1828G>A polymorphism of the UDP-glucuronosyltransferase gene (UGT1A1) for neonatal hyperbilirubinemia in Koreans

한국인 신생아 황달에서 UGT1A1 유전자의 1828G>A 단일염기다형성에 관한 연구

  • Kim, Ja Young (Department of Pediatrics, Sung-Ae General Hospital) ;
  • Kim, Mi Yeoun (Department of Pediatrics, Sung-Ae General Hospital) ;
  • Kim, Ji Sook (Department of Pediatrics, Sung-Ae General Hospital) ;
  • Kim, Eun Ryoung (Department of Pediatrics, Sung-Ae General Hospital) ;
  • Yoon, Seo Hyun (Department of Pharmacology, College of Medicine, Kyunghee University) ;
  • Lee, Hee Jae (Department of Pharmacology, College of Medicine, Kangwon National University) ;
  • Chung, Joo Ho (Department of Pharmacology, College of Medicine, Kyunghee University)
  • 김자영 (성애병원 소아과) ;
  • 김미연 (성애병원 소아과) ;
  • 김지숙 (성애병원 소아과) ;
  • 김은령 (성애병원 소아과) ;
  • 윤서현 (경희대학교 의과대학 약리학교실) ;
  • 이희제 (강원대학교 의과대학 약리학교실) ;
  • 정주호 (경희대학교 의과대학 약리학교실)
  • Received : 2005.08.09
  • Accepted : 2005.10.06
  • Published : 2006.01.15

Abstract

Purpose : The incidence of neonatal hyperbilirubinemia is twice as high in East Asians as in Caucasians. However, its metabolic basis has not been clearly explained. The UDP-glucuronosyltransferase gene(UGT1A1) mutation was found to be a risk factor of neonatal hyperbilirubinemia. We studied whether neonatal hyperbilirubinemia is associated with the 1828G>A(rs 10929303) polymorphism of the UGT1A1 gene, which encodes for a key enzyme of bilirubin metabolism. Methods : The genomic DNA was isolated from 80 Korean full term neonates who had greater than a 12 mg/dL level of serum bilirubin with no obvious cause, and the genomic DNA was also isolated from 164 Korean neonates of the control population. We studied a single nucleotide polymorphism (SNP) of 1828G>A in the untranslated region of the UGT1A1 gene by direct sequencing. Results : Three of the 80 neonates with a serum bilirubin level above 12 mg/dL had homozygous mutations and 10 of the 80 neonates with a serum bilirubin level above 12 mg/dL had heterozygous mutations. Thirteen of the 164 neonates of the control group had homozygous mutations and 16 neonates of the control group had heterozygous mutations. The allele frequency of 1828G>A polymorphism of UGT1A1 in the hyperbilirubinemia group was 10.0 percent, which was not significantly different from the allele frequency of 12.8 percent in the control group. Conclusion : In this study, the 1828G>A polymorphism of the UGT1A1 gene was detected in the Korean neonates with neonatal hyperbilirubinemia. Our results indicated that this SNP is not associated with the prevalence of hyperbilirubinemia in Koreans.

목 적 : 신생아 황달은 중국, 일본, 한국인 등 동양인에서 서양인에 비해 많이 발생하여 유전적인 요인이 있을 것으로 생각되며 빌리루빈 대사의 주된 효소인 Uridine diphosphate glucuronosyl transferase 유전자의 다형성이 관여한다고 보고되고 있다. 저자들은 빌리루빈 대사의 핵심 효소인 UGT1A1 유전자의 다형성이 한국인 신생아 황달과 어떤 연관성이 있는지 알아 보고자 본 연구를 시행하였다. 방 법 : 혈중 빌리루빈 수치가 12 mg/dL 이상의 건강하고, 위험인자가 없는 만삭아 중 신생아 황달 환아 80명과, 대조군 164명으로부터 혈액을 0.5 cc를 채취하여 DNA을 분리하였다. UGT1A1 유전자를 PCR로 증폭하여, 염기서열 분석 방법을 통해 UGT1A1 유전자 untranslated region의 1828G>A(rs 10929303) 단일염기다형성을 확인하였다. 결 과 : UGT1A1 유전자 3' untranslated region의 guanine에서 adenine으로의 1828G>A 단일염기다형성이 신생아 고빌리루빈군 중 총 혈청 빌리루빈이 12 mg/dL 이상인 80명 중 67명(83.8%)이 GG 유전형을 보였고 10명(12.5%)이 GA 이종접합, 3명(3.7%)이 AA 유전형을 나타냈다. 대조군 164명에서는 135명(82.3%)이 GG 유전형을 보였고, GA 이종접합은 16명(9.8%), AA 유전형은 13명(7.9%)으로 나타났다. 변이형 대립유전자 빈도는 고빌리루빈혈증군에서 10.0%로 대조군 12.8%와 비슷하였다(P=0.3687). 결 론 : 한국인 신생아 황달에서 UGT1A1 유전자의 1828G>A 다형성을 확인하였으나, 이는 고빌리루빈혈증군에서 대조군에서와 비슷한 빈도로 관찰되어 한국인 신생아 황달의 발생과 연관이 없을 것으로 생각된다.

Keywords

References

  1. Maisels MJ. Jaundice. In : Avery GB, Fletcher MA, Mac- Donald MG, editors. Neonatology : pathophysiology and management of the newborn. 5th ed. Philadelphia : JB Lippincott Co, 1999:765-819
  2. Friedman L, Lewis PJ, Clifton P, Bulpitt CJ. Factors influencing the incidence of neonatal jaundice. Br Med J 1978;1: 1235-7 https://doi.org/10.1136/bmj.1.6122.1235
  3. Horiguchi T, Bauer C. Ethnic differences in neonatal jaundice : Comparison of Japanese and Caucasian newborn infants. Am J Obstet Gynecol 1975;121:71-4 https://doi.org/10.1016/0002-9378(75)90978-3
  4. Linn S, Schoenbaum SC, Monson RR, Rosner B, Stubblefield PG, Ryan KJ. Epidemiology of neonatal hyperbilirubinemia. Pediatrics 1985;75:770-4
  5. Brown WR, Boon WH. Ethic group differences in plasma bilirubin levels of full-term, healthy Singapore newborns. Pediatrics 1965;36:745-51
  6. Khoury MJ, Calle EE, Joesoef RM. Recurrence risk of neonatal hyperbilirubinemia in siblings. Am J Dis Child 1988; 142:1065-9
  7. Newman TB, Easterlin MJ, Goldman ES, Stevenson DK. Laboratory evaluation of jaundice in newborns. Am J Dis Child 1990;144:364-8 https://doi.org/10.1001/archpedi.1990.02150270114039
  8. Gale R, Seidman DS, Dollberg S, Stervenson DK. Epidemiology of neonatal jaundice in the Jerusalem population. J Pediatr Gastroenterol Nutr 1990;10:82-6 https://doi.org/10.1097/00005176-199001000-00016
  9. Nielsen HE, Haase P, Blaabjerg J, Stryhn H, Hilden J. Risk factors and sib correlation in physiological neonatal jaundice. Acta Paediatr Scand 1987;76:504-11 https://doi.org/10.1111/j.1651-2227.1987.tb10507.x
  10. Drew JH, Kitchen WH. Jaundice in infants of greek parentage : the unknown factor may be environmental. J Pediatr 1976;89:248-52 https://doi.org/10.1016/S0022-3476(76)80457-X
  11. Koiwai O, Nishizawa M, Hasada K, Aono S, Adachi Y, Mamiya N, et al. Gilbert's syndrome is caused by a heterozygous missense mutation in the gene for bilirubin UDPglucuronosyltransferase. Hum Mol Genet 1995;4:1183-6. https://doi.org/10.1093/hmg/4.7.1183
  12. Yamamoto K, Sato H, Fujiyama Y, Doida Y, Bamba T. Contribution of two missense mutations(G71R and Y486D) of the bilirubin UDP glucosyltransferase(UGT1A1) gene phenotypes of Gilbert's syndrome and Crigler-Najjar syndrome type II. Biochim Biophys Acta 1998;1406:267-73 https://doi.org/10.1016/S0925-4439(98)00013-1
  13. Kadakol A, Ghosh SS, Sappal BS, Sharma G, Chowdhury NR. Genetic lesions of bilirubin uridine-diphosphoglucuronate glucuronosyltransferase(UGT1A1) causing Crigler- Najjar and Gilbert syndromes : correlation of genotype to phenotype. Hum Mutat 2000;16:297-306 https://doi.org/10.1002/1098-1004(200010)16:4<297::AID-HUMU2>3.0.CO;2-Z
  14. Burchell B, Hume R. Molecular genetic basis of Gilbert's syndrome. J Gastroenterol Hepatol 1999;14:960-6 https://doi.org/10.1046/j.1440-1746.1999.01984.x
  15. Beutler E, Gelbart T, Demina A. Racial variability in the UDP-glucuronosyl transferase 1(UGT1A1) promoter : A balanced polymorphism for regulation of bilirubin metabolism?Proc Natl Acad Sci USA 1998;95:8170-4
  16. Monaghan G, Ryan M, Seddon R, Hume R, Burchell B. Genetic variation in bilirubin UDP-glucuronosyltransferase gene promoter and Gilbert's syndrome. Lancet 1996;347: 578-81 https://doi.org/10.1016/S0140-6736(96)91273-8
  17. Ando Y, Chida M, Nakayama K, Saka H, Kamataki T. The UGT1A1*28 allele is relatively rare in a Japanese population. Pharmacogenetics 1998;8:357-60 https://doi.org/10.1097/00008571-199808000-00010
  18. Hong KW, Kang H, Kim IS, Kim JS, Kim ER, Lee HJ, et al. Polymorphism of UDP-glucuronosyltransferase gene (UGT1A1) of neonatal hyperbilirubinemia in Korea. Korean J Pediatr 2004;47:18-23
  19. Maruo Y, Nishizawa K, Sato H, Doida Y, Shimada M. Association of neonatal hyperbilirubinemia with bilirubin UDP-glucuronosyltransferase polymorphism. Pediatrics 1999; 103:1224-7 https://doi.org/10.1542/peds.103.6.1224
  20. Huang CS, Chang PF, Huang MJ, Chen ES, Hung KL, Tsou KI. Relationship between bilirubin UDP-glucuronosyltransferase 1A1 gene and neonatal hyperbilirubinemia. Pediatr Res 2002;52:601-5 https://doi.org/10.1203/00006450-200210000-00022
  21. Yamamoto A, Nishio H, Waku S, Yokoyama N, Yonetani M, Uetani Y, et al. Gly71Arg mutation of the bilirubin UDP-glucuronosyltransferase 1A1 gene is associated with neonatal hyperbilirubinemia in the Japanese population. Kobe J Med Sci 2002;48:73-7.
  22. Akaba K, Kimura T, Sasaki A, Tanabe S, Ikegami T, Hashimoto M, et al. Neonatal hyperbilirubinemia and mutation of the bilirubin uridine diphosphate glucuronosyltransferase gene : A common missense mutation among Japanese, Koreans and Chinese. Biochem Molec Biol Int 1998; 46:21-6
  23. Akaba K, Kimura T, Sasaki A, Tanabe S, Wakabayashi T, Hiroi M, et al. Neonatal hyperbilirubinemia and a common mutation of the bilirubin uridine diphosphate-glucuronosyltransferase gene in Japanese. J Hum Genet 1999;44:22-5 https://doi.org/10.1007/s100380050100
  24. Kang H, Lim JH, Kim JS, Kim ER, Kim SD, Lee HJ, et al. The association of neonatal hyperbilirubinemia with UGT1A1 and CYP1A2 gene polymorphism in Korean neonate.Korean J Pediatr 2005;48:35-41
  25. Huang CS, Luo GA, Huang MJ, Yu SC, Yang SS. Variations of the bilirubin uridine-diphosphoglucuronosyl transferase 1A1 gene in healthy Taiwanese. Pharmacogenetics 2000;10:539-44 https://doi.org/10.1097/00008571-200008000-00007
  26. Maruo Y, Addario CD, Mori A, Iwai M, Takahashi H, Sato H, et al. Two linked polymorphic mutations (A(TA)7TAA and T-3279G) of UGT1A1 as the principal cause of Gilbert syndrome. Hum Genet 2004;115:525-6 https://doi.org/10.1007/s00439-004-1183-x
  27. Kanai M, Kijima K, Shirahata E, Sasaki A, Akaba K, Umetsu K, et al. Neonatal hyperbilirubinemia and the bilirubin uridine diphosphate glucuronosyltransferase gene : the common -3263T> G mutation of phenobabital response enhancer module is not associated with the neoanatal hyperbilibinemia in Japanese. Pediatr Int 2005;47:137-41 https://doi.org/10.1111/j.1442-200x.2005.02030.x
  28. Ritter JK, Crawford JM, Owens IS. Cloning of two human liver bilirubin UDP-glucuronosyltransferase cDNAs with expression in COS-1 cells. J Biol Chem 1991;266:1043-7
  29. Bosma PJ, Chowdhury JR, Bakker C, Gantla S, de Boer A, Oostra BA, et al. The genetic basis of the reduced expression of bilirubin UDP-glucuronyltransferase 1 in Gilbert's syndrome. N Engl J Med 1995;333:1171-5 https://doi.org/10.1056/NEJM199511023331802
  30. Raijmarkers MT, Jansen PL, Steegers EA, Peters WH. Association of human liver bilirubin UDP-glucuronyltransferase activity with a polymorphism in the promoter region of the UGT1A1 gene. J Hepatol 2000;33:348-51 https://doi.org/10.1016/S0168-8278(00)80268-8
  31. Takeuchi K, Kobayashi Y, Tamaki S, Maruo Y, Araki J, Mifuji R, et al. Genetic polymorphisms of bilirubin uridine diphosphate glucrononsyltransferase gene in Japanese patients with Crigler-Najjar syndrome or Gilbert's syndrome as well as in healthy Japanese subjects. J Gstroenterol Hepatol 2004;19:955-7 https://doi.org/10.1111/j.1440-1746.2004.03524.x
  32. Huang CS, Chang PF, Huang MJ, Chen ES, Chen WC. Glucose-6-phosphate dehydrogenase deficiency, the UDPglucuronosyl transferase 1A1 gene, and neonatal hyperbilirubinemia. Gastroenterology 2002;123:127-33 https://doi.org/10.1053/gast.2002.34173
  33. Kim YH, Yeon JE, Jung GM, Kim HJ, Kim JS, Byun KS, et al. A study of polymorphism in UDP-glucuronyltransferase 1(UGT-1A1) promoter gene in Korean patients with Gilbert's syndrome. Korean J Hepatol 2002;8:132-8
  34. Bancroft JD, Kreamer B, Gourley GR. Gilbert,s syndrome accelerates development of neonatal jaundice. J Pediatr 1998;132:656-60 https://doi.org/10.1016/S0022-3476(98)70356-7
  35. Huang MJ, Kug KE, Teng Hc, Tang KS, Weng HW, Hung CS. Risk factors for severe hyperbilirubinemia in neonates. Pediatr Res 2004;56:682-9 https://doi.org/10.1203/01.PDR.0000141846.37253.AF
  36. Sutomo R, Talib NA, Yusoff NM, Van Rostenberghe H, Sadewa AH, Sunarti, et al. Screening for G71R mutation of the UGT1A1 gene in the Javanese- Indonesian and Malay- Malaysian populations. Pediatr Int 2004;46:565-9 https://doi.org/10.1111/j.1442-200x.2004.01959.x
  37. Sugatani J, Yamakawa K, Yoshinari K, Machida T, Takagi H, Mori M, et al. Identification of a defect in the UGT1A1 gene promoter and its association with hyperbilirubinemia. Biochem Biophys Res Commun 2002;292:492-7 https://doi.org/10.1006/bbrc.2002.6683