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Influencing Factors for Cure of Clonorchiasis by Praziquantel Therapy: Infection Burden and CYP3A5 Gene Polymorphism

Korean Journal of Parasitology 2011년 49권 1호 p.45 ~ 49
 ( Kim Chung-Hyeon ) - Seoul National University College of Medicine Department of Parasitology and Tropical Medicine

 ( Lee Jeong-Keun ) - Seoul National University College of Medicine Department of Parasitology and Tropical Medicine
 ( Chung Byung-Suk ) - Seoul National University College of Medicine Department of Parasitology and Tropical Medicine
 ( Li Shun-Yu ) - Seoul National University College of Medicine Department of Parasitology and Tropical Medicine
 ( Choi Min-Ho ) - Seoul National University College of Medicine Department of Parasitology and Tropical Medicine
 ( Hong Sung-Tae ) - Seoul National University College of Medicine Department of Parasitology and Tropical Medicine

Abstract


Chemotherapy of clonorchiasis with praziquantel (PZQ) is effective but about 15% of treated cases have been reported uncured. The present study investigated correlation of single nucleotide polymorphisms (SNPs) of the cytochrome P450 gene, CYP3A5 and cure of clonorchiasis. A total of 346 egg passing residents were subjected and treated by 3 doses of 25 mg/kg PZQ. Reexamination recognized 33 (9.5%) uncured and 313 cured. Numbers of eggs per gram of feces (EPGs) before treatment were significantly lower in the cured group than in the uncured group (2,011.2±3,600.0 vs 4,998.5±7,012.0, P<0.001). DNAs of the subjects were screened for SNPs at 7 locations of CYP3A5 using PCR. In the uncured group, the SNP frequencies at g.-20555G>A and g.27526C>T of CYP3A5 were 15.2% and 9.1% while those were 3.8% and 1.0%, respectively, in the cured group. The cure rate was significantly lower in the cases with SNP at g.27526C>T and EPGs≥1,000. In conclusion, EPGs and SNPs of CYP3A5 are factors which influence cure of clonorchiasis by PZQ therapy. It is strongly suggested to recommend 2-day medication for individuals with high EPGs≥1,000.

키워드

Clonorchis sinensis; clonorchiasis; praziquantel; cyochrome P450; CYP3A5; single nucleotide polymorphism (SNP); EPG
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