SCN1A polymorphisms influence the antiepileptic drugs responsiveness in Jordanian epileptic patients.

  • Rami Abduljabbar Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
  • Duaa Eid Tamimi Department of Pharmacology, School of Medicine, The University of Jordan, Amman, Jordan.
  • Al-Motassem Yousef Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
  • Ramzi Mukred Saeed Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
  • Mohammed Zawiah Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
Keywords: Epilepsy; drug-resistance; antiepileptic drugs; SCN1A polymorphisms.

Abstract


Aim: To evaluate whether the voltage-gated sodium channel alpha subunit 1 (SCN1A) gene polymorphisms influence the responsiveness of Jordanian epileptic patients to the antiepileptic drugs (AEDs).

Methods: A total of 72 AEDs-treated epileptics were polymerase chain reaction (PCR)- genotyped for six single nucleotide polymorphisms (SNPs), including SCN1A rs2298771, rs3812718, rs3812719, rs2217199, rs2195144 and rs1972445. Genotype and allele distributions in drug-responsive and drug-resistant patients were compared. The six SNPs haplotypes were examined, and the linkage disequilibrium (LD) was assessed.

Results: The genotypes of drug-resistant and drug-responsive groups were in Hardy-Weinberg equilibrium. Three genetic polymorphisms of the SCN1A gene seemed to influence the resistance to AEDs, on the level of alleles and genotypes. Data revealed that rs2298771 G allele, rs3812719 C allele, and rs2195144 T allele increased the risk of developing AEDs-resistance (OR=2.9; 95%CI = [1.4-5.9], p = 0.003; OR=2.4; 95%CI= [1.2- 4.7], p= 0.01; OR=2.3; 95%CI= [1.2- 4.7], p= 0.01) respectively. Haplotype analysis of SCN1A polymorphisms revealed high-degree LD that was associated with resistance to AEDs. A synergetic effect appears with highly significant association in GCCATG haplotype of rs2298771, rs3812718, rs3812719, rs2217199, rs2195144 and rs1972445 respectively (OR=2.8; 95%CI = [1.5-6.2], p = 0.002).

Conclusion: Data suggests that SCN1A polymorphisms could influence the resistance to AEDs in Jordanian epileptics at three SNPs (rs2298771; rs3812719; rs2195144). Additionally, haplotype analysis indicated a strong degree of LD between the six SCN1A polymorphisms. Further investigation with a larger sample size is needed to confirm the results of the current study.

References

1. Falco-Walter JJ, Scheffer IE, Fisher RS. The new definition and classification of seizures and epilepsy. Epilepsy Research. 2018;139:73-9.
2. Greene AE, Todorova MT, Seyfried TN. Perspectives on the metabolic management of epilepsy through dietary reduction of glucose and elevation of ketone bodies. Journal of neurochemistry. 2003;86(3):529-37.
3. Löscher W, Potschka H. Role of multidrug transporters in pharmacoresistance to antiepileptic drugs. Journal of pharmacology and experimental therapeutics. 2002;301(1):7-14.
4. Löscher W, Potschka H, Sisodiya SM, Vezzani A. Drug resistance in epilepsy: clinical impact, potential mechanisms, and new innovative treatment options. Pharmacological Reviews. 2020;72(3):606-38.
5. Wallace R, Scheffer I, Barnett S, Richards M, Dibbens L, Desai R, et al. Neuronal sodium-channel α1-subunit mutations in generalized epilepsy with febrile seizures plus. The American Journal of Human Genetics. 2001;68(4):859-65.
6. Wang P, Zhou Q, Sheng Y, Tang B, Liu Z, Zhou B. Association between two functional SNPs of SCN1A gene and efficacy of carbamazepine monotherapy for focal seizures in Chinese Han epileptic patients. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014;39(5):433-41.
7. Ragsdale DS, Avoli M. Sodium channels as molecular targets for antiepileptic drugs. Brain Research Reviews. 1998;26(1):16-28.
8. Parker D, Sanders E, Burghardt K. Pharmacogenetics of antiepileptic drugs: A brief review. Mental Health Clinician. 2016;6(1):28-34.
9. Kumari R, Lakhan R, Garg R, Kalita J, Misra U, Mittal B. Pharmacogenomic association study on the role of drug metabolizing, drug transporters and drug target gene polymorphisms in drug-resistant epilepsy in a north Indian population. Indian journal of human genetics. 2011;17(Suppl 1):S32.
10. Kwan P, Poon WS, Ng H-K, Kang DE, Wong V, Ng PW, et al. Multidrug resistance in epilepsy and polymorphisms in the voltage-gated sodium channel genes SCN1A, SCN2A, and SCN3A: correlation among phenotype, genotype, and mRNA expression. Pharmacogenetics and genomics. 2008;18(11):989-98.
11. Catterall WA. Structure and function of voltage‐gated sodium channels at atomic resolution. Experimental physiology. 2014;99(1):35-51.
12. Baum L, Haerian BS, Ng H-K, Wong VC, Ng PW, Lui CH, et al. Case–control association study of polymorphisms in the voltage-gated sodium channel genes SCN1A, SCN2A, SCN3A, SCN1B, and SCN2B and epilepsy. Human genetics. 2014;133(5):651-9.
13. Escayg A, Heils A, MacDonald BT, Haug K, Sander T, Meisler MH. A novel SCN1A mutation associated with generalized epilepsy with febrile seizures plus—and prevalence of variants in patients with epilepsy. The American Journal of Human Genetics. 2001;68(4):866-73.
14. Abou-Khalil B, Ge Q, Desai R, Ryther R, Bazyk A, Bailey R, et al. Partial and generalized epilepsy with febrile seizures plus and a novel SCN1A mutation. Neurology. 2001;57(12):2265-72.
15. Sugawara T, Mazaki–Miyazaki E, Ito M, Nagafuji H, Fukuma G, Mitsudome A, et al. Nav1. 1 mutations cause febrile seizures associated with afebrile partial seizures. Neurology. 2001;57(4):703-5.
16. Weale ME, Depondt C, Macdonald SJ, Smith A, San Lai P, Shorvon SD, et al. Selection and evaluation of tagging SNPs in the neuronal-sodium-channel gene SCN1A: implications for linkage-disequilibrium gene mapping. The American Journal of Human Genetics. 2003;73(3):551-65.
17. Shaheen U, Prasad DK, Sharma V, Suryaprabha T, Ahuja YR, Jyothy A, et al. Significance of MDR1 gene polymorphism C3435T in predicting drug response in epilepsy. Epilepsy research. 2014;108(2):251-6. Epub 2013/12/05. doi: 10.1016/j.eplepsyres.2013.11.009. PubMed PMID: 24300029.
18. Ma CL, Wu XY, Zheng J, Wu ZY, Hong Z, Zhong MK. Association of SCN1A, SCN2A and ABCC2 gene polymorphisms with the response to antiepileptic drugs in Chinese Han patients with epilepsy. Pharmacogenomics. 2014;15(10):1323-36. Epub 2014/08/27. doi: 10.2217/pgs.14.89. PubMed PMID: 25155934.
19. Grover S, Talwar P, Gourie-Devi M, Gupta M, Bala K, Sharma S, et al. Genetic polymorphisms in sex hormone metabolizing genes and drug response in women with epilepsy. Pharmacogenomics. 2010;11(11):1525-34. Epub 2010/12/03. doi: 10.2217/pgs.10.120. PubMed PMID: 21121773.
20. Wang P, Zhou Q, Sheng Y, Tang B, Liu Z, Zhou B. Association between two functional SNPs of SCN1A gene and efficacy of carbamazepine monotherapy for focal seizures in Chinese Han epileptic patients. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014;39(5):433-41. Epub 2014/06/13. doi: 10.3969/j.issn.1672-7347.2014.05.001. PubMed PMID: 24921390.
21. Subenthiran S, Abdullah NR, Joseph JP, Muniandy PK, Mok BT, Kee CC, et al. Linkage disequilibrium between polymorphisms of ABCB1 and ABCC2 to predict the treatment outcome of Malaysians with complex partial seizures on treatment with carbamazepine mono-therapy at the Kuala Lumpur Hospital. PloS one. 2013;8(5):e64827. Epub 2013/05/30. doi: 10.1371/journal.pone.0064827. PubMed PMID: 23717663; PubMed Central PMCID: PMCPMC3662793.
22. Sterjev Z, Trencevska GK, Cvetkovska E, Petrov I, Kuzmanovski I, Ribarska JT, et al. The association of C3435T single-nucleotide polymorphism, Pgp-glycoprotein gene expression levels and carbamazepine maintenance dose in patients with epilepsy. Neuropsychiatric disease and treatment. 2012;8:191-6. Epub 2012/05/10. doi: 10.2147/ndt.S28285. PubMed PMID: 22570551; PubMed Central PMCID: PMCPMC3346059.
23. Miller S, Dykes D, Polesky H. A simple salting out procedure for extracting DNA from human nucleated cells. Nucleic acids research. 1988;16(3):1215.
24. Bao Y, Liu X, Xiao Z. Association between two SCN1A polymorphisms and resistance to sodium channel blocking AEDs: a meta-analysis. Neurol Sci. 2018;39(6):1065-72. Epub 2018/03/28. doi: 10.1007/s10072-018-3308-3. PubMed PMID: 29582177.
25. Tamimi DE, Abduljabbar R, Yousef AM, Saeed RM, Zawiah M. Association between ABCB1 polymorphisms and response to antiepileptic drugs among Jordanian epileptic patients. Neurol Res. 2021;43(9):724-35. Epub 2021/05/06. doi: 10.1080/01616412.2021.1922182. PubMed PMID: 33949294.
26. Li H, Wang B, Chang C, Wu M, Xu Y, Jiang Y. The roles of variants in human multidrug resistance (MDR1) gene and their haplotypes on antiepileptic drugs response: a meta-analysis of 57 studies. PloS one. 2015;10(3):e0122043. Epub 2015/03/31. doi: 10.1371/journal.pone.0122043. PubMed PMID: 25816099; PubMed Central PMCID: PMCPMC4376792.
27. Kim DW, Lee SK, Chu K, Jang IJ, Yu KS, Cho JY, et al. Lack of association between ABCB1, ABCG2, and ABCC2 genetic polymorphisms and multidrug resistance in partial epilepsy. Epilepsy research. 2009;84(1):86-90. Epub 2009/01/27. doi: 10.1016/j.eplepsyres.2008.12.001. PubMed PMID: 19167193.
28. Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017;58(4):512-21. Epub 2017/03/10. doi: 10.1111/epi.13709. PubMed PMID: 28276062; PubMed Central PMCID: PMCPMC5386840.
29. Abo El Fotoh WM, Abd El Naby SA, Habib MS, AA AL, Kasemy ZA. The potential implication of SCN1A and CYP3A5 genetic variants on antiepileptic drug resistance among Egyptian epileptic children. Seizure. 2016;41:75-80. Epub 2016/08/09. doi: 10.1016/j.seizure.2016.07.005. PubMed PMID: 27498208.
30. Baghel R, Grover S, Kaur H, Jajodia A, Rawat C, Srivastava A, et al. Evaluating the Role of Genetic Variants on first‐line antiepileptic drug response in North India: Significance of SCN 1A and GABRA 1 Gene Variants in Phenytoin Monotherapy and its Serum Drug Levels. CNS neuroscience & therapeutics. 2016;22(9):740-57.
31. Haerian BS, Baum L, Kwan P, Tan HJ, Raymond AA, Mohamed Z. SCN1A, SCN2A and SCN3A gene polymorphisms and responsiveness to antiepileptic drugs: a multicenter cohort study and meta-analysis. Pharmacogenomics. 2013;14(10):1153-66.
32. Daci A, Beretta G, Vllasaliu D, Shala A, Govori V, Norata GD, et al. Polymorphic variants of SCN1A and EPHX1 influence plasma carbamazepine concentration, metabolism and pharmacoresistance in a population of Kosovar Albanian epileptic patients. PLoS One. 2015;10(11):e0142408.
33. Manna I, Gambardella A, Bianchi A, Striano P, Tozzi R, Aguglia U, et al. A functional polymorphism in the SCN1A gene does not influence antiepileptic drug responsiveness in Italian patients with focal epilepsy. Epilepsia. 2011;52(5):e40-e4.
34. Zimprich F, Stogmann E, Bonelli S, Baumgartner C, Mueller JC, Meitinger T, et al. A functional polymorphism in the SCN1A gene is not associated with carbamazepine dosages in Austrian patients with epilepsy. Epilepsia. 2008;49(6):1108-9.
35. Abe T, Seo T, Ishitsu T, Nakagawa T, Hori M, Nakagawa K. Association between SCN1A polymorphism and carbamazepine‐resistant epilepsy. British journal of clinical pharmacology. 2008;66(2):304-7.
36. Tate SK, Depondt C, Sisodiya SM, Cavalleri GL, Schorge S, Soranzo N, et al. Genetic predictors of the maximum doses patients receive during clinical use of the anti-epileptic drugs carbamazepine and phenytoin. Proceedings of the National Academy of Sciences of the United States of America. 2005;102(15):5507-12. Epub 2005/04/05. doi: 10.1073/pnas.0407346102. PubMed PMID: 15805193; PubMed Central PMCID: PMCPMC556232.
37. Angelopoulou C, Veletza S, Heliopoulos I, Vadikolias K, Tripsianis G, Stathi C, et al. Association of SCN1A gene polymorphism with antiepileptic drug responsiveness in the population of Thrace, Greece. Arch Med Sci. 2017;13(1):138-47. Epub 2017/02/02. doi: 10.5114/aoms.2016.59737. PubMed PMID: 28144265; PubMed Central PMCID: PMCPMC5206360.
38. Tate SK, Singh R, Hung CC, Tai JJ, Depondt C, Cavalleri GL, et al. A common polymorphism in the SCN1A gene associates with phenytoin serum levels at maintenance dose. Pharmacogenetics and genomics. 2006;16(10):721-6. Epub 2006/09/27. doi: 10.1097/01.fpc.0000230114.41828.73. PubMed PMID: 17001291.
39. Yip T, O'doherty C, Tan N, Dibbens L, Suppiah V. SCN1A variations and response to multiple antiepileptic drugs. The pharmacogenomics journal. 2014;14(4):385-9.
40. Hung C-C, Chang W-L, Ho J-L, Tai JJ, Hsieh T-J, Huang H-C, et al. Association of polymorphisms in EPHX1, UGT2B7, ABCB1, ABCC2, SCN1A and SCN2A genes with carbamazepine therapy optimization. Pharmacogenomics. 2012;13(2):159-69.
Published
2022/09/23
Section
Original paper