CYP2C19 基因多态性与冠心病危险因素对氯吡格雷抵抗的影响

目的:观察细胞色素P450系统药物代谢酶CYP2C19基因多态性以及相关临床因素对氯吡格雷抵抗的影响。方法:选择2010年11月至2011年5月我科拟行PCI术治疗的冠心病患者共145例,均给予氯吡格雷300mg负荷剂量,75mg维持剂量。①通过流式细胞仪检测血管舒张因子刺激酸磷蛋白血小板反应性指数VASP PRI(以VASP PRI≥50%,定义为氯吡格雷抵抗)分为氯吡格雷抵抗组和氯吡格雷反应组。②检测入选患者的药物代谢酶CYP2C19的基因型;根据不同等位基因功能缺失,分为快代谢基因型(*1/*1)、中间代谢基因型(*1/*2、*1/*3)和慢代谢基因型(*2/*2、*2/*3、*3/*3)。③观察CYP2C19基因型及相关临床危险因素对氯吡格雷反应性的影响,④观察氯吡格雷抵抗与临床不良终点事件主要临床不良终点事件[心源性死亡、再发心肌梗死、靶病变再次血运重建术(TLR)]和次要临床终点事件(支架内血栓形成、脑血管意外、大出血)之间的相关性。结果:检测出氯吡格雷抵抗的患者31例,其发生率为20.67%;检测出CYP2C19慢代谢基因型携带患者19例,所占比例为12.67%。慢代谢基因型患者与(快代谢基因型+中间代谢基因型患者)之间VASP PRI比为(49.20±8.45)%VS(44.17±5.41)%,P<0.05,氯吡格雷抵抗发生率之比为35.49%(n=11)VS16.81%(n=20),P<0.05。多元回归分析提示CYP2C19慢代谢基因型(OR:4.43;95%CI:3.28-8.37,P<0.05)和2型糖尿病(OR:2.76;95%CI:2.13-6.14;P<0.05)是氯吡格雷抵抗的两种危险因素。临床随访结果显示氯吡格雷抵抗组与氯吡格雷反应组主要临床不良终点事件的发生率比为6.45%(n=2)vs2.63%(n=3),P<0.05。结论:携带CPY2C19慢代谢基因型和患有2型糖尿病是导致氯吡格雷抵抗的两种重要的危险因素,氯吡格雷抵抗的发生增加了临床不良终点事件的风险。     

CYP1A1基因单核苷酸多态性与肺癌的相关性研究

目的:探讨代谢酶CYP1A1基因MspI位点多态性与新疆汉族人群肺癌遗传易感性之间的相关性.方法:应用聚合酶链式反应(PCR)-限制性片段长度多态性(RFLP)技术检测59例新疆汉族肺癌和84例新疆汉族健康人的CYP1A1基因MspI位点多态性分布频率,并分析了CYP1A1基因MspI位点多态性与新疆汉族人群肺癌遗传易感性和患者性别之间的相关性.结果:(1)CYP1A1基因MspI位点3种多态基因型分布频率在两组间比较差异有统计学意义(χ2=6.682,P=0.035),CC基因型在病例组的分布频率显著高于正常对照组.(2)携带突变CC基因型的个体较携带TT基因型的个体患肺癌的危险性增加(OR=3.759.95%CI=1.228-11.494,P=0.035).(3)男女肺癌患者的CYP1A1基因MspI位点基因型及等位基因频率的差异均无显著性(P>0.05).结论:(1)CC突变基因型可能是新疆汉族人群的肺癌易感因素.(2)CYP1A1基因MspI位点多态性可能与新疆汉族肺癌患者的性别无关.     

CYP2C8及CYP3A4细胞表达体系的构建及其在小分子激酶药物对紫衫醇代谢途径抑制研究中的应用

构建CYP2C8及其3种突变体细胞表达体系,以紫杉醇为底物研究CYP2C8基因多态性对其酶活性的影响,以及构建CYP2C8和CYP3A4共转染细胞体系研究小分子激酶抑制剂对紫杉醇代谢途径的抑制。根据基因文库分别合成CYP3A4以及CYP2C8及其3种突变体CYP2C8*2(805AT)、CYP2C8*3(416GA,1196AG)、CYP2C8*4(792CG)的基因编码片段,将其连接到PEGFP-N1表达质粒,测序验证。将CYP2C8野生型及其突变体分别转染HepG2细胞,24 h后加入紫杉醇进行孵育,通过建立好的LC-MS/MS方法对代谢物进行定量分析。同时,也将野生型CYP2C8和CYP3A4质粒按一定的浓度比转入Hep G2细胞构建共表达体系。并筛选出合适的质粒浓度比转染细胞,在加入紫杉醇孵育时,同时加入小分子激酶抑制剂,考察小分子激酶抑制剂对紫杉醇代谢途径的抑制作用。结果表明,CYP2C8*4代谢酶对紫杉醇的代谢能力存在明显差异,其中CYP2C8*2和CYP2C8*3代谢活性分别是野生型的81%(P0.05)和87%(P0.05),而CYP2C8*4则是野生型的65%(P0.01)。尼洛替尼完全抑制了紫杉醇的代谢,阿法替尼对紫杉醇的两条代谢途径抑制达30%,而伊马替尼选择性抑制了CYPD3A4的活性。不同基因型CYP2C8对紫杉醇的代谢存在差异,可能是导致临床疗效不同的原因。小分子激酶抑制剂在与紫杉醇联合使用时,对紫杉醇代谢的抑制各不相同。     

中国汉族急性白血病患儿化疗药物不良反应与CYP3A5*3的关联性研究

目的:探讨中国汉族儿童CYP3A5*3与白血病药物不良反应的关联.方法:入选2004年7月至2011年6月间确诊的急性白血病儿童52名,用PCR-RFLP方法测定CYP3A5*3突变,同时收集病人常规资料和不良反应.结果:白血病儿童主要不良反应为呕吐、口腔黏膜损害、一过性骨髓抑制、肝功能损害.且CYP3A5*3/*3病人相对于其他两组,更易于发生白细胞减少和粘膜损害.结论:CYP3A5*3与病人的不良反应发生密切相关,可作为白血病治疗效果预测基因.     

CYP2C8及CYP3A4细胞表达体系的构建及其在小分子激酶药物对紫衫醇代谢途径抑制研究中的应用北大核心CSCD

构建CYP2C8及其3种突变体细胞表达体系,以紫杉醇为底物研究CYP2C8基因多态性对其酶活性的影响,以及构建CYP2C8和CYP3A4共转染细胞体系研究小分子激酶抑制剂对紫杉醇代谢途径的抑制。根据基因文库分别合成CYP3A4以及CYP2C8及其3种突变体CYP2C8*2(805A>T)、CYP2C8*3(416G>A,1196A>G)、CYP2C8*4(792C>G)的基因编码片段,将其连接到PEGFP-N1表达质粒,测序验证。将CYP2C8野生型及其突变体分别转染HepG2细胞,24 h后加入紫杉醇进行孵育,通过建立好的LC-MS/MS方法对代谢物进行定量分析。同时,也将野生型CYP2C8和CYP3A4质粒按一定的浓度比转入Hep G2细胞构建共表达体系。并筛选出合适的质粒浓度比转染细胞,在加入紫杉醇孵育时,同时加入小分子激酶抑制剂,考察小分子激酶抑制剂对紫杉醇代谢途径的抑制作用。结果表明,CYP2C8*4代谢酶对紫杉醇的代谢能力存在明显差异,其中CYP2C8*2和CYP2C8*3代谢活性分别是野生型的81%(P<0.05)和87%(P<0.05),而CYP2C8*4则是野生型的65%(P<0.01)。尼洛替尼完全抑制了紫杉醇的代谢,阿法替尼对紫杉醇的两条代谢途径抑制达30%,而伊马替尼选择性抑制了CYPD3A4的活性。不同基因型CYP2C8对紫杉醇的代谢存在差异,可能是导致临床疗效不同的原因。小分子激酶抑制剂在与紫杉醇联合使用时,对紫杉醇代谢的抑制各不相同。     

卡马西平联合左甲状腺素对甲状腺功能减退症患者血清IGFBP-3、25(OH)D3的影响

目的:探讨卡马西平联合左甲状腺素对甲状腺功能减退症患者血清胰岛素样生长因子结合蛋白-3(IGFBP-3)、25羟维生素D3(25(OH)D_3)的影响。方法:选择2017年5月～2018年6月本院接诊的103例甲状腺功能减退症患者进行研究,通过随机数表法分为观察组52例和对照组51例,对照组给予左甲状腺素口服治疗,观察组在对照组基础上联合卡马西平口服治疗,两组患者均连续治疗8周。比较两组临床疗效、治疗前后甲状功能、血清IGFBP-3和25(OH)D_3的变化情况及不良反应。结果:治疗后,观察组患者的临床疗效为94.23%,明显高于对照组患者的84.31%(P0.05);观察组血清FT3、TSH均明显比对照组低,FT4明显高于对照组(P0.05);两组患者治疗后IGFBP-3和25(OH)D_3的指标水平均高于治疗前,且观察组结果高于对照组(P0.05);观察组不良反应总发生率为5.76%,低于对照组的13.73%,两组不良反应总发生率差异无统计学意义(P0.05)。结论:卡马西平联合左甲状腺素对甲状腺功能减退症患者临床效果显著,可有效改善患者甲状腺功能,调节患者血清IGFBP-3和25(OH)D_3的表达水平,且不良反应少、安全性高,值得推广。     

CYP3A5基因单核苷酸多态性rs3800959与氯吡格雷抵抗的相关性研究

目的:探讨细胞色素P450 3A5基因(CYP3A5)单核苷酸多态位点rs3800959与氯吡格雷抵抗(Clopidogrel resistance,CR)发生的关系。方法:于2010年3月至2011年10月期间,连续入选在沈阳军区总医院心内科住院的接受标准双联抗血小板治疗(阿司匹林+氯吡格雷)的冠心病患者共800例。以光学比浊法测定20μmol/L浓度ADP诱导的残余血小板聚集率(Residual plateletagglutination,RPA),并定义RPA≥70%为CR,所有入选患者分为CR组和氯吡格雷非抵抗组(Non-clopidogrel resistance,NCR)。所有入选病例提取血液白细胞基因组DNA后,采用直接测序的方法测定CYP3A5基因rs3800959单核苷酸多态位点的基因型及等位基因。结果:所入选的800例病人中,CR组为150例,NCR组为650例,CR发生率为18.75%。rs3800959基因型频率在CR组为TT型110例(73.3%)、CT型39例(26.0%)及CC型1例(0.7%);NCR组rs3800959基因型频率分别为477例、159例及14例(73.4%、24.5%及2.1%)。两组间各基因型频率分布无统计学差异(P=0.460,x2=1.554);T、C等位基因分布频率在两组间亦无明显差异(P=0.784,OR=0.942,95%CI=0.655~1.356)。结论:CYP3A5基因单核苷酸多态位点rs3800959与冠心病人CR的发生无相关关系。     

胆固醇7α-羟化酶基因 A-204C单核苷酸多态性及其与血浆血脂的关联

为探讨胆固醇7α-羟化酶基因(CYP7A1)多态性与中国四川汉族人群的分布及其与冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)易感性的关系,对183例CHD患者和101例对照用聚合酶链反应-限制性片段长度多态性方法(PCR-RFLP)进行CYP7A1基因A-204C基因座Eco31I酶切多态性分析。结果可见CYP7A1基因A-204C多态基因座等位基因C、A频率在CHD组和正常对照组分别为0.840、0.160和0.822、0.178,基因频率分布符合Hardy-Weiberg平衡定律。CYP7A1基因A-204C多态基因座基因型频率,等位基因A、C频率在CHD患者组和正常对照组间比较差异无显著性(P>0.05),但冠心病患者组中AA,AC,CC3种基因型之间总胆固醇(TC)的差异具有显著性(P<0.05),AA基因型患者的高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平较AC,CC基因型患者显著降低(P<0.05);而对照组中CC,CA基因型个体间总胆固醇(TC)水平差异有显著性(P<0.05)。中国汉族与白种人CYP7A1基因A-204C多态基因座等位基因频率比较,两者差异具有显著性(P<0.01)。提示CYP7A1基因A-204C多态基因座多态性与CHD无相关性,但与总胆固醇存在较密切的关联(P相似文献   

ACE、CYP11B2基因多态性与慢性心力衰竭患者醛固酮脱逸的关系

目的:研究CYP11B2-344C/T(醛固酮合成酶)及ACEI/D(血管紧张素转化酶)基因多态性与慢性心力衰竭(CHF)患者实施ACEI治疗后出现醛固酮脱逸表现的关系。方法:回顾分析2008年10月至2012年10月我科收治的252例CHF患者,全部患者应用ACEI治疗3月,醛固酮在基线以上为醛固酮脱逸,依据此标准将患者分为研究组(脱逸组,n=86)与对照组(非脱逸组,n=166),依据PCR(聚合酶链反应)及RFLP(片段长度限制多态性)等方法分别检测两组CYP11B2及ACE基因型,比较两组基因型频率的分布。结果:252例患者中,共86例出现醛固酮脱逸,发生率为34.1%。全部受试患者CYP11B2基因型及ACE基因型频率与Weinberg-Hardy平衡均相符(P均0.05)。研究组ACE I/D三种基因型的组间分布与对照组相较,无统计学差异(P0.05);CYP11B2基因TT型的频率与对照组相较,呈明显统计学差异(P0.05),等位基因C/T频率的组间分布同对照组相较,亦呈明显差异(P0.05)。研究组ACEI/D的基因多态性及CYP11B2-344C/T的多态性中,基因型联合组间分布与对照组相较,无统计学差异(P0.05)。结论:ACE基因多态性与CHF患者ACEI治疗后出现醛固酮脱逸无关,CYP11B2基因T等位基因及TT基因型多态性可能是CHF患者ACEI治疗后发生醛固酮脱逸的高危因素。醛固酮脱逸时,ACE、CYP11B2基因不具有协同效果。     

CYP3A5基因单核苷酸多态性rs3800959与氯吡格雷抵抗的相关性研究

目的:探讨细胞色素P450 3A5基因(CYP3A5)单核苷酸多态位点rs3800959与氯吡格雷抵抗(Clopidogrel resistance,CR)发生的关系.方法:于2010年3月至2011年10月期间,连续入选在沈阳军区总医院心内科住院的接受标准双联抗血小板治疗(阿司匹林+氯吡格雷)的冠心病患者共800例.以光学比浊法测定20μmol/L浓度ADP诱导的残余血小板聚集率(Residual platelet agglutination,RPA),并定义RPA＞ 70％为CR,所有入选患者分为CR组和氯吡格雷非抵抗组(Non-clopidogrel resistance,NCR).所有入选病例提取血液白细胞基因组DNA后,采用直接测序的方法测定CYP3A5基因rs3800959单核苷酸多态位点的基因型及等位基因.结果:所入选的800例病人中,CR组为150例,NCR组为650例,CR发生率为18.75％.rs3800959基因型频率在CR组为TT型110例(73.3％)、CT型39例(26.0％)及CC型1例(0.7％);NCR组rs3800959基因型频率分别为477例、159例及14例(73.4％、24.5％及 2.1％).两组间各基因型频率分布无统计学差异(P=0.460,x2=1.554);T、C等位基因分布频率在两组间亦无明显差异(P=0.784,OR=0.942,95％CI=0.655～1.356).结论:CYP3A5基因单核苷酸多态位点rs3800959与冠心病人CR的发生无相关关系.     

Hyaluronate degradation in 3T3 and simian virus-transformed 3T3 cells

The cellular control of hyaluronate levels was examined in cultures of simian virus 40-transformed 3T3 (SV3T3) and 3T3 cells which are known to differ in their metabolism of hyaluronate. When [3H]hyaluronate was added to cultures of the two cell lines, four times more ligand was bound per mg of protein by the SV3T3 cells than by the 3T3 cells. Of the bound [3H] hyaluronate, 40% was degraded by the SV3T3 cells to oligosaccharides characteristic of the breakdown of hyaluronate, but only 2% was degraded by 3T3 cells. Hyaluronidase activity was found in the cell layer and medium of the SV3T3 cultures, but was not detectable in 3T3 cells. The SV3T3 enzyme was active only at acidic pH, but at neutral pH the secreted SV3T3 hyaluronidase was thermally more stable then the cell-associated enzyme. In contrast, both cell lines were found to contain similar amounts of beta-glucuronidase and beta-N-acetylglucosaminidase activity. We conclude that the elevated capacity of SV3T3 cells to degrade hyaluronate may be partially responsible for their lack of the hyaluronate-containing pericellular coat which is prominent around 3T3 cells.     

Ether-linked lipids of Balb/c3T3, SV3T3 and concanavalin A-selected SV3T3 revertant cells

Ether-linked lipids were analyzed in Balb/c3T3, SV3T3 and Concanavalin A-selected SV3T3 revertant cells. The three cell lines were found to contain significant quantities of alk-1-enyl- and alkyl-linked phosphatidylethanolamine (PE) and phosphatidylcholine (PC) and small amounts of alkyldiacylglycerols. Compared to 3T3 cells, SV3T3 cells contain a higher amount of alk-1-enyl-linked PC, while in SV3T3 revertant cells the concentrations of the various ether lipids are similar to those of 3T3 cells. The major difference in the composition of ether groups of SV3T3 cells, compared to 3T3 cells, is an increase of 18:0 accompanied by a decrease of 18:1 in the alk-1-enyl-linked PE and PC. Alk-1-enyl-linked PC of SV3T3 revertant cells also shows an increase of 18:0, while the decrease of 18:1 was not statistically significant.     

Cell density and amino acid transport in 3T3, SV3T3, and SV3T3 revertant cells

The transport of selected neutral and cationic amino acids has been studied in Balb/c 3T3, SV3T3, and SV3T3 revertant cell lines. After properly timed preincubations to control the size of internal amino acid pools, the activity of systems A, ASC, L, and Ly⁺ has been discriminated by measurements of amino acid uptake (initial entry rate) in the presence and absence of sodium and of transportspecific model substrates. L-Proline, 2-aminoisobutyric acid, and glycine were primarily taken up by system A; L-alanine and L-serine by system ASC; L-phenylalanine by system L; and L-lysine by system Ly⁺ in SV3T3 cells. L-Proline and L-serine were also preferential substrates of systems A and ASC, respectively, in 3T3 and SV3T3 revertant cells. Transport activity of the Na⁺-dependent systems A and ASC decreased markedly with the increase of cell density, whereas the activity of the Na⁺-independent systems L and Ly⁺remained substantially unchanged. The density-dependent change in activity of system A occurred through a mechanism affecting transport maximum (V_max) rather than substrate concentration for half-maximal velocity (K_m). Transport activity of systems A and ASC was severalfold higher in transformed SV3T3 cells than in 3T3 parental cells at all the culture densities that could be compared. In SV3T3 revertant cells, transport activity by these systems remained substantially similar to that observed in transformed SV3T3 cells. The results presented here add cell density as a regulatory factor of the activity of systems A and ASC, and show that this control mechanism of amino acid transport is maintained in SV40 virus-transformed 3T3 cells that have lost density-dependent inhibition of growth, as well as in SV3T3 revertant cells that have resumed it.     

Protein degradation in 3T3 cells and tumorigenic transformed 3T3 cells

To study the relation of overall rates of protein degradation in the control of cell growth, we determined if transformation of fibroblasts to tumorigenicity affected their rates of degradation of short- and long-lived proteins. Rates of protein degradation were measured in nontumorigenic mouse Balb/c 3T3 fibroblasts, and in tumorigenic 3T3 cells transformed by different agents. Growing 3T3 cells, and cells transformed with Moloney sarcoma virus (MA-3T3) or Rous sarcoma virus (RS-3T3), degraded short- and long-lived proteins at similar rates. Simian virus 40 (SV-3T3)- and benzo(a)pyrene (BP-3T3)-transformed cells had slightly lower rates of degradation of both short- and long-lived proteins. Reducing the serum concentration in the culture medium from 10% to 0.5%, immediately caused about a twofold increase in the rate of degradation of long-lived proteins in 3T3 cells. Transformed lines increased their rates of degradation of long-lived proteins only by different amounts upon serum deprivation, but none of them to the same extent as did 3T3. Greater differences in the degradation rates of proteins were seen among the transformed cells than between 3T3 cells and some transformed cells. Thus, there was no consistent change in any rate of protein degradation in 3T3 cells due to transformation to tumorigenicity.     

3-Bromo-3-deazaneplanocin and 3-bromo-3-deazaaristeromycin: Synthesis and antiviral activity

As an outgrowth of our program to explore 3-deazaadenine carbocyclic nucleosides, 3-bromo-3-deazaneplanocin (5) and 3-bromo-3-deazaaristeromycin (6) have been synthesized from a readily available cyclopentenol and cyclopentanone and either 4-amino- or 4-chloro-1H-imidazo[4,5-c]pyridine (6-amino- or 6-chloro-3-deazaadenine) in 5 steps and 7 steps, respectively. Antiviral analysis found 5 to display significant activity towards a number of (-)-ssRNA and a few dsDNA viruses. Compound 6 was less active than 5 against selected examples of those viruses affected by 5.     

Endogenous hyaluronate-cell surface interactions in 3T3 and simian virus-transformed 3T3 cells

3T3 cells have a large, pericellular coat which contains 30 times more hyaluronate than the amount of cell surface hyaluronate associated with simian virus 40-transformed 3T3 (SV-3T3) cells. On the other hand, SV-3T3 cells have high affinity binding sites for exogenously added hyaluronate, whereas 3T3 cells have much lower affinity sites. Removal of cell surface hyaluronate from SV-3T3 cells by treatment with hyaluronidase caused a reproducible increase in their maximum binding capacity for exogenous hyaluronate but no significant change in binding affinity or specificity. For 3T3 cells, however, the maximum amount of binding decreased and the affinity of binding increased after hyaluronidase treatment. When endogenous cell surface hyaluronate was labeled metabolically and then the cells incubated in the presence of exogenous unlabeled hyaluronate, the labeled cell surface hyaluronate was quantitatively displaced from the SV-3T3 cells but was not displaced from the 3T3 cells. Chondroitin sulfate and heparin did not displace cell surface hyaluronate from either cell type. Membranes isolated from SV-3T3 cells bound hyaluronate specifically and with high affinity, whereas membranes from 3T3 cells did not consistently bind a significant amount of hyaluronate. We conclude from these studies that the retention of endogenous hyaluronate on the surface of SV-3T3 cells is mediated by binding sites similar to those detected by the addition of exogenous hyaluronate, and the mechanism of retention of endogenous hyaluronate on the surface of 3T3 cells differs from SV-3T3 cells.     

Synthesis and biological activity of 3 beta-fluorovitamin D3: comparison of the biological activity of 3 beta-fluorovitamin D3 and 3-deoxyvitamin D3

The alteration in the biologic activity of the vitamin D3 molecule resulting from the replacement of a hydrogen atom with a fluorine atom is a subject of fundamental interest. To investigate this problem we synthesized 3 beta-fluorovitamin D3 6 and its hydrogen analog, 3-deoxyvitamin D3 7, and tested the biologic activity of each by in vitro and in vivo methods. Contrary to previous reports which showed that 3 beta-fluorovitamin D3 was as active as vitamin D3 in vivo, we found that the fluoro-analog was less active than vitamin D3. With regard to stimulation of intestinal calcium transport and bone calcium mobilization in the D-deficient hypocalcemic rat, 3 beta-fluorovitamin D3 showed significantly greater biologic activity than its hydrogen analog, 3-deoxyvitamin D3. In the organ-cultured, embryonic chick duodenum, 3 beta-fluorovitamin D3 was approx 1/1000th as active as the native hormone, 1,25-dihydroxyvitamin D3, while 3-deoxyvitamin D3 was inactive even at microM concentrations, in the induction of the vitamin D-dependent, calcium-binding protein. With regard to in vitro activity in displacing radiolabeled 25-hydroxyvitamin D3 from vitamin D binding protein and radiolabelled 1,25-dihydroxyvitamin D3 from a chick intestinal cytosol receptor, 3 beta-fluorovitamin D3 and 3 beta-deoxyvitamin D3 both showed very poor binding efficiencies when compared with vitamin D3. Our results show that the substitution of a fluorine atom for a hydrogen atom at the C-3 position of the vitamin D3 molecule results in a fluorovitamin 6 with significantly more biological activity than its hydrogen analog, 3-deoxyvitamin D3 7.