Effects of UGT2B7, SCN1A and CYP3A4 on the therapeutic response of sodium valproate treatment in children with generalized seizures

Seizure. 2018 May:58:96-100. doi: 10.1016/j.seizure.2018.04.006. Epub 2018 Apr 14.

Abstract

Purpose: This study aims to evaluate the associations between genetic polymorphisms and the effect of sodium valproate (VPA) therapy in children with generalized seizures.

Methods: A total of 174 children with generalized seizures on VPA therapy were enrolled. Steady-state trough plasma concentrations of VPA were analyzed. Seventy-six single nucleotide polymorphisms involved in the absorption, metabolism, transport, and target receptor of VPA were identified, and their associations with the therapeutic effect (seizure reduction) were evaluated using logistic regression adjusted by various influence factors.

Results: rs7668282 (UGT2B7, T > C, OR = 2.67, 95% CI: 1.19 to 5.91, P = 0.017) was more prevalent in drug-resistant patients than drug-responsive patients. rs2242480 (CYP3A4, C > T, OR = 0.27, 95% CI: 0.095 to 0.79, P = 0.017) and rs10188577 (SCN1A, T > C, OR = 0.40, 95% CI: 0.17 to 0.94, P = 0.035) were more prevalent in drug-responsive patients compared to drug-resistant patients.

Conclusion: In children with generalized seizures on VPA therapy, polymorphisms of UGT2B7, CYP3A4, and SCN1A genes were associated with seizure reduction. Larger studies are warranted to corroborate the results.

Keywords: Children; Drug-resistant epilepsy; Generalized seizures; Genetic polymorphisms; Sodium valproate.

MeSH terms

  • Adolescent
  • Anticonvulsants / blood
  • Anticonvulsants / therapeutic use*
  • Child
  • Child, Preschool
  • Cytochrome P-450 CYP3A / genetics*
  • Drug Resistant Epilepsy / blood
  • Drug Resistant Epilepsy / drug therapy
  • Drug Resistant Epilepsy / epidemiology
  • Drug Resistant Epilepsy / genetics
  • Drug Therapy, Combination
  • Female
  • Genetic Association Studies
  • Glucuronosyltransferase / genetics*
  • Humans
  • Logistic Models
  • Male
  • NAV1.1 Voltage-Gated Sodium Channel / genetics*
  • Pharmacogenomic Variants
  • Polymorphism, Single Nucleotide
  • Prevalence
  • Seizures / blood
  • Seizures / drug therapy*
  • Seizures / epidemiology
  • Seizures / genetics
  • Treatment Outcome
  • Valproic Acid / blood
  • Valproic Acid / therapeutic use*

Substances

  • Anticonvulsants
  • NAV1.1 Voltage-Gated Sodium Channel
  • SCN1A protein, human
  • Valproic Acid
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human
  • UGT2B7 protein, human
  • Glucuronosyltransferase