Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Glutathione S-transferase polymorphism of neonatal hyperbilirubinemia in Korean neonates

한국인 신생아 황달과 Glutathione S-transferase 다형성에 관한 연구

  • 강창석 (성애병원 소아청소년과) ;
  • 홍승수 (성애병원 소아청소년과) ;
  • 김지숙 (성애병원 소아청소년과) ;
  • 김은령 (성애병원 소아청소년과)
  • Received : 2007.09.12
  • Accepted : 2008.02.02
  • Published : 2008.03.15
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Abstract

Purpose : Glutathione S-transferase (GST) is a polymorphic supergene family of detoxification enzymes that are involved in the metabolism of numerous diseases. Several allelic variants of GSTs show impaired enzyme activity and are suspected to increase the susceptibility to diseases. Bilirubin is bound efficiently by GST members. The most commonly expressed gene in the liver is GSTM1, and GSTT1 is expressed predominantly in the liver and kidneys. To ascertain the relationship between GST and neonatal hyperbilirubinemia, the distribution of the polymorphisms of GSTT1 and GSTM1 were investigated in this study. Methods : Genomic DNA was isolated from 88 patients and 186 healthy controls. The genotypes were analyzed by polymerase chain reaction (PCR). Results : The overall frequency of the GSTM1 null was lower in patients compared to controls (P=0.0187, Odds ratio (OR) =0.52, 95% confidence interval (CI), 0.31-0.88). Also, the GSTT1 null was lower in patients compared to controls (P=0.0014, OR=0.41, 95% CI=0.24-0.70). Moreover, the frequency of the null type of both, in the combination of GSTM1 and GSTT1, was significantly reduced in jaundiced patients (P=0.0008, OR=0.31, 95% CI=0.17-0.61). Conclusion : We hypothesized that GSTM1 and GSTT1 might be associated with neonatal hyperbilirubinemia. However, the GSTT1 and GSTM1 null type was reduced in patients. Therefore the null GSTT1, null GSTM1, and null type of both in the combination of GSTM1 and GSTT1 may be not a risk factor of neonatal jaundice.

목 적 : GSTs는 glutathione과 친전자성 화합물의 결합을 촉매하여 생체내에 독성 물질로부터 조직을 보호하는 효소로, 여러 다형성이 확인 되었으며 일부 GSTs의 null 유전자형을 가진 사람은 GSTs 단백을 생성하지 못하여 다양한 질병의 감수성에 영향을 미친다고 보고 되었다. 이것은 빌리루빈과 같은 non-substrate ligand와 결합하여 세포내로 운반하는 역할을 하는 대표적인 ligandin이며 빌리루빈을 간세포 내 소포체로 이동시켜 UGT를 통해 glucuronidation 시키는 역할을 한다. 이 연구에서는 빌리루빈 대사의 ligandin인 GSTs 중 GSTM1, GSTT1과 신생아 황달과 연관성이 있는 지 알아보고자 본 연구를 시행하였다. 방 법 : 혈청 빌리루빈 수치가 12 mg/dL 이상인 건강하고 위험인자가 없는 만삭아 중 신생아 고빌리루빈혈증 환아 88명, 대조군은 186명을 대상으로 혈액 0.5 cc를 채혈하여 DNA를 분류하였고 중합효소 연쇄 반응을 수행하여 DNA band를 확인하였다. 결 과 : 대조군의 GSTM1 null 유전형 58.1%, GSTT1의 null 유전형 53.2%였다. 환자군에서 GSTM1 null 유전형은 42% (P=0.0187), GSTT1 null 유전형은 31.8% (P=0.0014)로 통계학적 연관성이 있었다. GSTM1/GSTT1 null/null인 경우, 환자군에서 20명(22.7%)(P=0.0008), GSTM1/GSTT1 null/present인 경우 환자군에서 17명(19.3%) (P=0.0470), GSTM1/GSTT1 present/null인 경우 환자군에서 8명(9.1%) (P=0.0066)으로 나타났다 결 론 : GSTM1과 GSTT1 모두 환자군에서 null 유전형이 대조군에 비하여 더 적게 나타나 GSTs null 유전형이 신생아 고빌리루빈혈증의 위험인자는 아니었다.

Keywords

References

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