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Association of N-acetyltransferase 2 and cytochrome P450 2E1 gene polymorphisms with antituberculosis drug-induced hepatotoxicity in Western India

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Title Association of N-acetyltransferase 2 and cytochrome P450 2E1 gene polymorphisms with antituberculosis drug-induced hepatotoxicity in Western India
 
Creator GUPTA, VH
AMARAPURKAR, DN
SINGH, M
SASI, P
JOSHI, JM
BAIJAL, R
RAMEGOWDA, PH
AMARAPURKAR, AD
JOSHI, K
WANGIKAR, PP
 
Subject drug-induced hepatotoxicity
genetic polymorphisms
slow acetylator
TB patients
INDUCED HEPATITIS
RISK-FACTORS
LIVER-INJURY
CYP2E1 GENE
GENOTYPE
POPULATION
N-ACETYLTRANSFERASE-2
NAT2
PREDISPOSITION
SUSCEPTIBILITY
 
Description Background and Aim: Tuberculosis (TB) is a major public health problem in India. Despite the treatment availability and monitoring, drug-induced hepatotoxicity (DIH) is a serious concern and can lead to discontinuation of treatment. Anti-TB DIH is well known and can aggravate because of pharmacokinetic and pharmacodynamic interactions. Genetic polymorphism in the drug-metabolizing enzyme genes is an important factor that predisposes certain fraction of the population to drug-induced toxicity. The purpose of this study was to assess the association of N-acetyltransferase 2 (NAT2) and cytochrome P450 2E1 (CYP2E1) gene polymorphism with anti-TB DIH in Western Indian population. Methods: A prospective cohort study of 215 patients taking treatment against TB was performed. The NAT2 and CYP2E1 genotypes were determined using polymerase chain reaction and restriction fragment length polymorphism methods. Logistic regression model was used to calculate odds ratio at 95% confidence interval and their respective P values. Results: The risk of anti-TB DIH was significantly higher in slow acetylator (SA) than in intermediate and rapid acetylator of NAT2 genotypes (odds ratio: 2.3, P = 0.01). We also observed the homozygous point mutation at position 481, associated with higher risk of hepatotoxicity (P < 0.01). The major haplotype NAT2*4 seems to provide protection in DIH compared with non-DIH TB patients (P = 0.04). However, we did not find a significant association between CYP2E1 genotypes and anti-TB DIH. Conclusion: Increased susceptibility to isoniazid (INH)-induced hepatotoxicity due to presence of NAT2 SA polymorphism was demonstrated in Western Indian population. NAT2 genotyping can therefore serve as an important tool for identifying patients predisposed to anti-TB DIH.
 
Publisher WILEY-BLACKWELL
 
Date 2014-10-16T13:08:50Z
2014-10-16T13:08:50Z
2013
 
Type Article
 
Identifier JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 28(8)1368-1374
0815-9319
1440-1746
http://dx.doi.org/10.1111/jgh.12194
http://dspace.library.iitb.ac.in/jspui/handle/100/15627
 
Language en