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Effects of polymorphisms in ABCG2, SLCO1B1, SLC10A1 and CYP2C9/19 on plasma concentrations of rosuvastatin and lipid response in Chinese patients

    Hon-Kit Lee

    Department of Medicine & Therapeutics, The Chinese University of Kong Kong, Shatin, Hong Kong SAR, China

    Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China

    ,
    Miao Hu

    Department of Medicine & Therapeutics, The Chinese University of Kong Kong, Shatin, Hong Kong SAR, China

    ,
    Sandra SH Lui

    Department of Medicine & Therapeutics, The Chinese University of Kong Kong, Shatin, Hong Kong SAR, China

    ,
    Chung-Shun Ho

    Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China

    ,
    Chun-Kwok Wong

    Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong SAR, China

    &
    Brian Tomlinson

    * Author for correspondence

    Department of Medicine & Therapeutics, The Chinese University of Kong Kong, Shatin, Hong Kong SAR, China.

    Published Online:https://doi.org/10.2217/pgs.13.115

    Aim: This study examined whether the ABCG2 421C>A polymorphism and variants in other genes potentially related to the pharmacokinetics of rosuvastatin influenced the plasma concentration of rosuvastatin in Chinese patients with hypercholesterolemia. Patients & methods: Overnight fasting blood samples were collected from 291 patients who had received a rosuvastatin 10 mg night-time dose for at least 4 weeks. Plasma concentrations of rosuvastatin and N-desmethyl rosuvastatin were quantified using liquid chromatography tandem mass spectrometry. Results: In subjects with the ABCG2 421AA genotype (n = 39), the mean plasma concentrations of rosuvastatin and its metabolite were 63 and 41% greater than the values in those with the 421CA genotype (n = 108) and 120 and 99% greater than in those with the 421CC genotype (n = 129). The plasma concentrations of rosuvastatin were associated (r = -0.194; p = 0.001) with the percentage reduction in low-density lipoprotein cholesterol with rosuvastatin, but the association was not significant after adjusting for the ABCG2 421C>A polymorphism. The SLCO1B1 521T>C polymorphism was associated with increased plasma concentrations of rosuvastatin and impaired N-demethylation of rosuvastatin, but had no impact on its lipid-lowering effect. Polymorphisms in CYP2C9, CYP2C19 and SLC10A1 had minimal effects. Conclusion: These findings suggest that the increased plasma concentrations of rosuvastatin in Chinese patients are associated with increased lipid-lowering effects and lower doses of rosuvastatin should be effective in subjects with the ABCG2 421C>A variant.

    Original submitted 18 April 2013; Revision submitted 17 June 2013

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

    References

    • Arai H, Yamamoto A, Matsuzawa Y et al. Polymorphisms in four genes related to triglyceride and HDL-cholesterol levels in the general Japanese population in 2000. J. Atheroscler. Thromb.12(5),240–250 (2005).
    • Lee E, Ryan S, Birmingham B et al. Rosuvastatin pharmacokinetics and pharmacogenetics in white and Asian subjects residing in the same environment. Clin. Pharmacol. Ther.78(4),330–341 (2005).▪▪ Well-designed study demonstrating the ethnic differences in the pharmacokinetics of rosuvastatin.
    • Tzeng TB, Schneck DW, Birmingham BK et al. Population pharmacokinetics of rosuvastatin: implications of renal impairment, race, and dyslipidaemia. Curr. Med. Res. Opin.24(9),2575–2585 (2008).
    • White CM. A review of the pharmacologic and pharmacokinetic aspects of rosuvastatin. J. Clin. Pharmacol.42(9),963–970 (2002).
    • Hu M, To KK, Mak VW, Tomlinson B. The ABCG2 transporter and its relations with the pharmacokinetics, drug interaction and lipid-lowering effects of statins. Expert Opin. Drug Metab. Toxicol.7(1),49–62 (2011).
    • Romaine SP, Bailey KM, Hall AS, Balmforth AJ. The influence of SLCO1B1 (OATP1B1) gene polymorphisms on response to statin therapy. Pharmacogenomics J.10(1),1–11 (2009).
    • Ho RH, Tirona RG, Leake BF et al. Drug and bile acid transporters in rosuvastatin hepatic uptake: function, expression, and pharmacogenetics. Gastroenterology130(6),1793–1806 (2006).
    • Choi JH, Lee MG, Cho JY, Lee JE, Kim KH, Park K. Influence of OATP1B1 genotype on the pharmacokinetics of rosuvastatin in Koreans. Clin. Pharmacol. Ther.83(2),251–257 (2008).
    • Pasanen MK, Fredrikson H, Neuvonen PJ, Niemi M. Different effects of SLCO1B1 polymorphism on the pharmacokinetics of atorvastatin and rosuvastatin. Clin. Pharmacol. Ther.82(6),726–733 (2007).
    • 10  Zhang W, Yu BN, He YJ et al. Role of BCRP 421C>A polymorphism on rosuvastatin pharmacokinetics in healthy Chinese males. Clin. Chim. Acta373(1–2),99–103 (2006).
    • 11  Keskitalo JE, Zolk O, Fromm MF, Kurkinen KJ, Neuvonen PJ, Niemi M. ABCG2 polymorphism markedly affects the pharmacokinetics of atorvastatin and rosuvastatin. Clin. Pharmacol. Ther.86(2),197–203 (2009).
    • 12  Tomlinson B, Hu M, Lee VW et al.ABCG2 polymorphism is associated with the low-density lipoprotein cholesterol response to rosuvastatin. Clin. Pharmacol. Ther.87(5),558–562 (2010).
    • 13  Hu M, Lui SS, Mak VW et al. Pharmacogenetic analysis of lipid responses to rosuvastatin in Chinese patients. Pharmacogenet. Genomics20(10),634–637 (2010).
    • 14  Chasman DI, Giulianini F, Macfadyen J, Barratt BJ, Nyberg F, Ridker PM. Genetic determinants of statin-induced low-density lipoprotein cholesterol reduction: the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial. Circ. Cardiovasc. Genet.5(2),257–264 (2012).▪ First genome-wide analysis of lipid response to rosuvastatin and this analysis confirms the important role of the ABCG2 421C>A polymorphism in rosuvastatin response.
    • 15  Telbisz A, Muller M, Ozvegy-Laczka C et al. Membrane cholesterol selectively modulates the activity of the human ABCG2 multidrug transporter. Biochim. Biophys. Acta1768(11),2698–2713 (2007).
    • 16  Rodrigues AC, Hirata MH, Hirata RD. Impact of cholesterol on ABC and SLC transporters expression and function and its role in disposition variability to lipid-lowering drugs. Pharmacogenomics10(6),1007–1016 (2009).▪ Good review on the effect of drug transporters on statin response.
    • 17  Lee HK, Ho CS, Hu M, Tomlinson B, Wong CK. Development and validation of a sensitive method for simultaneous determination of rosuvastatin and N-desmethyl rosuvastatin in human plasma using liquid chromatography/negative electrospray ionization/tandem mass spectrometry. Biomed. Chromatogr. doi:10.1002/bmc.2944 (2013) (Epub ahead of print).
    • 18  Hu M, Mak VWL, Chu TTY, Waye MMY, Tomlinson B. Pharmacogenetics of HMG-CoA reductase inhibitors: optimizing the prevention of coronary heart disease. Curr. Pharmacogenomics Pers. Med.7(1),1–26 (2009).
    • 19  Zamber CP, Lamba JK, Yasuda K et al. Natural allelic variants of breast cancer resistance protein (BCRP) and their relationship to BCRP expression in human intestine. Pharmacogenetics13(1),19–28 (2003).
    • 20  Morisaki K, Robey RW, Ozvegy-Laczka C et al. Single nucleotide polymorphisms modify the transporter activity of ABCG2. Cancer Chemother. Pharmacol.56(2),161–172 (2005).
    • 21  Telbisz A, Ozvegy-Laczka C, Hegedus T, Varadi A, Sarkadi B. Effects of the lipid environment, cholesterol and bile acids on the function of the purified and reconstituted human ABCG2 protein. Biochem. J.450(2),387–395 (2013).
    • 22  Merino G, van Herwaarden AE, Wagenaar E, Jonker JW, Schinkel AH. Sex-dependent expression and activity of the ATP-binding cassette transporter breast cancer resistance protein (BCRP/ABCG2) in liver. Mol. Pharmacol.67(5),1765–1771 (2005).
    • 23  Martin PD, Dane AL, Nwose OM, Schneck DW, Warwick MJ. No effect of age or gender on the pharmacokinetics of rosuvastatin: a new HMG-CoA reductase inhibitor. J. Clin. Pharmacol.42(10),1116–1121 (2002).
    • 24  Konig J, Cui Y, Nies AT, Keppler D. A novel human organic anion transporting polypeptide localized to the basolateral hepatocyte membrane. Am. J. Physiol. Gastrointest. Liver Physiol.278(1),G156–G164 (2000).
    • 25  Iusuf D, van Esch A, Hobbs M et al. Murine Oatp1a/1b uptake transporters control rosuvastatin systemic exposure without affecting its apparent liver exposure. Mol. Pharmacol.83(5),919–929 (2013).▪ Very recent animal study investigating the impact of hepatic uptake transporters on the systemic and hepatic exposures to rosuvastatin.
    • 26  Watanabe T, Kusuhara H, Maeda K, Shitara Y, Sugiyama Y. Physiologically based pharmacokinetic modeling to predict transporter-mediated clearance and distribution of pravastatin in humans. J. Pharmacol. Exp. Ther.328(2),652–662 (2009).
    • 27  Choi MK, Shin HJ, Choi YL, Deng JW, Shin JG, Song IS. Differential effect of genetic variants of Na(+)-taurocholate co-transporting polypeptide (NTCP) and organic anion-transporting polypeptide 1B1 (OATP1B1) on the uptake of HMG-CoA reductase inhibitors. Xenobiotica41(1),24–34 (2011).
    • 28  Niemi M, Pasanen MK, Neuvonen PJ. SLCO1B1 polymorphism and sex affect the pharmacokinetics of pravastatin but not fluvastatin. Clin. Pharmacol. Ther.80(4),356–366 (2006).
    • 29  Kalliokoski A, Niemi M. Impact of OATP transporters on pharmacokinetics. Br. J. Pharmacol.158(3),693–705 (2009).
    • 30  Weiss J, Sauer A, Divac N et al. Interaction of angiotensin receptor type 1 blockers with ATP-binding cassette transporters. Biopharm. Drug Dispos.31(2–3),150–161 (2010).
    • 31  Sakaeda T, Fujino H, Komoto C et al. Effects of acid and lactone forms of eight HMG-CoA reductase inhibitors on CYP-mediated metabolism and MDR1-mediated transport. Pharm. Res.23(3),506–512 (2006).
    • 32  Macwan JS, Ionita IA, Akhlaghi F. A simple assay for the simultaneous determination of rosuvastatin acid, rosuvastatin-5S-lactone, and N-desmethyl rosuvastatin in human plasma using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Anal. Bioanal. Chem.402(3),1217–1227 (2012).