title: ABCB1 gene polymorphisms, ABCB1 haplotypes and ABCG2 c.421c > A are determinants of inter-subject variability in rosuvastatin pharmacokinetics.
abstract: A randomized cross-over pharmacokinetic study of rosuvastatin calcium (single dose: 5 mg, 10 mg and 20 mg; multiple doses: 10mg once daily for 7 days) was conducted in 12 healthy Chinese volunteers. Plasma concentrations of rosuvastatin were determined by an LC-ESI-MS-MS method. Single-nucleotide polymorphisms (SNPs) in ABCB1, ABCG2, SLCOB1, CYP2C9 and CYP3A5 were determined by TaqMan (MGB) genotyping assay. An impact of the aforementioned SNPs on steady state pharmacokinetic parameters [average steady state concentration (Cav,ss) and area under the plasma concentration versus time curve during the dosing interval at steady state (AUCss)], dose-normalized (based on 5 mg) pharmacokinetic parameters of single-dose rosuvastatin were further analyzed. Rosuvastatin exhibited linear pharmacokinetics and great inter-subject variability. Cav,ss, AUCss and dose-normalized peak plasma concentration (Cmax) and AUC(0-infinity) of single-dose rosuvastatin were significantly related with ABCB1 C1236T, G2677T/A and C3435T polymorphisms and ABCB1 haplotypes. Compared to homozygous wild type and heterozygous mutation gene carriers, subjects carrying the variant ABCB1 1236TT, 2677 non-G or 3435TT genotype had higher Cav,ss, AUCss, Cmax and AUC(0-infinity) (p < 0.05). ABCB1 haplotype (1236TT-2677TT-3435TT) had significant influence on dose-normalized pharmacokinetics of single-dose rosuvastatin. ABCB1 haplotype (1236TT-2677TT-3435TT) carriers (n = 12) had obvious higher Cmax (11.16 +/- 3.10 microg x L(-1) vs 8.35 +/- 3.31 microg x L(-1), p < 0.05) and AUC(0-infinity) (86.61 +/- 24.32 microg x h x L(-1) vs 62.60 +/- 26.19 microg x h x L(-1), p < 0.05) compared to non-1236TT-2677TT-3435TT carriers (n = 24). ABCG2 c.421C > A had a significant impact on rosuvastatin pharmacokinetics. Homozygotes (AA) carriers had obvious higher Cmax (12.20 +/- 4.09 microg x L(-1) vs 8.70 +/- 3.09 microg x L(-1), p < 0.05) and AUC(0-infinity) (98.74 +/- 25.36 microg x h x L(-1) vs 64.97 +/- 24.90 microg x h x L(-1), p < 0.05) values compared to heterozygotes (CA) and homozygotes (CC) carriers. There were no significant effects on single-dose and steady-state pharmacokinetics of rosuvastatin by CYP2C9*3 (1075A > C), CYP3A5*3 g.6986A > G, ABCG2 c.34G > A, SLCO1B1 c.521 T > C, c.388 A > G, g.11187 G > A, c.571 T > C and c.597 C > T. In addition, no difference in rosuvastatin pharmacokinetics was observed among subjects of different genders. We conclude that ABCB1 C1236T, G2677T/A and C3435T polymorphism, ABCB1 haplotypes and ABCG2 c.421C > A are determinants of inter-subject variability in rosuvastatin pharmacokinetics in healthy Chinese volunteers, and potentially affect the efficacy and toxicity of statin therapy.
authors.affiliation: Department of Pharmacy, the 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Zhou
authors.forename: Zou-Rong
authors.initials: ZR
authors.lastname: Ruan
authors.forename: Hong
authors.initials: H
authors.lastname: Yuan
authors.forename: Dong-Hang
authors.initials: DH
authors.lastname: Xu
authors.forename: Su
authors.initials: S
authors.lastname: Zeng
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics* / Q000378:metabolism*; D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2; D018528:ATP-Binding Cassette Transporters / Q000235:genetics* / Q000378:metabolism*; D000328:Adult; D019540:Area Under Curve; D044466:Asian People; D002352:Carrier Proteins / Q000235:genetics* / Q000378:metabolism*; D005260:Female; D005464:Fluorobenzenes / Q000493:pharmacokinetics*; D005838:Genotype; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000493:pharmacokinetics*; D007202:Indicators and Reagents; D008297:Male; D009363:Neoplasm Proteins / Q000235:genetics* / Q000378:metabolism*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic / Q000235:genetics; D020641:Polymorphism, Single Nucleotide; D011743:Pyrimidines / Q000493:pharmacokinetics*; D000068718:Rosuvastatin Calcium; D012727:Sex Characteristics; D013449:Sulfonamides / Q000493:pharmacokinetics*; D055815:Young Adult
chemical_list: C513055:ABCB1 protein, human; C116614:ABCG2 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2; D018528:ATP-Binding Cassette Transporters; D002352:Carrier Proteins; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007202:Indicators and Reagents; D009363:Neoplasm Proteins; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium