetic polymorphisms in ATP-binding cassette subfamily B member 1 (ABCB1, also known as MDR1) have been reported to be possibly associated with the regulation of response to antiseizure medications. The aim of this study was to investigate the association of ABCB1 polymorphisms with the efficacy of and adverse drug reactions to valproic acid among Chinese children with epilepsy. A total of 170 children from southern China with epilepsy treated with valproic acid for more than one year were recruited, including 61 patients with persistent seizures and 109 patients who were seizure-free. Two single nucleotide polymorphisms of ABCB1, rs1128503 and rs3789243, were genotyped using the Sequenom MassArray system. The two single nucleotide polymorphisms of ABCB1 were found to be significantly associated with treatment outcomes of valproic acid in children with epilepsy. Carriers with the TT genotype of ABCB1 rs1128503 were more inclined to exhibit persistent seizures after treatment with valproic acid (p = 0.013). The CC genotype of rs3789243 was observed to be a potential protective factor for valproic acid-induced gastrointestinal adverse drug reactions (p = 0.018), but possibly increased the risk of valproic acid-induced cutaneous adverse drug reactions (p = 0.011). In contrast, the CT genotype of rs3789243 was associated with a lower risk of valproic acid-induced cutaneous adverse drug reactions (p = 0.011). Haplotype analysis showed that CC haplotype carriers tended to respond better to valproic acid treatment (p = 0.009). Additionally, no significant association was found between ABCB1 polymorphisms and serum concentrations of valproic acid. This study revealed that the polymorphisms and haplotypes of the ABCB1 gene might be associated with the treatment outcomes of valproic acid in Chinese children with epilepsy.
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Affiliation(s)
- Jiahao Zhu
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Jieluan Lu
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
| | - Yaodong He
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Xianhuan Shen
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Hanbing Xia
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Wenzhou Li
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
| | - Jianping Zhang
- Department of Clinical Pharmacology, College of Pharmacy, Jinan University, Guangzhou 511436, China; (J.Z.); (J.L.); (Y.H.); (X.S.); (J.Z.)
| | - Xiaomei Fan
- Department of Pharmacy, Shenzhen Baoan Women’s and Children’s Hospital, Jinan University, Shenzhen 518102, China; (H.X.); (W.L.)
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Magadmi R, Alyoubi R, Moshrif T, Bakhshwin D, Suliman BA, Kamel F, Jamal M, Burzangi AS, Basit S. Polymorphisms in the Drug Transporter Gene ABCB1 Are Associated with Drug Response in Saudi Epileptic Pediatric Patients. Biomedicines 2023; 11:2505. [PMID: 37760947 PMCID: PMC10526247 DOI: 10.3390/biomedicines11092505] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 09/03/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Epilepsy is one of the most common chronic neurodisorders in the pediatric age group. Despite the availability of over 20 anti-seizure medications (ASMs) on the market, drug-resistant epilepsy still affects one-third of individuals. Consequently, this research aimed to investigate the association between single-nucleotide polymorphisms (SNPs) of the ATP-binding cassette subfamily B member 1 (ABCB1) gene in epileptic pediatric patients and their response to ASMs. This multicentric, cross-sectional study was conducted among Saudi children with epilepsy in Jeddah, Saudi Arabia. The polymorphism variants of ABCB1 rs1128503 at exon 12, rs2032582 at exon 21, and rs1045642 at exon 26 were genotyped using the Sanger sequencing technique. The study included 85 children with epilepsy: 43 patients demonstrated a good response to ASMs, while 42 patients exhibited a poor response. The results revealed that good responders were significantly more likely to have the TT genotypes at rs1045642 and rs2032582 SNPs compared to poor responders. Additionally, haplotype analysis showed that the T-G-C haplotype at rs1128503, rs2032582, and rs1045642 was only present in poor responders. In conclusion, this study represents the first pharmacogenetic investigation of the ABCB1 gene in Saudi epileptic pediatric patients and demonstrates a significant association between rs1045642 and rs2032582 variants and patient responsiveness. Despite the small sample size, the results underscore the importance of personalized treatment for epileptic patients.
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Affiliation(s)
- Rania Magadmi
- Department of Clinical Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (T.M.); (D.B.); (F.K.); (M.J.); (A.S.B.)
| | - Reem Alyoubi
- Pediatric Department, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Tahani Moshrif
- Department of Clinical Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (T.M.); (D.B.); (F.K.); (M.J.); (A.S.B.)
- Clinical Pharmacy Department, King Abdullah Medical Complex, Jeddah 23816 , Saudi Arabia
| | - Duaa Bakhshwin
- Department of Clinical Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (T.M.); (D.B.); (F.K.); (M.J.); (A.S.B.)
| | - Bandar A. Suliman
- College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia;
| | - Fatemah Kamel
- Department of Clinical Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (T.M.); (D.B.); (F.K.); (M.J.); (A.S.B.)
| | - Maha Jamal
- Department of Clinical Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (T.M.); (D.B.); (F.K.); (M.J.); (A.S.B.)
| | - Abdulhadi S. Burzangi
- Department of Clinical Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (T.M.); (D.B.); (F.K.); (M.J.); (A.S.B.)
| | - Sulman Basit
- Biochemistry and Molecular Medicine Department, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia;
- Centre for Genetics and Inherited Diseases, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia
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Li Z, Cao W, Sun H, Wang X, Li S, Ran X, Zhang H. Potential clinical and biochemical markers for the prediction of drug-resistant epilepsy: A literature review. Neurobiol Dis 2022; 174:105872. [PMID: 36152944 DOI: 10.1016/j.nbd.2022.105872] [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: 05/16/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 12/01/2022] Open
Abstract
Drug resistance is a major challenge in the treatment of epilepsy. Drug-resistant epilepsy (DRE) accounts for 30% of all cases of epilepsy and is a matter of great concern because of its uncontrollability and the high burden, mortality rate, and degree of damage. At present, considerable research has focused on the development of predictors to aid in the early identification of DRE in an effort to promote prompt initiation of individualized treatment. While multiple predictors and risk factors have been identified, there are currently no standard predictors that can be used to guide the clinical management of DRE. In this review, we discuss several potential predictors of DRE and related factors that may become predictors in the future and perform evidence rating analysis to identify reliable potential predictors.
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Affiliation(s)
- ZhiQiang Li
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei Cao
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - HuiLiang Sun
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin Wang
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - ShanMin Li
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - XiangTian Ran
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hong Zhang
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China.
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Pharmacogenetics of Drug-Resistant Epilepsy (Review of Literature). Int J Mol Sci 2021; 22:ijms222111696. [PMID: 34769124 PMCID: PMC8584095 DOI: 10.3390/ijms222111696] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 12/17/2022] Open
Abstract
Pharmacogenomic studies in epilepsy are justified by the high prevalence rate of this disease and the high cost of its treatment, frequent drug resistance, different response to the drug, the possibility of using reliable methods to assess the control of seizures and side effects of antiepileptic drugs. Candidate genes encode proteins involved in pharmacokinetic processes (drug transporters, metabolizing enzymes), pharmacodynamic processes (receptors, ion channels, enzymes, regulatory proteins, secondary messengers) and drug hypersensitivity (immune factors). This article provides an overview of the literature on the influence of genetic factors on treatment in epilepsy.
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