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      Function-Altering SNPs in the Human Multidrug Transporter Gene ABCB1 Identified Using a Saccharomyces-Based Assay

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          Abstract

          The human ABCB1 ( MDR1)-encoded multidrug transporter P-glycoprotein (P-gp) plays a major role in disposition and efficacy of a broad range of drugs including anticancer agents. ABCB1 polymorphisms could therefore determine interindividual variability in resistance to these drugs. To test this hypothesis we developed a Saccharomyces-based assay for evaluating the functional significance of ABCB1 polymorphisms. The P-gp reference and nine variants carrying amino-acid–altering single nucleotide polymorphisms (SNPs) were tested on medium containing daunorubicin, doxorubicin, valinomycin, or actinomycin D, revealing SNPs that increased (M89T, L662R, R669C, and S1141T) or decreased (W1108R) drug resistance. The R669C allele's highly elevated resistance was compromised when in combination with W1108R. Protein level or subcellular location of each variant did not account for the observed phenotypes. The relative resistance profile of the variants differed with drug substrates. This study established a robust new methodology for identification of function-altering polymorphisms in human multidrug transporter genes, identified polymorphisms affecting P-gp function, and provided a step toward genotype-determined dosing of chemotherapeutics.

          Author Summary

          Patients often show varied drug responses ranging from lack of therapeutic efficacy to life-threatening adverse drug reactions. Drug therapy would be greatly improved if it were possible to predict individual drug sensitivity and tailor drugs to patients' genetic makeup. Like all other organisms, humans have a set of transporters and enzymes to detoxify and eliminate foreign molecules including drugs. Understanding the function of genetic variants in these proteins is a key goal toward personalized medicine. To that end, we examined the functional consequences of naturally occurring genetic variants in P-glycoprotein, the most versatile human multidrug transporter. A novel method was developed and employed that can identify function-altering variants in human transporters. This methodology was robust and powerful in that the functional effect of genetic variants can be directly assessed in yeast where all confounding variables in humans are excluded. Surprisingly, the majority of single amino acid substitutions were found to cause alterations in resistance to three tested anticancer agents. This study extends the impact of yeast-based medical research to a new niche, pharmacogenomics.

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          Most cited references39

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          Transformation of intact yeast cells treated with alkali cations.

          Intact yeast cells treated with alkali cations took up plasmid DNA. Li+, Cs+, Rb+, K+, and Na+ were effective in inducing competence. Conditions for the transformation of Saccharomyces cerevisiae D13-1A with plasmid YRp7 were studied in detail with CsCl. The optimum incubation time was 1 h, and the optimum cell concentration was 5 x 10(7) cells per ml. The optimum concentration of Cs+ was 1.0 M. Transformation efficiency increased with increasing concentrations of plasmid DNA. Polyethylene glycol was absolutely required. Heat pulse and various polyamines or basic proteins stimulated the uptake of plasmid DNA. Besides circular DNA, linear plasmid DNA was also taken up by Cs+-treated yeast cells, although the uptake efficiency was considerably reduced. The transformation efficiency with Cs+ or Li+ was comparable with that of conventional protoplast methods for a plasmid containing ars1, although not for plasmids containing a 2 microns origin replication.
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            P-glycoprotein: from genomics to mechanism.

            Resistance to chemically different natural product anti-cancer drugs (multidrug resistance, or MDR) results from decreased drug accumulation, resulting from expression of one or more ATP-dependent efflux pumps. The first of these to be identified was P-glycoprotein (P-gp), the product of the human MDR1 gene, localized to chromosome 7q21. P-gp is a member of the large ATP-binding cassette (ABC) family of proteins. Although its crystallographic 3-D structure is yet to be determined, sequence analysis and comparison to other ABC family members suggest a structure consisting of two transmembrane (TM) domains, each with six TM segments, and two nucleotide-binding domains. In the epithelial cells of the gastrointestinal tract, liver, and kidney, and capillaries of the brain, testes, and ovaries, P-gp acts as a barrier to the uptake of xenobiotics, and promotes their excretion in the bile and urine. Polymorphisms in the MDR1 gene may affect the pharmacokinetics of many commonly used drugs, including anticancer drugs. Substrate recognition of many different drugs occurs within the TM domains in multiple-overlapping binding sites. We have proposed a model for how ATP energizes transfer of substrates from these binding sites on P-gp to the outside of the cell, which accounts for the apparent stoichiometry of two ATPs hydrolysed per molecule of drug transported. Understanding of the biology, genetics, and biochemistry of P-gp promises to improve the treatment of cancer and explain the pharmacokinetics of many commonly used drugs.
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              Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality.

              To determine the excess length of stay, extra costs, and mortality attributable to adverse drug events (ADEs) in hospitalized patients. Matched case-control study. The LDS Hospital, a tertiary care health care institution. All patients admitted to LDS Hospital from January 1, 1990, to December 31, 1993, were eligible. Cases were defined as patients with ADEs that occurred during hospitalization; controls were selected according to matching variables in a stepwise fashion. Controls were matched to cases on primary discharge diagnosis related group (DRG), age, sex, acuity, and year of admission; varying numbers of controls were matched to each case. Matching was successful for 71% of the cases, leading to 1580 cases and 20,197 controls. Crude and attributable mortality, crude and attributable length of stay, and cost of hospitalization. ADEs complicated 2.43 per 100 admissions to the LDS Hospital during the study period. The crude mortality rates for the cases and matched controls were 3.5% and 1.05%, respectively (P<.001). The mean length of hospital stay significantly differed between the cases and matched controls (7.69 vs 4.46 days; P<.001) as did the mean cost of hospitalization ($10,010 vs $5355; P<.001). The extra length of hospital stay attributable to an ADE was 1.74 days (P<.001). The excess cost of hospitalization attributable to an ADE was $2013 (P<.001). A linear regression analysis for length of stay and cost controlling for all matching variables revealed that the occurrence of an ADE was associated with increased length of stay of 1.91 days and an increased cost of $2262 (P<.001). In a similar logistic regression analysis for mortality, the increased risk of death among patients experiencing an ADE was 1.88 (95% confidence interval, 1.54-2.22; P<.001). The attributable lengths of stay and costs of hospitalization for ADEs are substantial. An ADE is associated with a significantly prolonged length of stay, increased economic burden, and an almost 2-fold increased risk of death.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Genet
                pgen
                PLoS Genetics
                Public Library of Science (San Francisco, USA )
                1553-7390
                1553-7404
                March 2007
                9 March 2007
                : 3
                : 3
                : e39
                Affiliations
                [1 ] Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, California, United States of America
                [2 ] Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, California, United States of America
                [3 ] Institute for Human Genetics, University of California San Francisco, San Francisco, California, United States of America
                Brandeis University, United States of America
                [4 ] Department of Biopharmaceutical Sciences, University of California San Francisco, San Francisco, California, United States of America
                Author notes
                * To whom correspondence should be addressed. E-mail: jrine@ 123456berkeley.edu
                Article
                06-PLGE-RA-0442R2 plge-03-03-04
                10.1371/journal.pgen.0030039
                1817653
                17352537
                1aa00df5-77b1-483f-abce-99769504ac4f
                Copyright: © 2007 Jeong et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 10 October 2006
                : 26 January 2007
                Page count
                Pages: 10
                Categories
                Research Article
                Biochemistry
                Biotechnology
                Genetics and Genomics
                Genetics and Genomics
                Genetics and Genomics
                Oncology
                Saccharomyces
                Homo (Human)
                Custom metadata
                Jeong H, Herskowitz I, Kroetz DL, Rine J (2007) Function-altering SNPs in the human multidrug transporter gene ABCB1 identified using a Saccharomyces-based assay. PLoS Genet 3(3): e39. doi: 10.1371/journal.pgen.0030039

                Genetics
                Genetics

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