Influence of uridine diphosphate glucuronosyltransferase 2B7 -161C>T polymorphism on the concentration of valproic acid in pediatric epilepsy patients

Ther Drug Monit. 2014 Jun;36(3):406-9. doi: 10.1097/FTD.0000000000000012.

Abstract

Background: Valproic acid (VPA) is widely used to treat various types of epilepsy. Interindividual variability in VPA pharmacokinetics may arise from genetic polymorphisms of VPA-metabolizing enzymes. This study aimed to examine the relationships between plasma VPA concentrations and the -161C>T single nucleotide polymorphism in uridine diphosphate glucuronosyltransferase (UGT) 2B7 genes in pediatric epilepsy patients.

Methods: This study included 78 pediatric epilepsy patients carrying the cytochrome P450 (CYP) 2C9*1/*1 genotype and who were not treated with the enzyme inducers (phenytoin, phenobarbital, and carbamazepine), lamotrigine, and/or topiramate. CYP2C9*3 and UGT2B7 -161C>T polymorphisms were identified using methods based on polymerase chain reaction-restriction fragment length polymorphism. Blood samples were drawn from each patient under steady-state conditions, and plasma VPA concentrations were measured.

Results: Significant differences in adjusted plasma VPA concentrations were observed between carriers of CC, CT, and TT genotypes in the UGT2B7 -161C>T polymorphism (P = 0.039). Patients with the CC genotype had lower adjusted plasma VPA concentrations than those with CT or TT genotype (P = 0.028).

Conclusions: These data suggest that the UGT2B7 -161C>T polymorphism in pediatric epilepsy patients carrying the CYP2C9*1/*1 genotype affects VPA concentration.

MeSH terms

  • Age Factors
  • Anticonvulsants / blood
  • Anticonvulsants / pharmacokinetics*
  • Anticonvulsants / therapeutic use
  • Body Weight
  • Child
  • Child, Preschool
  • Cytochrome P-450 CYP2C9 / genetics
  • Drug Therapy, Combination
  • Epilepsy / drug therapy*
  • Female
  • Genotype
  • Glucuronosyltransferase / genetics*
  • Humans
  • Male
  • Polymorphism, Single Nucleotide
  • Sex Factors
  • Valproic Acid / blood
  • Valproic Acid / pharmacokinetics*
  • Valproic Acid / therapeutic use

Substances

  • Anticonvulsants
  • Valproic Acid
  • Cytochrome P-450 CYP2C9
  • UGT2B7 protein, human
  • Glucuronosyltransferase