目的 探索药物代谢、转运和免疫反应基因多态性与中国人群抗结核药致肝损害的关联。方法 利用“中国结核病防治规划抗结核病药品不良反应研究”的人群资料和样本,构建1:4巢式病例对照研究,选择与抗结核药物所致肝损害相关的三相代谢基因以及相关免疫基因,采用TaqMan分型技术检测基因单核苷酸多态性(SNP),结合Lasso回归和多因素条件logistic回归筛选易感基因。结果 共检测33个基因的75个SNP位点,Lasso回归和logistic回归的合并分析显示,SLCO1B1 rs4149014、HSPA1L rs2227956、STAT3 rs1053023和IL-6 rs2066992基因多态性与抗结核药致肝损害的关联有统计学意义(P〈0.05)。结论 SLCO1B1、HSPA1L、STAT3和IL-6 基因可能是抗结核治疗人群发生药物性肝损害的易感基因。
Objective To investigate the association between the polymorphisms of genes involving in drug metabolism and transport as well as immunological reaction and the risk of anti-tuberculosis drug-induced liver injury (ATLI) in Chinese. Methods This 1:4 matched case-control study was conducted by using the data from a cohort study of Anti-tuberculosis Drugs Induced Adverse Reactions in National Tuberculosis Prevention and Control Progtam of China. Genes involving in three phase of drug metabolism and transport as well as related immunological reaction were chosen and single nucleotide polymorphisms (SNPs) were genotyped by TaqMan allele discrimination technology. Lasso regression and multivariate conditional logistic regression analysis were used to select susceptible genes. Results A total of 33 genes with 75 SNPs were tested. The combined results of Lasso and regression logistic regression analysis showed that genetic polymorphism of SLCO1B1 rs4149014, HSPA1L rs2227956, STAT3 rs1053023 and IL-6 rs2066992 were significantly associated with the risk of ATLI (P〈0.05). Conclusion SLCO1B1, HSPA1L, STAT3 and IL-6 might be the susceptibility genes of drug induced liver injury in patients receiving anti-tuberculosis treatment.