title: The impact of glutathione S-transferase genotype and phenotype on the adverse drug reactions to azathioprine in patients with inflammatory bowel diseases.
abstract: Azathioprine (AZA) is a thiopurine prodrug which is widely used in patients with inflammatory bowel disease (IBD). However, the use is limited in one-third of patients because of adverse drug reactions (ADRs) or a lack of clinical response. It has been considered that the polymorphic enzyme thiopurine S-methyltransferase (TPMT) plays an important role in the in vivo process of AZA and the occurrence of its myelotoxicity. Glutathione S-transferase (GST) mutation is another pharmacogenetic polymorphism which is probably involved in AZA metabolism and tolerance. The aim of this study was to investigate the association among GST polymorphism, enzyme activity and AZA-related ADRs in Chinese Han patients with IBD. We found that the patients who became neutropenic had a significantly higher GSTs activity when compared with of the patients who did not develop ADRs (analysis of variance, P < 0.001). There was also a significant underrepresentation of GSTP1*-105V allele among patients developing ADRs (odds ratio [OR] = 0.125, 95% confidence interval [CI] = 0.022-0.709, P = 0.0012). The patients with higher GST activity constituted a pharmacogenetic high risk group for leucopenia during AZA treatment. GST-P1 Ile105/Ile105 genotype appeared to be a promising marker indicating predisposition to AZA-related ADRs.
authors.affiliation: Department of Pharmacy, the First Affiliated Hospital of Jinan University, Guangzhou, PR China; Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, PR China. Electronic address: liu_ui@hotmail.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.affiliation: Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, PR China; Laboratory of Molecular Toxicology, Wadsworth Center, New York State Department of Health, and School of Public Health, State University of New York at Albany, Albany, NY, 12201, United States.
authors.forename: Liang
authors.initials: L
authors.lastname: Ding
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China; Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Fangbin
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, PR China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China.
authors.forename: Pinjin
authors.initials: P
authors.lastname: Hu
authors.affiliation: Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, PR China.
authors.forename: Huichang
authors.initials: H
authors.lastname: Bi
authors.affiliation: Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, PR China. Electronic address: echonony@foxmail.com.
authors.forename: Min
authors.initials: M
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000483:Alleles; D000704:Analysis of Variance; D044466:Asian People; D001379:Azathioprine / Q000009:adverse effects* / Q000378:metabolism*; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D005982:Glutathione Transferase / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000201:enzymology* / Q000235:genetics*; D007970:Leukopenia / Q000139:chemically induced* / Q000453:epidemiology / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced* / Q000453:epidemiology / Q000235:genetics; D010641:Phenotype; D011110:Polymorphism, Genetic; D012307:Risk Factors; D055815:Young Adult
chemical_list: D005982:Glutathione Transferase; D001379:Azathioprine
keywords: Adverse effects; Azathioprine; Glutathione S-transferases; Inflammatory bowel disease