基于HLA-B基因多态性的别嘌醇个体化用药临床研究分析  

Individualized medication clinical research analysis of allopurinol based on HLA-B gene polymorphism

作　　者：宫珺 向倩[1] 王梓凝[1] 谢秋芬[1] 胡琨[1] 周颖[1] 崔一民[1,2,3] GONG Jun;XIANG Qian;WANG Zi-ning;XIE Qiu-fen;HU Kun;ZHOU Ying;CUI Yi-min(Department of Pharmacy,Peking University First Hospital,Beijing 100034,China;Institute of Clinical Pharmacology,Peking University First Hospital,Beijing 100034,China;Department of Pharmacy Administration and Clinical Pharmacy,School of Pharmaceutical Sciences,Peking University Health Science Center,Beijing 100191,China)

机构地区：[1]北京大学第一医院药学部,北京100034 [2]北京大学第一医院临床药理研究所,北京100034 [3]北京大学药学院药事管理与临床药学系,北京100191

出　　处：《中国临床药理学杂志》2022年第10期1133-1136,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家重大新药创制基金资助项目(2018ZX09201014-003,2017ZX09101001);国家自然科学基金资助项目(81872940,82073935,81973395);北京市科学技术委员会医药创新品种研发培育及产业支撑平台能力建设基金资助项目(Z191100007619038)。

摘　　要：别嘌醇被广泛用于痛风和高尿酸血症的一线治疗,在使用过程中疗效显著、价格低廉,但随其在临床的广泛应用,有关其不良反应的报道也逐渐增加。HLA-B基因多态性对别嘌醇的使用有重要影响。HLA-B*58:01等位基因携带者应用别嘌醇可能增加严重皮肤不良反应的风险。HLA-B*58:01基因是检测别嘌醇诱导的皮肤药物不良反应的高度特异性和有效的遗传标记,基因检测可用于检查是否携带HLA-B*58:01等位基因,有助于指导临床医生调整痛风及高尿酸血症患者的治疗方案。筛查HLA-B*58:01基因可能有助于患者防止患者别嘌醇诱导的严重皮肤不良反应的发生。本研究综述了基于HLA-B基因多态性的别嘌醇个体化药物治疗现状,整理了相关指导意见,为治疗策略的优化提供参考。Allopurinol is widely used in the first-line treatment of gout and hyperuricemia.It has significant curative effect and a low price during use.However,with its extensive clinical application,reports of its adverse reactions have gradually increased.HLA-B gene polymorphism played an important role on the metabolic activation of allopurinol.The use of allopurinol in carriers of the HLA-B*58:01 allele may increase the risk of serious skin adverse reactions.HLA-B*58:01 gene is a highly specific and effective genetic marker for the detection of allopurinol-induced skin adverse drug reactions.Clinical genotyping tests can be used to examine the presence of the HLA-B*58:01 allele,and may help clinicians to adjust the treatment of patients with gout and hyperuricemia.Screening for HLA-B*58:01 gene may help patients to prevent the occurrence of allopurinol-induced severe skin adverse reactions.This article reviewed the progress of individualized drug therapy of allopurinol based on HLA-B gene polymorphism.Relevant guidelines were sorted out to provide reference for the optimization of therapy strategies.

关 键 词：HLA-B基因 别嘌醇 个体化治疗 

分 类 号：R97[医药卫生—药品]