RESUMO
PURPOSE: This study was the first to evaluate the effect of CYP3A5*3 gene polymorphisms on plasma concentration of perampanel (PER) in Chinese pediatric patients with epilepsy. METHODS: We enrolled 98 patients for this investigation. Plasma PER concentrations were measured using liquid chromatography-tandem mass spectrometry. Leftover samples from standard therapeutic drug monitoring were allocated for genotyping analysis. The primary measure of efficacy was the rate of seizure reduction with PER treatment at the final checkup. RESULTS: The plasma concentration showed a linear correlation with the daily dose taken ( r â =â 0.17; P â <â 0.05). The ineffective group showed a significantly lower plasma concentration of PER (490.5â ±â 297.1 vs. 633.8â ±â 305.5â µg/ml; P â =â 0.019). For the mean concentration-to-dose (C/D) ratio, the ineffective group showed a significantly lower C/D ratio of PER (3.2â ±â 1.7 vs. 3.8â ±â 2.0; P â =â 0.040). The CYP3A5*3 CC genotype exhibited the highest average plasma concentration of PER at 562.8â ±â 293.9 ng/ml, in contrast to the CT and TT genotypes at 421.1â ±â 165.6 ng/ml and 260.0â ±â 36.1 ng/ml. The mean plasma PER concentration was significantly higher in the adverse events group (540.8â ±â 285.6 vs. 433.0â ±â 227.2 ng/ml; P â =â 0.042). CONCLUSION: The CYP3A5*3 gene's genetic polymorphisms influence plasma concentrations of PER in Chinese pediatric patients with epilepsy. Given that both efficacy and potential toxicity are closely tied to plasma PER levels, the CYP3A5*3 genetic genotype should be factored in when prescribing PER to patients with epilepsy.
Assuntos
Anticonvulsivantes , Citocromo P-450 CYP3A , Epilepsia , Nitrilas , Piridonas , Humanos , Citocromo P-450 CYP3A/genética , Criança , Feminino , Masculino , Epilepsia/tratamento farmacológico , Epilepsia/genética , Nitrilas/farmacocinética , Piridonas/farmacocinética , Piridonas/administração & dosagem , Piridonas/efeitos adversos , Pré-Escolar , Anticonvulsivantes/farmacocinética , Anticonvulsivantes/administração & dosagem , Anticonvulsivantes/efeitos adversos , Polimorfismo de Nucleotídeo Único/genética , Genótipo , Adolescente , Povo Asiático/genética , População do Leste AsiáticoRESUMO
OBJECTIVE: This study was the first to evaluate the effect of CYP3A4 gene polymorphisms on the plasma concentration and effectiveness of perampanel (PER) in Chinese pediatric patients with epilepsy. METHODS: We enrolled 102 patients for this investigation. The steady-state concentration was determined after patients maintained a consistent PER dosing regimen for at least 21 days. Plasma PER concentrations were measured using liquid chromatography-tandem mass spectrometry. Leftover samples from standard therapeutic drug monitoring were allocated for genotyping analysis. The primary measure of efficacy was the rate of seizure reduction with PER treatment at the final check-up. RESULTS: The CYP3A4×10 GC phenotype exhibited the highest average plasma concentration of PER at 491.1⯱â¯328.1â¯ng/mL, in contrast to the CC phenotype at 334.0⯱â¯161.1â¯ng/mL. The incidence of adverse events was most prominent in the CYP3A4×1â¯G TT and CYP3A4×10 GC groups, with rates of 77.8â¯% (7 of 9 patients) and 50.0â¯% (46 of 92 patients), respectively. Moreover, the percentage of patients for whom PER was deemed ineffective was least in the CYP3A4×1â¯G TT and CYP3A4×10 CC groups, recorded at 11.1â¯% (1 of 9 patients) and 10.0â¯% (1 of 10 patients), respectively. There was a significant correlation between PER plasma concentration and either exposure or toxicity (both with pâ¯<â¯0.05). We suggest a plasma concentration range of 625-900â¯ng/mL as a suitable reference for PER in Chinese patients with epilepsy. CONCLUSION: The CYP3A4×10 gene's genetic polymorphisms influence plasma concentrations of PER in Chinese pediatric patients with epilepsy. Given that both efficacy and potential toxicity are closely tied to plasma PER levels, the CYP3A4 genetic phenotype should be factored in when prescribing PER to patients with epilepsy.
Assuntos
Anticonvulsivantes , Citocromo P-450 CYP3A , Epilepsia , Nitrilas , Piridonas , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Anticonvulsivantes/farmacocinética , Anticonvulsivantes/uso terapêutico , China , Citocromo P-450 CYP3A/genética , População do Leste Asiático/genética , Epilepsia/tratamento farmacológico , Epilepsia/genética , Genótipo , Nitrilas/farmacocinética , Polimorfismo Genético/genética , Piridonas/farmacocinética , Piridonas/uso terapêutico , Piridonas/sangue , Resultado do TratamentoRESUMO
OBJECTIVE: To clone heavy-chain and light-chain variable region (VH and VL) gene of mouse-anti-human CD71 monoclonal antibody (mAb). METHOD: One-step method was used to extract total RNA, and a set of oligonucleotide primers were designed to amplify the cDNAs with reverse transcriptase-polymerase chain reaction (RT-PCR), and the resultant products were respectively cloned into PMD18-T vector and their sequences analyzed. RESULTS: The PCR product obtained with the oligonucleotide primers for the variable region of mouse immunoglobulin heavy chain was about 350 bp and that with oligonucleotide primers for the light chain was about 320 bp, and their DNA sequences were determined. CONCLUSION: The length of the cloned heavy chain variable region was 348 bp, belonging to mouse heavy-chain subgroup II(A); the light-chain variable region was 336 bp that belongs to mouse kappa light-chain subgroup II.