CN100377744C - Compound medicine for predicting ACEI pressure reducing medicine effect - Google Patents
Compound medicine for predicting ACEI pressure reducing medicine effect Download PDFInfo
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- CN100377744C CN100377744C CNB2005101155528A CN200510115552A CN100377744C CN 100377744 C CN100377744 C CN 100377744C CN B2005101155528 A CNB2005101155528 A CN B2005101155528A CN 200510115552 A CN200510115552 A CN 200510115552A CN 100377744 C CN100377744 C CN 100377744C
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Images
Abstract
The present invention relates to a compound medicine which improves the curative effect of ACEI hypotensors. The compound medicine improves the curative effect of ACEI hypotensors on the basis of testing the polymorphic site genotype of ADRB2 genes; the compound medicine contains ACEI hypotensors and beta 2 adrenoreceptor agonists or antagonists. The present invention has the advantages of providing convenience for doctors to select medicines according to individual difference, increasing the efficiency and safety of clinical medication and therapy, and reducing the risk of toxic and side effect and economic burden.
Description
The application is for dividing an application, and the application number of original application is 02123875.8, and the applying date is on July 5th, 2002.
Technical field
The present invention relates to a kind of compound medicines of predicting the depressor drug effect, be used in particular for predicting the method and the application thereof of ACEI hypotensor drug effect by measurement function gene polymorphism sites genotype.
Background technology
Hypertension is one of China and global modal chronic disease, is to cause serious cardiovascular diseases such as myocardial infarction, apoplexy, and the main cause of kidney disease etc.Hypertension is 11% in China's prevalence, existing at present patient more than 100,000,000, the about 3,000,000 New Development patients of annual increase.Angiotensin-convertion enzyme inhibitor (ACEI) hypotensor is the most frequently used class medicine of clinic control hypertension.It mainly brings into play the blood pressure lowering drug effect by the activity that suppresses ACE enzyme in the renin angiotensin aldosterone system.
The antihypertensive effect of existing each hypotensor is unsatisfactory, and the effective percentage of single drug is about 60-70%, and individual difference is big.This mainly is owing to lack the indication mechanism of measurable curative effect of medication, so the doctor has no way of selecting according to individual variation when medication, has reduced the efficient and the safety of clinical application, treatment relatively, has increased the risk that toxic and side effects and financial burden take place.
Principle of the present invention is as follows:
One, the mechanism of blood pressure regulating and antihypertensive drugs regulating and controlling effect:
Renin angiotensin aldosterone system all has important effect in blood pressure regulating and hypertension incidence.Tonin (ACE) is activating enzymes this path-regulation and control blood pressure, that have crucial biological significance.Proangiotensin is under the feritin effect in the body, change into angiotensin I, the effect of menses angiotensin invertase (ACE) again, generate Angiotensin II, Angiotensin II can cause that blood vessel shrinks, stimulates the aldosterone secretion strongly, cause vasoconstriction and water-sodium retention, cause hypertension.Angiotensin II can cause that also myocardial hypertrophy, blood vessel hyperplasia and blood vessel wall middle level thicken etc.
Angiotensin-convertion enzyme inhibitor (ACEI) hypotensor, main blood vessel dilating reduces the secretion of aldosterone by suppressing the activity of ACE, the performance hypotensive effect.
Benazepril is the long-acting ACE inhibitor of a kind of non-sulfydryl, and only need once oral every day, and common dose is 5-80mg, and clinical being widely used in treated light, moderate essential hypertension.(Moser M，Abraham PA，Bennett WM，et al.，Theeffects of benazepril，a new angiotensin-converting enzyme inhibitor，in mild to moderate essentialhypertension：amulticenter study.Clin Pharmacol Ther 1991，49(3)：322-9)。The clinical medicine commonly used of other ACEI classes also comprises: captopril (captopril), enalapril (enalapril), cilazapril (cilazapril), benazepril (benazepril), perindopril (perindopril), thunder come Puli (ramipril), fosinopril (fosinopril) etc.
Two, the human ADRB2 gene pleiomorphism Gly16Arg that finds of the present invention is to the predicting function of ACEI class antihypertensive drug drug effect:
A kind of receptor (beta 2 adrenoreceptor) that is distributed widely in the G albumen Rhizoma Nelumbinis connection in each tissue in the body of human ADRB2 gene code, this receptor can cause vasodilation under the agonist effect, bronchiectasis and steatolysis etc. are physiological effect widely.There is pattern (the Reihsaus E of the single nucleotide polymorphism of several change ADRB2 function of receptors in the ADRB2 gene, Innis M, MacIntyre N, Liggett SB.Mutations in the gene encoding for the beta 2-adrenergicreceptor in normal and asthmatic subjects.Am J Respir Cell Mol Biol 1993; 8 (3): 334-9).Wherein ADRB2 gene Gly16/Arg16 polymorphic site is that these proteic 16 bit codons of coding have substituted arginine by glycine.
Find in the research that the effect of human beta-2-adrenoreceptor (ADRB2) gene Gly16Arg polymorphism and ACEI hypotensor is closely related.The Hypertensive Population of two groups of light, moderates being taken the antihypertensive effect of ACEI hypotensor (benazepril, captopril) back diastolic pressure analyzes, the result has the antihypertensive effect of identical trend: Gly16/Gly16 (GG) homozygous mutation type best, the antihypertensive effect of Gly16/Arg16 (GR) heterozygote takes second place, and the antihypertensive effect of Arg16/Arg16 (RR) homozygous wildtype is the poorest.Simultaneously, on the basis of knowing ADRB2 gene Gly16Arg pleomorphism site, in conjunction with the physiological parameter or the further feature parameter that obtain, blood pressure lowering amplitude that can quantitative forecast ACEI class antihypertensive drug.
Thus, can be with the indication mechanism of ADRB2 gene genotype as prediction ACEI class antihypertensive drug.Not only can indicate and qualitative and predict the drug effect of ACEI hypotensor quantitatively, and can indicate ADRB2 active function state, instruct the research and development of compound antihypertensive drug thus.
Three, with ADRB2 gene Gly16Arg polymorphic position point prediction ACEI class antihypertensive drug drug effect and the principle that instructs the compound antihypertensive drug research and development:
A kind of application of predicting the method for ACEI hypotensor drug effect, this is applied as the research and development of instructing the resisting hypertension compound medicine: by measuring experimenter's ADRB2 gene A rg16Gly pleomorphism site genotype, the activity of prediction ADRB2 receptor, adding acts on the ADRB2 receptor and changes its active chemical compound in compound medicine, thereby regulates ACEI hypotensor drug effect.
According to people's beta-2-adrenoreceptor (ADRB2) gene Gly16Arg polymorphism and the closely-related feature of benazepril drug effect among the present invention, the benazepril antihypertensive effect successively decreases in proper order according to ADRB2Gly16Arg polymorphism genotype GG, GR, RR in the Different Individual.In addition, the in vitro study to Chinese hamster ovary cell and the main smooth muscle cell of human body shows that compare with expressing the allelic cell of Arg16, the allelic cell of Gly16 of expressing in the ADRB2 gene can strengthen the active down function of ADRB2.According to foundations such as above-mentioned principle, zoopery and clinical observations, can design the compound medicines of the strengthened ACEI drug effect of regulating the ADRB2 function according to ADRB2Gly16Arg polymorphism genotype, so ADRB2 gene pleiomorphism testing result can be applied to following two kinds of situations:
(1) when the RR genotype, following mechanism can be applied in and instruct research and development ACEI class medicine and ADRB2 agonist to make the compound voltage reducing new drug, will improve the blood pressure lowering drug effect of ACEI class medicine, and principle is as follows:
Have reciprocal action between ADRB2 and angiotensin-ii receptor, angiotensin-ii receptor and ADRB2 may compete vascular smooth muscle cell surface β-arrestin jointly.Animal data shows that this gene has 88.0% homology in this gene and the human brain in rat heart muscle, and the 16th is Gly, and the 27th is Glu; Arg16-Gly can aggravate the downward modulation of receptor, and Gln-27-Glu then makes downward modulation reduce.Infer to the genotypic people of RR significant effect will be arranged especially in view of the above, ADRB2 receptor stimulating agent and ACEI coupling can improve the blood pressure lowering drug effect of ACEI.
(2) when GG or RG genotype, following mechanism can be applied in and instruct research and development ACEI class medicine and beta-2-adrenoreceptor antagonist to make the compound voltage reducing new drug, will improve the blood pressure lowering drug effect of ACEI class medicine, and principle is as follows:
Using ACEI treatment hypertension separately can cause nervous plain I of blood plasma medium vessels and feritin content to increase, the increase of angiotensin I content simultaneously may excite the Chymotrypsin of a kind of Chymase of being called that angiotensin i-converting is become Angiotensin II, cause Angiotensin II to increase at blood plasma or local organization intensive amount, reduce the blood pressure lowering drug effect of ACEI, if ACEI coupling beta receptor antagonist can be reduced the content of feritin in the blood plasma, the amount that makes proangiotensin convert angiotensin I to reduces, and then the amount of Angiotensin II is descended.Thereby use beta-blocker may influence the blood pressure lowering drug effect of ACEI.
Summary of the invention
The technical problem that solves
For improving the individual selection of clinical application, improve curative effect of medication, reduce the generation of toxic and side effects, the invention provides a kind of test kit, method, software and compound medicines of the ACEI of prediction hypotensor drug effect, predict and improve the drug effect of ACEI hypotensor by measuring the receptor gene polymorphism loci gene type.
Technical scheme
For achieving the above object, take following technical scheme:
A kind of test kit of predicting ACEI hypotensor drug effect, by measuring ADRB2 functional gene polymorphism site estimation depressor drug effect, its composition comprises: primer (Primer); Restricted enzyme NcoI and restricted enzyme buffer 4 also can comprise PCR buffer (PCRbuffer), hot resistant DNA polymerase (Taq) and deoxidation triphosphoric acid mononucleotide (dNTP).
The sequence of described primer (Primer) is: forward primer: ADRB25 ' GCCTTCTTGCTGGCACCCCAT3 '; Downstream primer: ADRB25 ' CAGACGCTCGAACTTGGCCATG 3 '.This primer is artificial design and adopts oligonucleotide synthesizer synthetic.The G/C ratio is reasonable, and the annealing temperature of positive anti-chain is approaching, has only this enzyme (NocI) restriction enzyme site in the amplified fragments, high specificity.
A kind of method of predicting ACEI hypotensor drug effect, this method are predicted ACEI hypotensor drug effect by the genotype of mensuration experimenter's ADRB2 gene A rg16Gly pleomorphism site.
Comprise the steps: in the described mensuration ADRB2Arg16Gly polymorphic site genotype
(1) genomic DNA of extraction host cell;
(2) use polymerase chain reaction (PCR) amplification ADRB2 functional gene;
(3) digestion with restriction enzyme;
(4) electrophoresis detection ADRB2Arg16Gly polymorphic site genotype;
In the described prediction drug effect, by detecting gene type prediction ACEI hypotensor drug effect:
When genotype is Gly16/Gly16 homozygous mutation type, the blood pressure lowering amplitude maximum of ACEI hypotensor drug effect; The blood pressure lowering amplitude of ACEI hypotensor drug effect was taken second place when genotype was the Gly16/Arg16 heterozygote; The blood pressure lowering amplitude of ACEI hypotensor drug effect was minimum when genotype was the Arg16/Arg16 homozygous wildtype.
A kind of software of predicting ACEI hypotensor drug effect, on the basis of measuring ADRB2 functional gene polymorphism loci gene type, realize following steps by the computer language procedure computing:
(1) obtains ADRB2 functional gene shape parameter and basic physiological parameter: age, body weight, sex, height, basic SBP and basic DBP;
(2) carry out following computing:
Y
0(Δ SBP)=(1.60* heterozygous mutant+2.41* homozygous mutation)+(0.26* age-0.15* body weight+0.02* height-1.86* sex+0.35* baseline SBP)-18.0;
Z
0(Δ DBP)=(0.24* heterozygous mutant+1.47* homozygous mutation)-(0.13* age+0.08* body weight+0.02* height+1.60* sex-0.38* baseline DBP)-14.3
(3) according to operation result quantitative forecast ACEI hypotensor drug effect.
A kind of compound medicines that improves ACEI hypotensor drug effect is being measured the curative effect of improving the ACEI hypotensor on the genotypic basis of ADRB2 gene polymorphism sites, and this compound medicines comprises ACEI class Altace Ramipril and beta 2 adrenoreceptor agonists or antagonist.
Beneficial effect
The invention provides a kind of test kit, methodology and the cover software that utilize functional gene prediction ACEI class curative effect of antihypertensive drug, can be used as the indication mechanism of ACEI hypotensor drug effect, by measurement function gene A DRB2Arg16Gly polymorphic site genotype, prediction ACEI hypotensor curative effect; Also can be with genotype as parameter in conjunction with basic physiological parameter and special parameter by calculating the drug effect of predicting the ACEI hypotensor quantitatively, improve precision of prediction; Be convenient to the doctor and when medication, select, improved the efficient and the safety of clinical application and treatment, reduced the risk that toxic and side effects and financial burden take place according to individual variation.The present invention can also instruct new drug development to form the compound new drug of two class ACEI classes at least by measuring genotype, and is special in the not good patient of present therapeutic effect, and better choice is provided.In a word, use the invention achievement of this class (kind) functional gene polymorphism, select medicine, prediction medication curative effect and instruct new drug development to have the using value of industry and service instructing the clinical of antihypertensive drug from now on more economically effectively.
Description of drawings
Fig. 1 is an ADRB2 gene type assay agarose gel electrophoretogram
The specific embodiment
Embodiment 1: use test kit prediction ACEI hypotensor drug effect
A kind of test kit of predicting ACEI hypotensor drug effect, its composition comprises:
A liquid: PCR buffer (PCRbuffer), composition are KCL, Tris-HCl and MgCl
2
B liquid: deoxidation triphosphoric acid mononucleotide (dNTP);
C liquid: primer (Primer), it is synthetic to close instrument by oligonucleotide;
D liquid: hot resistant DNA polymerase (Taq); Storage temperature is-20 ℃;
E liquid: restricted enzyme NcoI; Storage temperature is-20 ℃;
F liquid: restricted enzyme buffer 4, composition are Tris-acetic acid, magnesium acetate, potassium acetate and dithiothreitol, DTT.
The sequence of the primer in this test kit is:
Forward primer: ADRB25 ' GCCTTCTTGCTGGCACCCCAT 3 ';
Downstream primer: ADRB25 ' CAGACGCTCGAACTTGGCCATG 3 '.
Use the step of this test kit prediction ACEI hypotensor drug effect as follows:
(1) amplifying target genes fragment: add genomic DNA 20ng, A liquid 1ul, B liquid 1.6ul, C liquid 0.2ul, D liquid 0.05ul in the 10 μ lPCR reaction systems; Carry out the PCR reaction by following condition:
95℃ 5-15min，
(2) digestion with restriction enzyme:, put 37 ℃ of calorstat insulations more than 4 hours by reactant being mixed as lower volume:
PCR product 10ul
F liquid 1.5ul
E liquid 0.3ul
Distilled water adds to 15ul (1 * digestion volume)
(3) electrophoresis detection ADRB2Arg16Gly pleomorphism site genotype:
The enzyme action afterproduct is with 3.5% agarose gel electrophoresis, use the TAE electrophoretic buffer, DNA Marker uses 50bp or 100bpDNAladder (available from Shanghai biotechnology Services Co., Ltd), and consumption is the 1ug/ hole, voltage is 250V, and electrophoresis time is 20～50 minutes.Gel behind the electrophoresis is through ethidium bromide staining, observed result under uv analyzer.
As shown in Figure 1, M is DNAmarker, with the reference as testing result of the present invention of its 100bp and the segmental position of 150bp.146bp that the present invention relates to and 128bp two fragments appear at above-mentioned two with reference between the band.Electrophoresis result only shows the segmental homozygous wildtype Arg/Arg of being of 146bp, as 2,5; Electrophoresis result show 146bp and 128bp two segmental be heterozygote Gly/Arg, as 1,3,4,6,7,9; Electrophoresis result only shows the segmental homozygous mutation type Gly/Gly of being of 128bp, as 8.
(4) prediction drug effect:
When genotype is Gly16/Gly16 homozygous mutation type, the blood pressure lowering amplitude maximum of ACEI hypotensor drug effect;
The blood pressure lowering amplitude of ACEI hypotensor drug effect was taken second place when genotype was the Gly16/Arg16 heterozygote;
The blood pressure lowering amplitude of ACEI hypotensor drug effect was minimum when genotype was the Arg16/Arg16 homozygous wildtype.
Embodiment 2: measure ADRB2 receptor polymorphisms loci gene type and infer the drug effect of ACEI hypotensor benazepril.
(1), measure ADRB2Arg16Gly polymorphic site genotype:
(1) genomic DNA of extraction host cell:
(a) add the 30ml erythrocyte cracked liquid in whole blood, slowly shake up, room temperature left standstill 10 minutes, during, shake for several times, thoroughly splitting erythrocyte;
(b) leave the heart/minutes 10 minutes in 4 ℃, 2000, remove supernatant, the leukocyte that will precipitate is broken up on the rotation oscillator, adds protease 40ul, RNA enzyme 50ul, shakes up, and adds write cell lysis buffer and puts 15ml, and 37 ℃ of water-baths of mixing were taken out after 20 minutes, put in the cold water;
(c) add cold albumen precipitation liquid 4ml, be placed on-20 ℃ of refrigerators 5 minutes behind the mixing, take out in 4 ℃, 3000 rev/mins centrifugal 10 minutes.Supernatant poured into slowly shake in the 50ml centrifuge tube that has added the 15ml isopropyl alcohol for several times, separate out to the DNA floccule;
(d) the DNA floccule of separating out is moved to another 1.5ml and has packed on the 75% alcoholic acid filter paper, make evaporate dried.
(e) add DNA hydrating fluid 1.5ml, put shaking table, shaken over night, standby;
(f) mensuration of DNA concentration adopts ultraviolet spectrophotometry, measures the OD value under two wavelength of 260nm and 280nm respectively, is DNA concentration with OD260nm * 50 income values.And with OD260nm/OD280nm ratio estimation DNA purity;
(2) use PCR-RFLP method amplification ADRB2 functional gene:
With PCR instrument amplification ADRB2 functional gene, contain genomic DNA 20ng in the 10ulPCR reaction system, 1.5mmol/L MgCl2,200 μ mol/L dNTP, 50mmol/L KCl, 10mmol/L Tris-HCl (pH 9.0), 0.5U/ μ l Taq archaeal dna polymerase, reaction buffer, each primer 0.2 μ mol/L (0.1～0.4 μ mol/L all can), the sequence of primer is:
Forward primer: ADRB25 ' GCCTTCTTGCTGGCACCCCAT 3 '
Downstream primer: ADRB25 ' CAGACGCTCGAACTTGGCCATG 3 '
The PCR reaction condition is as follows:
95℃ 5-15min，
72℃ 7～15min。
(3) PCR product size: 168bp
(4) digestion with restriction enzyme: (NocI is available from Shanghai biotechnology Services Co., Ltd)
PCR product 10ul
Enzyme cutting buffering liquid 4 1.5ul
Restricted enzyme NcoI 0.3ul (5u/10ul)
Distilled water 32ul
Mix back 37 ℃ of calorstats insulation more than 4-15 hour.
(5) electrophoresis detection ADRB2 Arg16Gly polymorphic site genotype:
Method and result are with embodiment 1.
(2), prediction drug effect: method is with embodiment 1.
Above method verifies that by two groups of clinical observations the result is as follows:
The patient takes the blood pressure lowering amplitude that the benazepril after-contraction is pressed, and two groups of observation analysis results of A and B have identical trend, and promptly the Gly16/Gly16 homozygote is maximum, and the Gly16/Arg16 heterozygote takes second place, and the Arg16/Arg16 homozygote is minimum.Two groups of samples are merged, find that also the Gly16 allele of ADRB2 gene can increase blood pressure lowering (dSBP) amplitude of taking benazepril after-contraction pressure and statistical significance (p=0.02) is arranged.The patient takes diastolic pressure blood pressure lowering amplitude (dDBP) behind the benazepril, and the Gly16 allele of only also finding the ADRB2 gene in the crowd can increase this trend of blood pressure lowering (dSBP) amplitude of taking diastolic pressure behind the benazepril.The results are shown in Table 1.
To be used as whether dichotomic variable promptly reduce to blood pressure after patient's Drug therapy to drug reaction is that standard is divided into variable effectively normally, invalid two kinds of (i.e.SBP＜140mmHg, DBP＜90mmHg), further inquired into the relation of ARDB2R16G polymorphic site and medicine effect.The results are shown in Table 2.
The treatment of table 1 benazepril is hyperpietic's underpressure and the genotypic relation of ADRB2 (relative antihypertensive effect) after 16 days
| Genotype | Observed number | Systolic pressure decline (mm Hg) | Diastolic pressure decline (mm Hg) | ||||||||
| Mean | Standard deviation | Coefficient of association | Standard error | The P value | Mean | Standard deviation | Coefficient of association | Standard error | The P value | ||
| A organizes RR § GR GG | 106 181 91 | 12.7 16.6 17.4 | 17.7 19.4 16.7 | -3.4 -3.8 | 2.0 2.3 | 0.099 0.092 | 8.8 12.1 12.0 | 11.5 13.4 13.1 | 2.7 1.9 | 1.4 1.6 | 0.054 0.245 |
| B organizes RR § GR GG | 219 323 103 | 8.6 10.3 11.0 | 15.1 14.7 15.3 | 1.8 2.9 | 1.2 1.7 | 0.129 0.088 | 4.9 4.7 6.2 | 10.1 10.2 10.5 | -0.4 1.2 | 0.8 1.1 | 0.629 0.310 |
| Merging group RR § GR GG | 325 504 194 | 9.9 12.5 14.0 | 16.1 16.8 16.2 | 2.4 3.2 | 1.1 1.4 | 0.020 0.024 | 6.2 7.3 8.9 | 10.7 11.9 12.1 | 0.7 1.4 | 0.7 0.9 | 0.347 0.150 |
The treatment of table 2 benazepril is hyperpietic's underpressure and the genotypic relation of ADRB2 (being depressurized to the normal value effect) after 16 days
| Genotype | SBP is effective | DBP is effective | ||||||||||
| Basis SBP 〉=140 | SBP after the medication＜140 | ％ | Odds ratio | 95% credibility interval | The P value | Basis DBP 〉=90 | DBP after the medication＜90 | ％ | Odds ratio | 95% credibility interval | The P value | |
| A organizes RR § GR GG | 194 289 91 | 72 111 43 | 37.1 38.4 47.3 | 1.00 0.99 1.56 | - 0.6-1.5 0.9-2.8 | - 0.966 0.141 | 178 253 84 | 78 113 45 | 43.8 44.7 53.6 | 1.00 1.07 1.47 | - 0.7-1.6 0.8-2.6 | - 0.737 0.178 |
| B organizes RR § GR GG | 99 169 83 | 31 70 34 | 31.3 41.4 41.0 | 1.00 1.88 1.61 | - 1.0-3.4 0.8-3.2 | - 0.038 0.174 | 76 150 79 | 36 90 51 | 47.4 60.0 64.6 | 1.00 1.93 2.06 | - 1.1-3.5 1.0-4.1 | - 0.033 0.040 |
| Merging group RR § GR GG | 293 458 174 | 103 181 77 | 34.8 39.5 44.3 | 1.00 1.26 1.52 | - 0.9-1.8 1.0-2.4 | - 0.189 0.065 | 254 403 163 | 114 203 96 | 44.9 50.4 58.9 | 1.00 1.29 1.63 | - 0.9-1.8 1.1-2.5 | - 0.141 0.027 |
Embodiment 3: measure ADRB2 gene polymorphism sites genotype and predict the drug effect of ACEI hypotensor captopril
Method is observed the result similar to benazepril with embodiment 2 in the zoopery of ACEI class medicine captopril (captopril).
Embodiment 4: measure ADRB2 gene polymorphism sites genotype and predict the drug effect of ACEI hypotensor fosinopril
Method is observed the result similar to benazepril with embodiment 2 in the zoopery of ACEI class medicine fosinopril (fosinopril).
On the basis of measuring ADRB2 functional gene polymorphism loci gene type, realize following steps by the computer language procedure computing:
(1) obtains ADRB2 functional gene shape parameter and basic physiological parameter: age, body weight, sex, height, basic SBP and basic DBP;
(2) carry out following computing:
Y
0(Δ SBP)=(1.60* heterozygous mutant+2.41* homozygous mutation)+(0.26* age-0.15* body weight+0.02* height-1.86* sex+0.35* baseline SBP)-18.0;
Z
0(Δ DBP)=(0.24* heterozygous mutant+1.47* homozygous mutation)-(0.13* age+0.08* body weight+0.02* height+1.60* sex-0.38* baseline DBP)-14.3;
(3) according to operation result quantitative forecast ACEI hypotensor drug effect.
The value mode of the genotype parameter value in the above step (1) is as follows: by the genotype value of the ADRB2 gene polymorphism sites of measuring, when taking place assorted and suddenling change (GR type), assorted and sudden change parameter gets 1, and the homozygous mutation parameter gets 0; When homozygous mutation takes place (GG type), assorted and sudden change parameter gets 0, and the homozygous mutation parameter gets 1.
The value mode of the basic physiological parameter value in the above step (1) is as follows: parameter treating excess syndrome border age at age numerical value, unit are year; Body weight parameter treating excess syndrome border body weight value, unit is a kilogram (kg); The sex parameter gets 1 for the man, for the woman gets 2; Height parameter treating excess syndrome border height values, unit is a rice (m); Basis SBP parameter is basic systolic blood pressure value, and unit is a millimetres of mercury; Basis DBP parameter is basic diastolic blood pressure value, and unit is a millimetres of mercury.
The Y that calculates through step (2)
0Value is the variable quantity of systolic pressure (millimetres of mercury), Z
0Value is the variable quantity of diastolic pressure (millimetres of mercury), can predict the drug effect of ACEI hypotensor quantitatively by these two values.
On the basis of measuring ADRB2 functional gene polymorphism loci gene type, realize following steps by the computer language procedure computing:
Step has been obtained in step (1) after genotype parameter and the basic physiological parameter with embodiment 5, obtains special parameter again: existing smoking, previously smoking, drink, education, occupation; After in step (2), carrying out computing, to Y
0And Z
0Value is carried out following correction calculation:
Y
0(Δ SBP)=(1.55* heterozygous mutant+2.44* homozygous mutation)-(0.26* age+0.14* body weight+0.003* height+3.14* sex-0.35* baseline SBP)-19.1
Z
0(Δ DBP)=(0.19* heterozygous mutant+1.42* homozygous mutation)-(0.14* age+0.08* body weight+0.02* height+2.04* sex-0.39* baseline DBP)-15.0
Y after the correction
0Z again
0Carry out following computing:
Y
1(Δ SBP)=Y
0The existing smoking of-0.62*-1.24* previously smoking-1.64* drinks-0.38* education-0.61* occupation
Z
1(Δ DBP)=Z
0The existing smoking of+1.04*-0.34* previously smoking-1.45* drinks-0.79* education-0.17* occupation
The value mode of the special parameter value in the above step (1) is as follows: existing smoking parameter is according to the present smoking situation value of experimenter, gets 1 when being, gets 0 for not the time; Previously the value of smoking parameter is with aforementioned, gets 1 when being, gets 0 for not the time; The parameter of drinking is according to experimenter's the situation of drinking value, gets 1 when being, gets 0 for not the time; The education parameter is according to experimenter's situation value of receiving an education, and gets 0 for primary school and when following, gets 1 for the junior middle school and when above; Occupation gets 0 according to the professional situation value that the experimenter was engaged in during for agricultural, gets 1 when non-agricultural.The value mode of all the other parameters is with embodiment 5.
With above parameter substitution step (2), the Y that draws as calculated
1Value is the variable quantity of systolic pressure (millimetres of mercury), Z
1Value is the variable quantity of diastolic pressure (millimetres of mercury), can predict the drug effect of ACEI hypotensor quantitatively by these two values, and by simple query mode obtain existing smoking, previously smoking, drink, characteristic parameters such as education, occupation, what calculate predicts depreciation down than the more accurate blood pressure of embodiment 5.
On the basis of measuring ADRB2 functional gene polymorphism loci gene type, realize following steps by the computer language procedure computing:
Step has been obtained in step (1) after genotype parameter and the basic physiological parameter with embodiment 5, obtains special parameter QTc again; After in step (2), carrying out computing, to Y
0And Z
0Value is carried out following correction calculation:
Y
0(Δ SBP)=(1.67* heterozygous mutant+2.58* homozygous mutation)-(0.27* age+0.15* body weight+0.03* height+2.18* sex-0.35* baseline SBP)-13.1
Z
0(Δ DBP)=(0.56* heterozygous mutant+1.70* homozygous mutation)-(0.13* age+0.08* body weight+0.06* height+2.00* sex-0.38* baseline DBP)-9.4
Y after the correction
0Z again
0Carry out following computing:
Y
2(ΔSBP)＝Y
0-4.70QTc
Z
2(ΔDBP)＝Z
0-0.53QTc
The value mode of the special parameter value in the above step (1) is as follows: special parameter QTc is the heart rate Q-Tc interval, QTc=QT/RR, and wherein QT is a time value between electrocardial vector Q-T, RR is a time value between R-R.The value mode of all the other parameters is with embodiment 5.
With above parameter substitution step (2), the Y that draws as calculated
2Value is the variable quantity of systolic pressure (millimetres of mercury), Z
2Value is the variable quantity of diastolic pressure (millimetres of mercury), can predict the drug effect of ACEI hypotensor quantitatively by these two values, and can obtain special parameter QTc by electrocardiogram objective measurement result, available as calculated than the more accurate blood pressure drops predictive value of embodiment 5.
On the basis of measuring ADRB2 functional gene polymorphism loci gene type, realize following steps by the computer language procedure computing:
Step is with embodiment 6, in step (1), obtained genotype parameter, basic physiological parameter and special parameter after, obtain special parameter QTc again; After in step (2), carrying out computing, to Y
1And Z
1Value is carried out following correction calculation:
Y
1(Δ SBP)=(1.65* heterozygous mutant+2.65* homozygous mutation)-(0.27* age+0.14* body weight+0.02* height+3.69* sex-0.35* baseline SBP)-(the existing smoking of 0.59*+1.86* previously smoking+1.81* drinks+0.61* education+0.81* occupation)-13.6
Z
1(Δ DBP)=(0.49* heterozygous mutant+1.64* homozygous mutation)-(0.14* age+0.08* body weight+0.05* height+2.47* sex-0.38* baseline DBP)+(the existing smoking of 0.94*-0.58* previously smoking-1.55* drinks-0.66* education+0.06* occupation)-10.0
Y after the correction
1Z again
1Carry out following computing:
Y
3(ΔSBP)＝Y
1-5.9QTc
Z
3(ΔDBP)＝Z
1-0.97QTc
The obtaining value method of QTc is with embodiment 7, and the value mode of all the other parameters is with embodiment 6.
With above parameter substitution step (2), the Y that draws as calculated
3Value is the variable quantity of systolic pressure (millimetres of mercury), Z
3Value is the variable quantity of diastolic pressure (millimetres of mercury), can predict the drug effect of ACEI hypotensor quantitatively by these two values, by increasing every special parameters that prediction significance is arranged, calculate than previous embodiment 5 or embodiment 6 or all more accurate blood pressure drops predictive value of embodiment 7 more.
Embodiment 9: a kind of the present invention uses described ACEI class blood pressure lowering compound medicines: benazepril+albuterol
This compound medicines manufactures and designs on the genotypic basis of mensuration ADRB2 gene polymorphism sites, improves the curative effect of ACEI hypotensor.
Albuterol is a kind of clinical ADRB2 agonist commonly used, mainly treats respiratory system disease, is not used for compound preparation treatment hypertension as yet.
Zoopery with genotypic two kidneys of RR one folder type Hypertensive Rats shows, benazepril+albuterol compound medicine, and hypotensive effect is greater than benazepril medicine group.
Embodiment 10: a kind of the present invention uses described ACEI class blood pressure lowering compound medicines: benazepril+labetalol
This compound medicines manufactures and designs on the genotypic basis of mensuration ADRB2 gene polymorphism sites, improves the curative effect of ACEI hypotensor.
Labetalol is a kind of clinical ADRB2 antagonist commonly used, is not used to associating compound preparation treatment hypertension as yet.
The zoopery of genotypic two kidneys of non-RR one folder type Hypertensive Rats shows, benazepril+labetalol compound medicine, and hypotensive effect is greater than benazepril medicine group.
Claims (4)
1. compound medicines that improves ACEI hypotensor drug effect, it is characterized in that: this compound medicines comprises ACEI class Altace Ramipril and beta 2 adrenoreceptor agonists or antagonist.
2. the compound medicines that improves ACEI hypotensor drug effect as claimed in claim 1 is characterized in that: described ACEI hypotensor is one or more in captopril (captopril), enalapril (enalpril), cilazapril (cilazapril), benazepril (benazepril), perindopril (perindopril), ramipril (ramipril), fosinopril (fosinopril), lisinopril (lisinopril), losartan (losartan), the valsartan (valsartan).
3. the compound medicines that improves ACEI hypotensor drug effect as claimed in claim 1 or 2 is characterized in that: described beta 2 adrenoreceptor agonists is one or more in albuterol (salbutamol), terbutaline (terbutaline), procaterol (procaterol), formoterol (formoterol), clorprenaline (clorprenaline), the salmaterol (salmeterol).
4. the compound medicines that improves ACEI hypotensor drug effect as claimed in claim 1 or 2 is characterized in that: described beta 2 adrenoreceptor antagonist is one or more in Propranolol (propranolol), labetalol (labetalol), nadolol (nadolol), the celiprolol (celiprolol).
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNA021238758A CN1465712A (en) | 2002-07-05 | 2002-07-05 | Kit for5 forecasting ACEI group hypotensor effect, method, software and compound medicine thereof |
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| Application Number | Title | Priority Date | Filing Date |
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| CNA021238758A Division CN1465712A (en) | 2002-07-05 | 2002-07-05 | Kit for5 forecasting ACEI group hypotensor effect, method, software and compound medicine thereof |
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| Publication Number | Publication Date |
|---|---|
| CN1781554A CN1781554A (en) | 2006-06-07 |
| CN100377744C true CN100377744C (en) | 2008-04-02 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB2005101155528A Expired - Lifetime CN100377744C (en) | 2002-07-05 | 2002-07-05 | Compound medicine for predicting ACEI pressure reducing medicine effect |
| CNA021238758A Pending CN1465712A (en) | 2002-07-05 | 2002-07-05 | Kit for5 forecasting ACEI group hypotensor effect, method, software and compound medicine thereof |
Family Applications After (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNA021238758A Pending CN1465712A (en) | 2002-07-05 | 2002-07-05 | Kit for5 forecasting ACEI group hypotensor effect, method, software and compound medicine thereof |
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| Country | Link |
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| CN (2) | CN100377744C (en) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101029336B (en) * | 2006-03-01 | 2010-11-03 | 北京华安佛医药研究中心有限公司 | Reagent kit for predicting serotonin re-uptake inhibitor medicine effect |
| CN101063166B (en) * | 2006-04-30 | 2012-07-25 | 安徽省生物医学研究所 | Reagent case for predicting action effect of angiotensin conversion enzyme inhibitor medicament |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1181019A (en) * | 1995-04-07 | 1998-05-06 | 诺瓦蒂斯有限公司 | Combination compositions containing benazepril or beazeprilat and valsartan |
| CN1296814A (en) * | 2000-11-28 | 2001-05-30 | 中国药科大学 | Medical aerosol without freon for treating diseases in respiratory system |
| WO2001047509A2 (en) * | 1999-12-24 | 2001-07-05 | Smithkline Beecham P.L.C. | Composition for the treatment diabetes mellitus containing an insuline sensitizer and agent used in the treatment of cardiac conditions |
| US20020032149A1 (en) * | 1997-08-28 | 2002-03-14 | Kenneth Kensey | In vivo delivery methods and compositions |
-
2002
- 2002-07-05 CN CNB2005101155528A patent/CN100377744C/en not_active Expired - Lifetime
- 2002-07-05 CN CNA021238758A patent/CN1465712A/en active Pending
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1181019A (en) * | 1995-04-07 | 1998-05-06 | 诺瓦蒂斯有限公司 | Combination compositions containing benazepril or beazeprilat and valsartan |
| US20020032149A1 (en) * | 1997-08-28 | 2002-03-14 | Kenneth Kensey | In vivo delivery methods and compositions |
| WO2001047509A2 (en) * | 1999-12-24 | 2001-07-05 | Smithkline Beecham P.L.C. | Composition for the treatment diabetes mellitus containing an insuline sensitizer and agent used in the treatment of cardiac conditions |
| CN1296814A (en) * | 2000-11-28 | 2001-05-30 | 中国药科大学 | Medical aerosol without freon for treating diseases in respiratory system |
Also Published As
| Publication number | Publication date |
|---|---|
| CN1465712A (en) | 2004-01-07 |
| CN1781554A (en) | 2006-06-07 |
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