Tacrine-induced liver damage: an analysis of 19 candidate genes.
Alfirevic, Ana a; Mills, Tracy b; Carr, Daniel a; Barratt, Bryan J. b; Jawaid, Ansar b; Sherwood, James b; Smith, John C. b; Tugwood, Jonathan c; Hartkoorn, Ruben a; Owen, Andrew a; Park, Kevin B. a; Pirmohamed, Munir a
Pharmacogenetics and Genomics.
17(12):1091-1100, December 2007.
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Objectives: Tacrine, the first acetylcholinesterase inhibitor used in the treatment of Alzheimer's disease, is associated with transaminase elevation in up to 50% of patients. The mechanism of tacrine-induced liver damage is not fully understood, but earlier studies have suggested that genetic factors may play a role. Our aim was to investigate whether single-nucleotide polymorphisms (SNPs) in 19 candidate genes were associated with tacrine-induced liver damage.
Methods: Sixty-nine patients of Caucasian origin treated with tacrine for Alzheimer's disease were investigated by genotyping 241 SNPs in 19 candidate genes potentially related to hepatotoxicity. The association with ABCB4 [which encodes MultiDrug Resistance Protein 3 (MDR3)] was explored in transepithelial transport studies using the ABCB4-transfected pig kidney epithelial cell line (LLC-PK1).
Results: The strongest association between alanine aminotransferase levels and three SNPs within ATP-binding cassette, subfamily B (MDR/TAP), member 4 (ABCB4) (uncorrected P=0.0005) was not significant after adjusting for multiple testing. No association was demonstrated with ATP-binding cassette, subfamily B (MDR/TAP), member 1 (ABCB1) or carnitine O-octanoyltransferase (CROT) which are located adjacent to ABCB4. Using the transepithelial transport system we failed to show a difference in tacrine accumulation between ABCB4-transfected and parental cell lines. The association with ABCB4 warrants further testing using either another population and/or functional studies.
(C) 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins