Document Detail

Association of multidrug resistance in epilepsy with a polymorphism in the drug-transporter gene ABCB1.
MedLine Citation:
PMID:  12686700     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: One third of patients with epilepsy have drug-resistant epilepsy, which is associated with an increased risk of death and debilitating psychosocial consequences. Because this form is resistant to multiple antiepileptic drugs, the mode of resistance must be nonspecific, involving drug-efflux transporters such as ATP-binding cassette sub-family B member 1 (ABCB1, also known as MDR1 and P-glycoprotein 170). We hypothesized that the CC genotype at the ABCB1 C3435T polymorphism, which is associated with increased expression of the protein, influences the response to antiepileptic-drug treatment. METHODS: ABCB1 3435 was genotyped in 315 patients with epilepsy, classified as drug-resistant in 200 and drug-responsive in 115, and 200 control subjects without epilepsy. Recently devised methods were used to control for population stratification, and linkage disequilibrium was calculated across the gene. RESULTS: As compared with patients with drug-responsive epilepsy, patients with drug-resistant epilepsy were more likely to have the CC genotype at ABCB1 3435 than the TT genotype (odds ratio, 2.66; 95 percent confidence interval, 1.32 to 5.38; P=0.006). There was no genetic stratification between the two groups of patients. The polymorphism fell within an extensive block of linkage disequilibrium spanning much or all of the gene, implying that the polymorphism may not itself be causal but rather may be linked with the causal variant. CONCLUSIONS: These pharmacogenomic results identify a genetic factor associated with resistance to antiepileptic drugs.
Asra Siddiqui; Reinhold Kerb; Michael E Weale; Ulrich Brinkmann; Alice Smith; David B Goldstein; Nicholas W Wood; Sanjay M Sisodiya
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  348     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-10     Completed Date:  2003-04-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1442-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2003 Massachusetts Medical Society
Department of Molecular Pathogenesis, Institute of Neurology, London, UK.
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MeSH Terms
Case-Control Studies
Drug Resistance, Multiple / genetics*
Epilepsy / drug therapy,  genetics*
Gene Frequency
Genes, MDR*
Linkage Disequilibrium
P-Glycoprotein / genetics*
Polymorphism, Genetic*
Reg. No./Substance:
Comment In:
N Engl J Med. 2003 Apr 10;348(15):1480-2   [PMID:  12686705 ]

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