The association between cytochrome P450 polymorphisms and anti-tuberculosis drug-induced liver injury: a systematic review and meta-analysis
| Autor: | Peidu Jiang, Xingren Liu, Jing Feng, Dalin Xu, Feifei Jiang, Fei Deng, Jingwei Zhang, Song Ren |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Tuberculosis Antitubercular Agents Gastroenterology 03 medical and health sciences 0302 clinical medicine Cytochrome P-450 Enzyme System Polymorphism (computer science) Internal medicine Humans Medicine heterocyclic compounds 030212 general & internal medicine Ethambutol Advanced and Specialized Nursing Polymorphism Genetic business.industry Isoniazid Odds ratio Pyrazinamide bacterial infections and mycoses medicine.disease Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Meta-analysis Chemical and Drug Induced Liver Injury business Rifampicin medicine.drug |
| Zdroj: | Annals of Palliative Medicine. 10:6518-6534 |
| ISSN: | 2224-5839 2224-5820 |
| DOI: | 10.21037/apm-21-1224 |
| Popis: | BACKGROUND Isoniazid (INH), rifampicin (RMP), pyrazinamide (PZA), and ethambutol (EMB) are the four most common drugs for the first-line treatment of tuberculosis (TB). Although chemotherapy drugs are widely used in the treatment of TB, and achieved good results, but the side effects, especially anti-tuberculosis drug-induced liver injury (ATDILI), cannot be overlooked. Many researchers have made efforts to uncover the association of cytochrome P450 (CYP) enzyme genetic polymorphisms with ATDILI. In this study, we systematically reviewed and meta-analyzed the relationship between CYP polymorphism and susceptibility to ATDILI. METHODS We carried out literature searches of PubMed, Ovid, the Cochrane Library, Web of Science and Chinese National Knowledge Infrastructure (CNKI). Medical Subject Headings (MeSH) terms including "cytochrome P450 enzyme", "drug-induced liver injury", "polymorphism", "tuberculosis", and "hepatotoxicity" were used as keywords for our searches. RESULTS The pooled odds ratio (OR) of all studies for CYP2E1 to the risk of ATDILI was 1.18 [95% confidence interval (CI): 0.82-1.71]. The articles in this meta-analysis were observed to be mildly heterogeneous. Further subgroup analysis revealed that the patients who receiving a four-drug protocol (INH + RIF + PZA + EMB) or three-drug protocol (INH + RIF + PZA) regimens showed a higher risk of ATDILI than those who receiving INH alone. However, subgroup analyses according to participants' ethnic origin, study type, and the definition of ATDILI produced no statistically significant results. Associations between other genes in the CYP family and ATDILI were indistinct and equivocal. DISCUSSION Our meta-analysis has uncovered an association between CYP2E1 RsaI/PstI polymorphisms and ATDILI, especially among patients who receive a four-drug (INH + RIF + PZA + EMB) or three-drug (INH + RIF + PZA) anti-TB treatment regimen. |
| Databáze: | OpenAIRE |
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