Cytochromes P450(CYPs)play a prominent role in catalyzing phase I xenobiotic biotransformation and account for about 75%of the total metabolism of commercially available drugs,including chemotherapeutics.The gene expr...Cytochromes P450(CYPs)play a prominent role in catalyzing phase I xenobiotic biotransformation and account for about 75%of the total metabolism of commercially available drugs,including chemotherapeutics.The gene expression and enzyme activity of CYPs are variable between individuals,which subsequently leads to different patterns of susceptibility to carcinogenesis by genotoxic xenobiotics,as well as differences in the efficacy and toxicity of clinically used drugs.This research aimed to examine the presence of the CYP2B6*9 polymorphism and its possible association with the incidence of B-CLL in Egyptian patients,as well as the clinical outcome after receiving cyclophosphamide chemotherapy.DNA was isolated from whole blood samples of 100 de novo B-CLL cases and also from 100 sex-and age-matched healthy individuals.The presence of the CYP2B6*9(G516T)polymorphism was examined by PCR-based allele specific amplification(ASA).Patients were further indicated for receiving chemotherapy,and then they were followed up.The CYP2B6*9 variant indicated a statistically significant higher risk of B-CLL under different genetic models,comprising allelic(T-allele vs.G-allele,OR=4.8,p<0.001)and dominant(GT+TT vs.GG,OR=5.4,p<0.001)models.Following cyclophosphamide chemotherapy,we found that the patients with variant genotypes(GT+TT)were less likely to achieve remission compared to those with the wild-type genotype(GG),with a response percentage of(37.5%vs.83%,respectively).In conclusion,our findings showed that the CYP2B6*9(G516T)polymorphism is associated with B-CLL susceptibility among Egyptian patients.This variant greatly affected the clinical outcome and can serve as a good therapeutic marker in predicting response to cyclophosphamide treatment.展开更多
目的:舒芬太尼镇痛效果存在个体差异。本研究旨在评价CYP2B6(CPB6)*4和OPRM1基因多态性对膝关节镜下患者术后舒芬太尼静脉镇痛效应的影响。方法:选择择期腰麻硬膜外联合麻醉下行膝关节镜前交叉韧带重建术患者210例,患者术后使用静脉镇...目的:舒芬太尼镇痛效果存在个体差异。本研究旨在评价CYP2B6(CPB6)*4和OPRM1基因多态性对膝关节镜下患者术后舒芬太尼静脉镇痛效应的影响。方法:选择择期腰麻硬膜外联合麻醉下行膝关节镜前交叉韧带重建术患者210例,患者术后使用静脉镇痛泵。术前采集2 mL静脉血置入抗凝管,留作检测CPB6*4和OPRM1的基因多态性,根据CPB6*4和OPRM1基因的不同基因组将患者分为A/A组、G/A组、G/G组、T/T组和C/T组,观察不同基因组患者术后疼痛数字评分(Numerical Rating Scale,NRS)、病人自控镇痛(patient controlled analgesia,PCA)按压次数、舒芬太尼用量、术后开始出现疼痛的时间以及术后不良事件的发生率。结果:共纳入202例患者,CPB6*4rs2279343中A/A组76例,G/A组110例,G/G组16例;OPRM1 rs73568641中T/T组194例,C/T组8例。与G/A组和A/A组相比,G/G组术后7 d NRS均降低(均P<0.05);术后1和3 d NRS、PCA按压次数、舒芬太尼用量、术后开始疼痛的时间、术后不良反应、术后住院时间及术后3个月慢性疼痛的发生率差异均无统计学意义(均P>0.05)。与T/T组相比,C/T组术后1和3 d NRS、PCA按压次数、舒芬太尼用量增加,差异均有统计学意义(均P<0.05);术后7 d NRS、术后开始疼痛的时间、术后不良反应、术后住院时间及术后3个月慢性疼痛的发生率比较差异均无统计学意义(均P>0.05)。结论:CPB6*4和OPRM1基因多态性是引起膝关节镜患者术后舒芬太尼静脉镇痛个体化差异的遗传因素。展开更多
目的研究CYP2B6基因多态性对宫颈癌患者应用右美托咪定临床麻醉效果的影响。方法选取接受治疗的宫颈癌患者112例,术前均禁食禁饮,建立外周静脉通道和心电监护,麻醉诱导后,静脉输注丙泊酚1.5 mg/(kg·h)、瑞芬太尼2μg/(kg·h),...目的研究CYP2B6基因多态性对宫颈癌患者应用右美托咪定临床麻醉效果的影响。方法选取接受治疗的宫颈癌患者112例,术前均禁食禁饮,建立外周静脉通道和心电监护,麻醉诱导后,静脉输注丙泊酚1.5 mg/(kg·h)、瑞芬太尼2μg/(kg·h),随后静脉持续输注右美托咪定,剂量为0.2μg/(kg·h),手术过程中根据患者的具体情况追加丙泊酚。于清晨空腹且未服药前采集静脉血后,采用PCR-RFLP法检测宫颈癌患者CYP2B6基因型,记录患者手术时间、苏醒时间和追加丙泊酚的总用量,以及临床麻醉效果、不良反应,观察比较CYP2B6不同基因型对宫颈癌患者右美托咪定麻醉效果的影响。结果入组患者的CYP2B6 516G> T等位基因的野生型纯合子、突变型纯合子和突变型杂合子的分布符合Hardy-Weinberg平衡(P>0.05)。其中,GG、GT基因型突变的频率分别为55.36%和31.25%,G等位基因的频率为69.38%。当CYP2B6 516G> T基因型为GT或TT时,患者的Ramsay评分明显低于GG基因型的患者,而VAS评分明显高于GG基因型的患者,且差异均有统计学意义(GG vs. GT:P<0.01,GG vs. TT:P<0.05)。而所有患者的手术时间没有明显差异(P>0.05),与GG基因型相比,GT/TT基因型的患者苏醒时间更长,丙泊酚的总用量更多(GG vs. GT:P<0.01,GG vs. TT:P<0.05);术后,GT基因型患者出现呼吸抑制的有6例(17.14%),而呕吐或头晕的患者有5例(14.29%),心动过缓的患者有2例(5.71%)。结论 CYP2B6 516G> T基因发生突变后会显著影响宫颈癌患者应用右美托咪定的麻醉效果,延长患者苏醒时间,增加丙泊酚的用量和提高不良反应的概率。展开更多
文摘Cytochromes P450(CYPs)play a prominent role in catalyzing phase I xenobiotic biotransformation and account for about 75%of the total metabolism of commercially available drugs,including chemotherapeutics.The gene expression and enzyme activity of CYPs are variable between individuals,which subsequently leads to different patterns of susceptibility to carcinogenesis by genotoxic xenobiotics,as well as differences in the efficacy and toxicity of clinically used drugs.This research aimed to examine the presence of the CYP2B6*9 polymorphism and its possible association with the incidence of B-CLL in Egyptian patients,as well as the clinical outcome after receiving cyclophosphamide chemotherapy.DNA was isolated from whole blood samples of 100 de novo B-CLL cases and also from 100 sex-and age-matched healthy individuals.The presence of the CYP2B6*9(G516T)polymorphism was examined by PCR-based allele specific amplification(ASA).Patients were further indicated for receiving chemotherapy,and then they were followed up.The CYP2B6*9 variant indicated a statistically significant higher risk of B-CLL under different genetic models,comprising allelic(T-allele vs.G-allele,OR=4.8,p<0.001)and dominant(GT+TT vs.GG,OR=5.4,p<0.001)models.Following cyclophosphamide chemotherapy,we found that the patients with variant genotypes(GT+TT)were less likely to achieve remission compared to those with the wild-type genotype(GG),with a response percentage of(37.5%vs.83%,respectively).In conclusion,our findings showed that the CYP2B6*9(G516T)polymorphism is associated with B-CLL susceptibility among Egyptian patients.This variant greatly affected the clinical outcome and can serve as a good therapeutic marker in predicting response to cyclophosphamide treatment.
文摘目的:舒芬太尼镇痛效果存在个体差异。本研究旨在评价CYP2B6(CPB6)*4和OPRM1基因多态性对膝关节镜下患者术后舒芬太尼静脉镇痛效应的影响。方法:选择择期腰麻硬膜外联合麻醉下行膝关节镜前交叉韧带重建术患者210例,患者术后使用静脉镇痛泵。术前采集2 mL静脉血置入抗凝管,留作检测CPB6*4和OPRM1的基因多态性,根据CPB6*4和OPRM1基因的不同基因组将患者分为A/A组、G/A组、G/G组、T/T组和C/T组,观察不同基因组患者术后疼痛数字评分(Numerical Rating Scale,NRS)、病人自控镇痛(patient controlled analgesia,PCA)按压次数、舒芬太尼用量、术后开始出现疼痛的时间以及术后不良事件的发生率。结果:共纳入202例患者,CPB6*4rs2279343中A/A组76例,G/A组110例,G/G组16例;OPRM1 rs73568641中T/T组194例,C/T组8例。与G/A组和A/A组相比,G/G组术后7 d NRS均降低(均P<0.05);术后1和3 d NRS、PCA按压次数、舒芬太尼用量、术后开始疼痛的时间、术后不良反应、术后住院时间及术后3个月慢性疼痛的发生率差异均无统计学意义(均P>0.05)。与T/T组相比,C/T组术后1和3 d NRS、PCA按压次数、舒芬太尼用量增加,差异均有统计学意义(均P<0.05);术后7 d NRS、术后开始疼痛的时间、术后不良反应、术后住院时间及术后3个月慢性疼痛的发生率比较差异均无统计学意义(均P>0.05)。结论:CPB6*4和OPRM1基因多态性是引起膝关节镜患者术后舒芬太尼静脉镇痛个体化差异的遗传因素。
文摘目的研究CYP2B6基因多态性对宫颈癌患者应用右美托咪定临床麻醉效果的影响。方法选取接受治疗的宫颈癌患者112例,术前均禁食禁饮,建立外周静脉通道和心电监护,麻醉诱导后,静脉输注丙泊酚1.5 mg/(kg·h)、瑞芬太尼2μg/(kg·h),随后静脉持续输注右美托咪定,剂量为0.2μg/(kg·h),手术过程中根据患者的具体情况追加丙泊酚。于清晨空腹且未服药前采集静脉血后,采用PCR-RFLP法检测宫颈癌患者CYP2B6基因型,记录患者手术时间、苏醒时间和追加丙泊酚的总用量,以及临床麻醉效果、不良反应,观察比较CYP2B6不同基因型对宫颈癌患者右美托咪定麻醉效果的影响。结果入组患者的CYP2B6 516G> T等位基因的野生型纯合子、突变型纯合子和突变型杂合子的分布符合Hardy-Weinberg平衡(P>0.05)。其中,GG、GT基因型突变的频率分别为55.36%和31.25%,G等位基因的频率为69.38%。当CYP2B6 516G> T基因型为GT或TT时,患者的Ramsay评分明显低于GG基因型的患者,而VAS评分明显高于GG基因型的患者,且差异均有统计学意义(GG vs. GT:P<0.01,GG vs. TT:P<0.05)。而所有患者的手术时间没有明显差异(P>0.05),与GG基因型相比,GT/TT基因型的患者苏醒时间更长,丙泊酚的总用量更多(GG vs. GT:P<0.01,GG vs. TT:P<0.05);术后,GT基因型患者出现呼吸抑制的有6例(17.14%),而呕吐或头晕的患者有5例(14.29%),心动过缓的患者有2例(5.71%)。结论 CYP2B6 516G> T基因发生突变后会显著影响宫颈癌患者应用右美托咪定的麻醉效果,延长患者苏醒时间,增加丙泊酚的用量和提高不良反应的概率。
