Short communication: high prevalence of the cytochrome P450 2C8*2 mutation in Northern Ghana

Trop Med Int Health. 2005 Dec;10(12):1271-3. doi: 10.1111/j.1365-3156.2005.01525.x.

Abstract

Recently, Ghana has changed the first-line treatment of uncomplicated malaria from chloroquine to amodiaquine (AQ) plus artesunate. AQ may cause adverse events such as agranulocytosis and hepatoxicity. The pro-drug AQ is transformed by cytochrome P450 CYP2C8 to the active metabolite N-desethylaminodiaquine. Several polymorphic variants of CYP2C8 are known, some with reduced activity. In 200 randomly selected children from Northern Ghana, we determined the allele frequencies of the CYP2C8 variants CYP2C8*1 (wild type), CYP2C8*2, CYP2C8*3, and CYP2C8*4. We did not detect CYP2C8*3 and CYP2C8*4, but CYP2C8*2 showed an allele frequency of 0.1675. AQ metabolism in patients with CYP2C8*2 may be impaired, and with an increase of AQ based treatment the risk of severe adverse events may mount.

MeSH terms

  • Amodiaquine / adverse effects
  • Amodiaquine / therapeutic use
  • Antimalarials / adverse effects
  • Antimalarials / therapeutic use
  • Artemisinins / therapeutic use
  • Artesunate
  • Aryl Hydrocarbon Hydroxylases / genetics*
  • Child
  • Child, Preschool
  • Cytochrome P-450 CYP2C8
  • Drug Therapy, Combination
  • Female
  • Gene Frequency
  • Ghana
  • Humans
  • Infant
  • Malaria, Falciparum / drug therapy
  • Malaria, Falciparum / genetics*
  • Male
  • Mutation*
  • Polymorphism, Genetic / genetics
  • Prevalence
  • Prodrugs / adverse effects
  • Prodrugs / therapeutic use
  • Sesquiterpenes / therapeutic use

Substances

  • Antimalarials
  • Artemisinins
  • Prodrugs
  • Sesquiterpenes
  • Amodiaquine
  • Artesunate
  • Aryl Hydrocarbon Hydroxylases
  • CYP2C8 protein, human
  • Cytochrome P-450 CYP2C8