BACKGROUND: Considerable variability in sensitivity to corticosteroids (CS) has been observed among individuals with regard to both the natural and synthetic compounds. The role of genetic polymorphisms in modulating CS function, and hence in disease susceptibility, has been extensively analyzed. Their impact on therapeutic response still remains to be explored. The role of cytochrome P450 (CYP) 3A4 in corticosteroid metabolism, and that of the glucocorticoid receptor (NR3C1) in regulation of responsive genes, renders CYP3A4 and NR3C1 polymorphisms as potential candidates for pharmacogenetic analysis. AIM: The aim of the study was to analyze the role of these polymorphisms in the outcome of a disease treated with CS drugs. METHODS: Towards this aim we analyzed the CYP3A4-290A/G substitution and three NR3C1 polymorphisms (200G/A, 1220A/G and BclI RFLP) in 222 children with acute lymphoblastic leukemia (ALL) whose treatment protocols, among other components, contained corticosteroid drugs. RESULTS: The analysis of survival probabilities in relation to the indicated genotypes showed only an association between homozygosity for allele G of the NR3C1 BclI RFLP polymorphism and overall survival (univariate and multivariate hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.0, 7.6 and 5.2, 95% CI 1.4, 18.9, respectively). The association reflects a correlation with disease progression and prognosis, and may vary depending on risk of relapse. CONCLUSION: A reduction in survival probability in children with ALL was associated with homozygosity for G allele of the NR3C1BclI RFLP polymorphism, particularly in certain patient subgroups. Further analysis is required to replicate this finding and to understand the mechanism underlying the observed association.
BACKGROUND: Considerable variability in sensitivity to corticosteroids (CS) has been observed among individuals with regard to both the natural and synthetic compounds. The role of genetic polymorphisms in modulating CS function, and hence in disease susceptibility, has been extensively analyzed. Their impact on therapeutic response still remains to be explored. The role of cytochrome P450 (CYP) 3A4 in corticosteroid metabolism, and that of the glucocorticoid receptor (NR3C1) in regulation of responsive genes, renders CYP3A4 and NR3C1 polymorphisms as potential candidates for pharmacogenetic analysis. AIM: The aim of the study was to analyze the role of these polymorphisms in the outcome of a disease treated with CS drugs. METHODS: Towards this aim we analyzed the CYP3A4-290A/G substitution and three NR3C1 polymorphisms (200G/A, 1220A/G and BclI RFLP) in 222 children with acute lymphoblastic leukemia (ALL) whose treatment protocols, among other components, contained corticosteroid drugs. RESULTS: The analysis of survival probabilities in relation to the indicated genotypes showed only an association between homozygosity for allele G of the NR3C1 BclI RFLP polymorphism and overall survival (univariate and multivariate hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.0, 7.6 and 5.2, 95% CI 1.4, 18.9, respectively). The association reflects a correlation with disease progression and prognosis, and may vary depending on risk of relapse. CONCLUSION: A reduction in survival probability in children with ALL was associated with homozygosity for G allele of the NR3C1BclI RFLP polymorphism, particularly in certain patient subgroups. Further analysis is required to replicate this finding and to understand the mechanism underlying the observed association.
Authors: Jun J Yang; Cheng Cheng; Wenjian Yang; Deqing Pei; Xueyuan Cao; Yiping Fan; Stanley B Pounds; Geoffrey Neale; Lisa R Treviño; Deborah French; Dario Campana; James R Downing; William E Evans; Ching-Hon Pui; Meenakshi Devidas; W P Bowman; Bruce M Camitta; Cheryl L Willman; Stella M Davies; Michael J Borowitz; William L Carroll; Stephen P Hunger; Mary V Relling Journal: JAMA Date: 2009-01-28 Impact factor: 56.272
Authors: Stella M Davies; Michael J Borowitz; Gary L Rosner; Kristin Ritz; Meenakshi Devidas; Naomi Winick; Paul L Martin; Paul Bowman; James Elliott; Cheryl Willman; Soma Das; Edwin H Cook; Mary V Relling Journal: Blood Date: 2008-01-08 Impact factor: 22.113
Authors: Mikhail M Kostik; Alexandra A Klyushina; Mikhail V Moskalenko; Larisa A Scheplyagina; Valentina I Larionova Journal: Pediatr Rheumatol Online J Date: 2011-01-13 Impact factor: 3.054
Authors: Sarah Tayler; Katarina Hazuchova; Anna Riddle; James W Swann; Barbara Glanemann Journal: J Vet Intern Med Date: 2022-06-10 Impact factor: 3.175