title: CYP2C polymorphisms, phenytoin metabolism and gingival overgrowth in epileptic subjects.
abstract: Previous studies suggested that the onset of phenytoin-induced gingival overgrowth depended on serum phenytoin concentration. Cytochrome P450 2C (CYP2C) plays an important role in phenytoin metabolism. Recently, single nucleotide polymorphisms in the coding region of CYP 2C influencing phenytoin metabolism were identified. The purpose of the present study was to see if CYP 2C polymorphisms might relate to the onset and severity of phenytoin-induced gingival overgrowth. Twenty-eight epileptic patients taking phenytoin aged 15 to 75 (mean age: 42.2 years old, 20 males and 8 females) and 56 unrelated healthy subjects aged 30 to 48 (mean age: 36.8 years old, 48 males and 8 females) were examined for CYP 2C polymorphisms. All epileptic subjects were examined for the degree of gingival overgrowth, daily phenytoin dose and serum phenytoin concentration. The results indicated about 7% of the subjects including epileptic and healthy subjects examined were positive for CYP 2C9*3. However, the degree of gingival overgrowth did not directly correlate with CYP 2C polymorphisms. Nevertheless, the subjects with severer gingival overgrowth exhibited significantly higher serum phenytoin concentration, indicating that phenytoin metabolism is an important determinant for the severity of the disease. Additionally, CYP 2C9*3 carriers exhibited significantly higher serum drug concentration to drug dose. Therefore, we concluded although the gene analysis is not directly related to diagnose the disease itself, it can be utilized in estimating serum phenytoin concentration from drug dose, which in turn serves to predict the future development and clinical course of the disease.
authors.affiliation: Department of Patho-physiology/Periodontal Science, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama 700-8525, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Soga
authors.forename: Fusanori
authors.initials: F
authors.lastname: Nishimura
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ohtsuka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Araki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Iwamoto
authors.forename: Hisa
authors.initials: H
authors.lastname: Naruishi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shiomi
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Shogo
authors.initials: S
authors.lastname: Takashiba
authors.forename: Kenji
authors.initials: K
authors.lastname: Shimizu
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Gomita
authors.forename: Eiji
authors.initials: E
authors.lastname: Oka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000097:blood; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics; D065731:Cytochrome P-450 CYP2C19; D065729:Cytochrome P-450 CYP2C9; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics*; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D005881:Gingiva / Q000187:drug effects / Q000473:pathology; D005886:Gingival Hypertrophy / Q000139:chemically induced / Q000201:enzymology / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D006899:Mixed Function Oxygenases / Q000235:genetics; D010672:Phenytoin / Q000009:adverse effects* / Q000097:blood; D020641:Polymorphism, Single Nucleotide
chemical_list: D000927:Anticonvulsants; C400322:cytochrome P-450 CYP2C subfamily; D010672:Phenytoin; D003577:Cytochrome P-450 Enzyme System; D006899:Mixed Function Oxygenases; C450260:CYP2C9 protein, human; D065729:Cytochrome P-450 CYP2C9; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19