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Published in: BMC Anesthesiology 1/2023

Open Access 01-12-2023 | Paracetamol | Research

Pharmacogenetics in critical care: association between CYP3A5 rs776746 A/G genotype and acetaminophen response in sepsis and septic shock

Authors: C. Scorcella, R. Domizi, S. Amoroso, A. Carsetti, E. Casarotta, P. Castaldo, C. D’angelo, E. Damiani, F. Gasparri, A. Donati, E. Adrario

Published in: BMC Anesthesiology | Issue 1/2023

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Abstract

Background

Pharmacogenetics could represent a further resource to understand the interindividual heterogeneity of response of the host to sepsis and to provide a personalized approach to the critical care patient.

Methods

Secondary analysis of data from the prospective observational study NCT02750163, in 50 adult septic and septic shock patients treated with Acetaminophen (ACT) for pyrexia. We investigated the presence of two polymorphisms, located respectively in the genes UGT1A1 and CYP3A5, that encode for proteins related to the hepatic metabolism of ACT. The main dependent variables explored were plasmatic concentration of ACT, body temperature and hepatic parameters.

Results

8% of the patients carried CYP3A5 rs776746 A/G genotypes and showed significantly higher plasma levels of ACT than GG wild type patients, and than patients with UGT1A1 rs8330 C/G genotypes.

Conclusions

Identifying specific genotypes of response to ACT may be helpful to guide a more personalized titration of therapy in sepsis and septic shock. CYP3A5 might be a good biomarker for ACT metabolism; however further studies are needed to confirm this result.

Trial registration

NCT02750163.
Literature
2.
go back to reference Rello J, van Engelen TSR, Alp E, Calandra T, Cattoir V, Kern WV, Netea MG, Nseir S, Opal SM, van de Veerdonk FL, Wilcox MH, Wiersinga WJ. Towards precision medicine in sepsis: a position paper from the European Society of Clinical Microbiology and Infectious Diseases. Clin Microbiol Infect. 2018;24(12):1264–72. https://doi.org/10.1016/j.cmi.2018.03.011. Epub 2018 Mar 24 PMID: 29581049.CrossRefPubMed Rello J, van Engelen TSR, Alp E, Calandra T, Cattoir V, Kern WV, Netea MG, Nseir S, Opal SM, van de Veerdonk FL, Wilcox MH, Wiersinga WJ. Towards precision medicine in sepsis: a position paper from the European Society of Clinical Microbiology and Infectious Diseases. Clin Microbiol Infect. 2018;24(12):1264–72. https://​doi.​org/​10.​1016/​j.​cmi.​2018.​03.​011. Epub 2018 Mar 24 PMID: 29581049.CrossRefPubMed
5.
go back to reference Luzum JA, Petry N, Taylor AK, Van Driest SL, Dunnenberger HM, Cavallari LH. Moving Pharmacogenetics Into Practice: It’s All About the Evidence! Clin Pharmacol Ther. 2021;110(3):649–61. https://doi.org/10.1002/cpt.2327. Epub 2021 Jul 7. PMID: 34101169; PMCID: PMC8376790. Luzum JA, Petry N, Taylor AK, Van Driest SL, Dunnenberger HM, Cavallari LH. Moving Pharmacogenetics Into Practice: It’s All About the Evidence! Clin Pharmacol Ther. 2021;110(3):649–61. https://​doi.​org/​10.​1002/​cpt.​2327. Epub 2021 Jul 7. PMID: 34101169; PMCID: PMC8376790.
10.
go back to reference Court MH, Freytsis M, Wang X, Peter I, Guillemette C, Hazarika S, Duan SX, Greenblatt DJ, Lee WM, Acute Liver Failure Study Group. The UDP-glucuronosyltransferase (UGT) 1A polymorphism c.2042C>G (rs8330) is associated with increased human liver acetaminophen glucuronidation, increased UGT1A exon 5a/5b splice variant mRNA ratio, and decreased risk of unintentional acetaminophen-induced acute liver failure. J Pharmacol Exp Ther. 2013;345(2):297–307. https://doi.org/10.1124/jpet.112.202010. Epub 2013 Feb 13. PMID: 23408116; PMCID: PMC3629801.CrossRefPubMedPubMedCentral Court MH, Freytsis M, Wang X, Peter I, Guillemette C, Hazarika S, Duan SX, Greenblatt DJ, Lee WM, Acute Liver Failure Study Group. The UDP-glucuronosyltransferase (UGT) 1A polymorphism c.2042C>G (rs8330) is associated with increased human liver acetaminophen glucuronidation, increased UGT1A exon 5a/5b splice variant mRNA ratio, and decreased risk of unintentional acetaminophen-induced acute liver failure. J Pharmacol Exp Ther. 2013;345(2):297–307. https://​doi.​org/​10.​1124/​jpet.​112.​202010. Epub 2013 Feb 13. PMID: 23408116; PMCID: PMC3629801.CrossRefPubMedPubMedCentral
19.
go back to reference Caudle KE, Klein TE, Hoffman JM, Muller DJ, Whirl-Carrillo M, Gong L, McDonagh EM, Sangkuhl K, Thorn CF, Schwab M, Agundez JA, Freimuth RR, Huser V, Lee MT, Iwuchukwu OF, Crews KR, Scott SA, Wadelius M, Swen JJ, Tyndale RF, Stein CM, Roden D, Relling MV, Williams MS, Johnson SG. Incorporation of pharmacogenomics into routine clinical practice: the Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline development process. Curr Drug Metab. 2014;15(2):209–17. https://doi.org/10.2174/1389200215666140130124910. PMID:24479687;PMCID:PMC3977533.CrossRefPubMedPubMedCentral Caudle KE, Klein TE, Hoffman JM, Muller DJ, Whirl-Carrillo M, Gong L, McDonagh EM, Sangkuhl K, Thorn CF, Schwab M, Agundez JA, Freimuth RR, Huser V, Lee MT, Iwuchukwu OF, Crews KR, Scott SA, Wadelius M, Swen JJ, Tyndale RF, Stein CM, Roden D, Relling MV, Williams MS, Johnson SG. Incorporation of pharmacogenomics into routine clinical practice: the Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline development process. Curr Drug Metab. 2014;15(2):209–17. https://​doi.​org/​10.​2174/​1389200215666140​130124910. PMID:24479687;PMCID:PMC3977533.CrossRefPubMedPubMedCentral
20.
go back to reference H. Court M, Freytsis M, Wang X, Peter I, Guillemette C, Hazarika S, Duan SX, Greenblatt DJ, Lee WM and the Acute Liver Failure Study Group. The UDP-glucuronosyltransferase (UGT) 1A polymorphism c.2042C>G (rs8330) is associated with increased human liver acetaminophen glucuronidation, increased UGT1A exon 5a/5b splice variant mRNA ratio, and decreased risk of unintentional acetaminophen-induced acute liver failure. J Pharmacol Exp Ther. 2013;345(2):297–307. https://doi.org/10.1124/jpet.112.202010 H. Court M, Freytsis M, Wang X, Peter I, Guillemette C, Hazarika S, Duan SX, Greenblatt DJ, Lee WM and the Acute Liver Failure Study Group. The UDP-glucuronosyltransferase (UGT) 1A polymorphism c.2042C>G (rs8330) is associated with increased human liver acetaminophen glucuronidation, increased UGT1A exon 5a/5b splice variant mRNA ratio, and decreased risk of unintentional acetaminophen-induced acute liver failure. J Pharmacol Exp Ther. 2013;345(2):297–307. https://​doi.​org/​10.​1124/​jpet.​112.​202010
Metadata
Title
Pharmacogenetics in critical care: association between CYP3A5 rs776746 A/G genotype and acetaminophen response in sepsis and septic shock
Authors
C. Scorcella
R. Domizi
S. Amoroso
A. Carsetti
E. Casarotta
P. Castaldo
C. D’angelo
E. Damiani
F. Gasparri
A. Donati
E. Adrario
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2023
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-023-02018-y

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