{"created":"2020-08-30T20:03:14.187822+00:00","id":3157,"links":{},"metadata":{"_buckets":{"deposit":"b2e3d66a-3ba8-42d3-bda5-bc593836c3ac"},"_deposit":{"id":"3157","owners":[],"pid":{"revision_id":0,"type":"recid","value":"3157"},"status":"published"},"_oai":{"id":"oai:meral.edu.mm:recid/3157","sets":["1582963366982:1596631759527"]},"communities":["um1"],"item_1583103067471":{"attribute_name":"Title","attribute_value_mlt":[{"subitem_1551255647225":"Effect of GSTP1 polymorphism on efficacy and safety of cyclophosphamide aggressive therapy in lupus nephropathy patients","subitem_1551255648112":""}]},"item_1583103085720":{"attribute_name":"Description","attribute_value_mlt":[{"interim":"
Background Lupus nephritis (LN) occurs in up to 60% of adults with systemic lupus erythematosus (SLE) and is a predictor
\nof poor survival. Cyclophosphamide (CYC) is regarded as the most effective immunosuppressive medication to improve
\nsurvival for patients with LN.
\nObjective This prospective hospital-based study was conducted to identify the effect of glutathione S transferase Pi-1
\n(GSTP1) genotypes on the efficacy and safety of CYC aggressive therapy.
\nMethods We enrolled SLE nephropathy patients admitted to the Department of Rheumatology of the 500-bed Yangon
\nSpecialty Hospital (YSH), Yangon, Myanmar, who received CYC aggressive therapy for 6 months according to treatment
\nguidelines for SLE patients with renal involvement. The frequencies of I/I, I/V and V/V GSTP1 genotypes were determined
\nusing the polymerase chain reaction-restriction fragment length polymorphism method. The efficacy of CYC aggressive
\ntherapy between LN patients with wild GSTP1 (I/I) and those with polymorphic GSTP1 (I/V or V/V) genotypes was evaluated
\nby comparing 24-h urinary protein levels and assessing the remission rates at 3 and 6 months after initiation of CYC.
\nCYC-related myelotoxicity was assessed by reviewing complete blood picture results on the 10th day after CYC treatment.
\nResults In total, 95 eligible patients were recruited. The frequencies of I/I, I/V and V/V GSTP1 genotypes were 54.7, 41.1
\nand 4.2%, respectively. At 3 and 6 months after CYC treatment, mean 24-h urinary protein had significantly decreased from
\nbaseline in both wild and polymorphic genotype groups (p < 0.001). No significant differences were seen between the wild
\nand polymorphic genotype groups with regard to changes in 24-h urinary protein levels, remission at 3 and 6 months or
\nmyelotoxicity.
\nConclusion CYC aggressive therapy had similar efficacy and caused no significant differences in myelotoxicity in wild GSTP1
\n(I/I) and polymorphic GSTP1 (I/V or V/V) genotypes in patients treated according to YSH guidelines for SLE patients with
\nrenal involvement.