SCLERODERMA IS ASSOCIATED WITH DIFFERENCES IN INDIVIDUAL ROUTES OF DRUG-METABOLISM - A STUDY WITH DAPSONE, DEBRISOQUIN, AND MEPHENYTOIN

被引:45
作者
MAY, DG
BLACK, CM
OLSEN, NJ
CSUKA, ME
TANNER, SB
BELLINO, L
PORTER, JA
WILKINSON, GR
BRANCH, RA
机构
[1] VANDERBILT UNIV, DEPT PHARMACOL, DIV CLIN PHARMACOL, NASHVILLE, TN 37232 USA
[2] VANDERBILT UNIV, DEPT MED, NASHVILLE, TN 37232 USA
[3] ROYAL FREE HOSP, DEPT RHEUMATOL, LONDON, ENGLAND
[4] MED COLL WISCONSIN, DEPT RHEUMATOL, MILWAUKEE, WI 53226 USA
关键词
D O I
10.1038/clpt.1990.151
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Exposure to certain environmental agents may induce a scleroderma-like syndrome in a small proportion of individuals. Differences in susceptibility could involve metabolic activation of a protoxin, with affected patients having a greater converting ability. This possibility was investigated in 84 patients with scleroderma and 108 control subjects with in vivo probes of specific pathways of metabolism. Scleroderma was associated with reduced hydroxylating activity for dapsone and S-mephenytoin, whereas the ability to hydroxylate debrisoquin and N-acetyl dapsone was similar in both groups. Logistic regression confirmed these associations based on the shift in frequency distribution. Individuals who were poor metabolizers for mephenytoin and only modest N-hydroxylators of dapsone had a tenfold increased risk of scleroderma (p = 0.008). Thus this combined metabolic impairment may be causally involved in the development of scleroderma or, alternatively, the disease may produce inhibition of selected metabolizing enzymes in a subset of patients. © 1990.
引用
收藏
页码:286 / 295
页数:10
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