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Yorifuji K, Uemura Y, Horibata S, Tsuji G, Suzuki Y, Miyagawa K, Nakayama K, Hirata KI, Kumagai S, Emoto N. CHST3 and CHST13 polymorphisms as predictors of bosentan-induced liver toxicity in Japanese patients with pulmonary arterial hypertension. Pharmacol Res 2018; 135:259-264. [PMID: 30118797 DOI: 10.1016/j.phrs.2018.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 01/24/2023]
Abstract
Bosentan, an endothelin receptor antagonist, has been widely used as a first-line drug for the treatment of pulmonary arterial hypertension (PAH). In addition, bosentan is approved for patients with digital ulcers related to systemic sclerosis. Liver dysfunction is a major adverse effect of bosentan and may lead to discontinuation of therapy. The purpose of this study was to identify genomic biomarkers to predict bosentan-induced liver injury. A total of 69 PAH patients were recruited into the study. An exploratory analysis of 1936 single-nucleotide polymorphisms (SNPs) in 231 genes involved in absorption, distribution, metabolism, and elimination of multiple medications using Affimetrix DMET™ (Drug Metabolism Enzymes and Transporters) chips was performed. We extracted 16 SNPs (P < 0.05) using the Jonckheere-Terpstra trend test and multiplex logistic analysis; we identified two SNPs in two genes, CHST3 and CHST13, which are responsible for proteoglycan sulfation and were significantly associated with bosentan-induced liver injury. We constructed a predictive model for bosentan-induced liver injury (area under the curve [AUC]: 0.89, sensitivity: 82.61%, specificity: 86.05%) via receiver operating curve (ROC) analysis using 2 SNPs and 2 non-genetic factors. Two SNPs were identified as potential predictive markers for bosentan-induced liver injury in Japanese patients with pulmonary arterial hypertension. This is the first pharmacogenomics study linking proteoglycan sulfating genes to drug-induced liver dysfunction, a frequently observed clinical adverse effect of bosentan therapy. These results may provide a way to personalize PAH medicine as well as provide novel mechanistic insights to drug-induced liver dysfunction.
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Affiliation(s)
- Kennosuke Yorifuji
- Laboratory of Clinical Pharmaceutical Science, Kobe Pharmaceutical University, 4-19-1 Motoyama-kitamachi, Higashinada, Kobe 658-8558, Japan; The Shinko Institute for Medical Research, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe 651-0072, Japan; Department of Pharmacy, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe 651-0072, Japan
| | - Yuko Uemura
- The Shinko Institute for Medical Research, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe 651-0072, Japan
| | - Shinji Horibata
- The Shinko Institute for Medical Research, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe 651-0072, Japan; Department of Pharmacy, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe 651-0072, Japan
| | - Goh Tsuji
- The Shinko Institute for Medical Research, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe 651-0072, Japan; Center for Rheumatic Diseases, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe 651-0072, Japan
| | - Yoko Suzuki
- Laboratory of Clinical Pharmaceutical Science, Kobe Pharmaceutical University, 4-19-1 Motoyama-kitamachi, Higashinada, Kobe 658-8558, Japan; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe Graduate School of Medicine, 7-5-1 Kusunoki, Chuo, Kobe 650-0017, Japan
| | - Kazuya Miyagawa
- Laboratory of Clinical Pharmaceutical Science, Kobe Pharmaceutical University, 4-19-1 Motoyama-kitamachi, Higashinada, Kobe 658-8558, Japan; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe Graduate School of Medicine, 7-5-1 Kusunoki, Chuo, Kobe 650-0017, Japan
| | - Kazuhiko Nakayama
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe Graduate School of Medicine, 7-5-1 Kusunoki, Chuo, Kobe 650-0017, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe Graduate School of Medicine, 7-5-1 Kusunoki, Chuo, Kobe 650-0017, Japan
| | - Shunichi Kumagai
- The Shinko Institute for Medical Research, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe 651-0072, Japan; Center for Rheumatic Diseases, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe 651-0072, Japan
| | - Noriaki Emoto
- Laboratory of Clinical Pharmaceutical Science, Kobe Pharmaceutical University, 4-19-1 Motoyama-kitamachi, Higashinada, Kobe 658-8558, Japan; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe Graduate School of Medicine, 7-5-1 Kusunoki, Chuo, Kobe 650-0017, Japan.
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