High-throughput genotyping by DHPLC of the dihydropyrimidine dehydrogenase gene implicated in (fluoro)pyrimidine catabolism

Int J Oncol. 2003 Feb;22(2):325-32.

Abstract

Dihydropyrimidine dehydrogenase (DPD) is the first and rate-limiting enzyme in the degradation of pyrimidines and pyrimidine base analogs including the anticancer drugs 5-fluorouracil (5-FU) and Xeloda. A decreased DPD enzyme activity has been described in cancer patients experiencing severe and life-threatening toxicity after 5-FU treatment and distinct sequence variants in the DPD gene (DPYD) have been associated with impaired enzyme function. The most prominent mutation in the DPD deficient patient group, a mutation in the splicing donor consensus sequence of intron 14, IVS14+1g>a, resulting in a truncated protein, has been observed in the Caucasian population at frequencies as high as 0.91%-0.94%. This underlines the need for a test system for DPYD mutations in patients undergoing chemotherapy with 5-FU or with Xeloda. To set up a fast and sensitive method to identify variant DPYD alleles, we analyzed 50 healthy individuals by denaturing high performance liquid chromatography (DHPLC). A primer set spanning the whole coding region and the exon-intron boundaries of DPYD was used. In addition, a cDNA-based assay was developed to rapidly identify the 165 base pair deletion in the corresponding RNA of IVS14+1g>a mutation carriers. The optimal mutation detection was elaborated for each of the PCR fragments. DHPLC analysis detected 5 different genetic alterations occurring in the coding region of the gene, as well as 10 intronic sequence variants, respectively. In conclusion, high-throughput screening for DPYD variants by DHPLC may be a reliable tool in the investigation of the molecular basis of DPD deficiency. Furthermore, it will help to identify patients at risk for toxic side effects upon chemotherapy using 5-FU and will facilitate individual treatment of patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alleles
  • Amino Acid Substitution
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / pharmacokinetics*
  • Biotransformation
  • Capecitabine
  • Chromatography, High Pressure Liquid / methods*
  • DNA Mutational Analysis / methods*
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / pharmacokinetics*
  • Dihydrouracil Dehydrogenase (NADP)
  • Exons / genetics
  • Female
  • Fluorouracil / adverse effects
  • Fluorouracil / pharmacokinetics*
  • Genes
  • Genotype*
  • Humans
  • Inactivation, Metabolic
  • Introns / genetics
  • Male
  • Mutation, Missense
  • Oxidoreductases / deficiency
  • Oxidoreductases / genetics*
  • Point Mutation
  • Polymerase Chain Reaction
  • Protein Denaturation
  • Pyrimidines / metabolism*
  • Pyrimidines / pharmacokinetics
  • RNA Splice Sites / genetics
  • Sensitivity and Specificity
  • Sequence Deletion
  • Time Factors
  • White People / genetics

Substances

  • Antineoplastic Agents
  • Pyrimidines
  • RNA Splice Sites
  • Deoxycytidine
  • Capecitabine
  • Oxidoreductases
  • Dihydrouracil Dehydrogenase (NADP)
  • Fluorouracil