Skip to main content
Log in

Combined influence of ABCB1 genetic polymorphism and DNA methylation on aspirin resistance in Chinese ischemic stroke patients

  • Evidence- and experienced-based Neurology article
  • Published:
Acta Neurologica Belgica Aims and scope Submit manuscript

Abstract

Genetic variants of ABCB1 may affect intestinal absorption of aspirin (ASA). However, it is unclear whether ABCB1 polymorphisms and DNA methylation are associated with ASA efficacy for ischemic stroke. Our aims is to investigate the association between ABCB1 polymorphisms and methylation status on the antiplatelet effects of ASA in Chinese Han ischemic stroke patients. This is a prospective cohort analysis of eligible stroke patients who received ASA. Patients were divided into two groups according to the thrombelastogram and platelet aggregation test: aspirin resistance (AR) and aspirin-sensitive (AS) groups. The ABCB1 genetic polymorphism and the methylation status of promoter regions were analyzed using PCR–RFLP and the combined bisulfite restriction analysis (COBRA). The number of genotype CC + TT of C3435T in the AR group was greater than that of the AS group (p = 0.007). The DNA methylation levels of ABCB1 promoter in the AS group was higher than that of the AR group (p < 0.001), and the promoter methylation levels showed significant different among the CC, CT, and TT genotypes of C3435T individuals (p = 0.006), while there was no obvious difference between different genotypes of C1236T and G2677T/A polymorphisms (p > 0.05). We also found that the methylation status of the ABCB1 promoter correlated positively with arachidonic acid inhibition (AA%) (R = 0.781, p < 0.001).The ABCB1 polymorphism and methylation status was associated with the reduced efficacy of ASA treatment in ischemic stroke. Genetic polymorphism and DNA methylation of ABCB1 should be concerned when prescribing ASA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Mcgrath E, O’Conghaile A, Eikelboom JW, Dinneen SF, Oczkowski C, O’Donnell MJ (2011) Validity of composite outcomes in meta-analyses of stroke prevention trials: the case of aspirin. Cerebrovasc Dis 32(1):22–27

    Article  Google Scholar 

  2. Hankey GJ, Eikelboom JW (2006) Aspirin resistance. Lancet 367(9510):606

    Article  CAS  Google Scholar 

  3. Kugai M, Uchiyama K, Tsuji T, Yoriki H, Fukui A, Qin Y, Higashimura Y, Mizushima K, Yoshida N, Katada K (2013) MDR1 is related to intestinal epithelial injury induced by acetylsalicylic acid. Cell Physiol Biochem Int J Exper Cell Physiol Biochem Pharmacol 32(4):942

    Article  CAS  Google Scholar 

  4. Özhan G, Kara M, Sari FM, Yanar HT, Ercan G, Alpertunga B (2013) Associations between the functional polymorphisms in the transporter gene and colorectal cancer risk: a case-control study in Turkish population. Toxicol Mech Methods 23(4):235–239

    Article  Google Scholar 

  5. Wu, L. X. ,  Zhao, H. B. ,  Wen, C. J. ,  Li, Y. ,  Shao, Y. Y. , Yang, Z. , Zhou H. H. (2016) Combined influence of genetic polymorphism and dna methylation on abcb1 expression and function in healthy chinese males. European Journal of Drug Metabolism & Pharmacokinetics

    Google Scholar 

  6. Mega JL, Close SL, Wiviott SD, Shen L, Walker JR, Simone T, Antman EM, Braunwald E, Sabatine MS (2010) Genetic variants in ABCB1, CYP2C19, and cardiovascular outcomes following treatment with clopidogrel and prasugrel. Lancet 376(9749):1312

    Article  CAS  Google Scholar 

  7. Cayla G, Hulot JS, O’Connor SA, Pathak A, Scott SA, Gruel Y, Silvain J, Vignalou JB, Huerre Y, De lBAJJ (2011) Clinical, angiographic, and genetic factors associated with early coronary stent. Thrombosis 306(16):1765–1774

    CAS  Google Scholar 

  8. Feinberg AP (2007) Phenotypic plasticity and the epigenetics of human disease. Nature 447(7143):433–440

    Article  CAS  Google Scholar 

  9. Tomiyasu H, Goto-Koshino Y, Fujino Y, Ohno K, Tsujimoto H (2014) Epigenetic regulation of the ABCB1 gene in drug-sensitive and drug-resistant lymphoid tumour cell lines obtained from canine patients. Vet J 199(1):103

    Article  CAS  Google Scholar 

  10. Li XG, Ma N, Wang B, Li XQ, Mei SH, Zhao K, Wang YJ, Li W, Zhao ZG, Sun SS (2016) The impact of P2Y12 promoter DNA methylation on the recurrence of ischemic events in Chinese patients with ischemic cerebrovascular disease. Sci Rep 6:34570

    Article  CAS  Google Scholar 

  11. Boiso MS, Zackrisson AL, Jakobsen FI, Karlsson L, Carlsson B, Tillmar A, Kugelberg FC, Ahlner J, Hägg S, Gréen H (2013) ABCB1 gene polymorphisms are associated with suicide in forensic autopsies. Pharmacogenet Genomics 23(9):463–469

    Article  Google Scholar 

  12. Bilichak A, Kovalchuk I (2010) The Combined Bisulfite Restriction Analysis (COBRA) assay for the analysis of locus-specific changes in methylation patterns. Methods Mol Biol 631:23

    Article  Google Scholar 

  13. Xiong Z, Laird PW (1997) COBRA: a sensitive and quantitative DNA methylation assay. Nucleic Acids Res 25(12):2532–2534

    Article  CAS  Google Scholar 

  14. Floyd CN, Ferro A (2014) Mechanisms of aspirin resistance. Pharmacol Ther 141(1):69–78

    Article  CAS  Google Scholar 

  15. Zhang N, Wang Z, Zhou L (2017) Aspirin resistance are associated with long-term recurrent stroke events after ischaemic stroke. Brain Res Bull 134:205–210

    Article  CAS  Google Scholar 

  16. Chouchi M, Kaabachi W, Klaa H, Tizaoui K, Turki BY, Hila L (2017) Relationship between ABCB1 3435TT genotype and antiepileptic drugs resistance in Epilepsy: updated systematic review and meta-analysis. BMC Neurol 17(1):32

    Article  Google Scholar 

  17. Sreemanta P (2014) Frequency and genotype distribution of ABCB1 gene polymorphisms among Maharashtrian population of Central India. Xenobiotica Fate Foreign Compd Biol Syst 44(6):579–582

    Article  Google Scholar 

  18. Cascorbi I (2011) P-glycoprotein: tissue distribution, substrates, and functional consequences of genetic variations. Handb Exp Pharmacol 201(201):261–283

    Article  CAS  Google Scholar 

  19. Ishikawa T, Tsuji A, Inui K, Sai Y, Anzai N, Wada M, Endou H, Sumino Y (2004) The genetic polymorphism of drug transporters: functional analysis approaches. Pharmacogenomics 5(1):67–99

    Article  CAS  Google Scholar 

  20. Kim YO, Kim SY, Yun DH, Lee SWJEN (2012) Association between ABCB1 polymorphisms and ischemic stroke in Korean population. Exper Neurobiol 21(4):164–171

    Article  Google Scholar 

  21. Sharma V, Kaul S, Alhazzani A, Prabha TS, Rao PP, Dadheech S, Jyothy A, Munshi A (2012) Association of C3435T multi drug resistance gene-1 polymorphism with aspirin resistance in ischemic stroke and its subtypes. J Neurol Sci 315(1–2):72

    Article  CAS  Google Scholar 

  22. Safan MA, Elhelbawy NG, Midan DA, Khader HF (2016) ABCB1 polymorphisms and steroid treatment in children with idiopathic nephrotic syndrome. Br J Biomed Sci 74(1):36–41

    Article  Google Scholar 

  23. Wang D, Johnson AD, Papp AC, Kroetz DL, Sadée W (2005) Multidrug resistance polypeptide 1 (MDR1, ABCB1) variant 3435C>T affects mRNA stability. Pharmacogenet Genomics 15(10):693

    Article  CAS  Google Scholar 

  24. Leschziner GD, Andrew T, Pirmohamed M, Johnson MR (2007) ABCB1 genotype and PGP expression, function and therapeutic drug response: a critical review and recommendations for future research. Pharmacogenomics J 7(3):154–179

    Article  CAS  Google Scholar 

  25. Oberstadt MC, Bienmöller S, Weitmann K, Herzog S, Hentschel K, Rimmbach C, Vogelgesang S, Balz E, Fink M, Michael H (2013) Epigenetic modulation of the drug resistance genes MGMT, ABCB1 and ABCG2 in glioblastoma multiforme. BMC Cancer 13(1):617

    Article  Google Scholar 

  26. Takane H, Kobayashi D, Hirota T, Kigawa J, Terakawa N, Otsubo K, Ieiri I (2004) Haplotype-oriented genetic analysis and functional assessment of promoter variants in the MDR1 (ABCB1) gene. J Pharmacol Exp Ther 311(3):1179–87

    Article  CAS  Google Scholar 

  27. Jiang ZP, Xu P, Liu RR, Li HD, Wang GP, Zhao XL, Chen FP (2008) Correlation between MDR1 methylation status in the promoter region and MDR1 genetic polymorphism in 194 healthy Chinese Han subjects. Pharmacogenomics 9(12):1801

    Article  CAS  Google Scholar 

  28. Yang J, Zhou JS, Zhao YX, Yang ZH, Zhao HD, Zhang YD, Zou JJ (2015) ABCB1 hypomethylation is associated with decreased antiplatelet effects of clopidogrel in Chinese ischemic stroke patients. Pharmazie 70(2):97

    CAS  PubMed  Google Scholar 

  29. Li X, Zhao K, Ma N, Sun S, Miao Z, Zhao Z (2017) Association of ABCB1 promoter methylation with aspirin exposure, platelet function, and clinical outcomes in Chinese intracranial artery stenosis patients. Eur J Clin Pharmacol 73(10):1261–1269

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yan Wang.

Ethics declarations

Conflict of interest

We have no financial and personal relationships with other person or organizations that can inappropriately influence our work. We have no conflict of interest.

Ethical approval

The approval for the study was obtained from the ethics committee of the affiliated hospital of Qingdao university.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xu, L., Wang, Y. Combined influence of ABCB1 genetic polymorphism and DNA methylation on aspirin resistance in Chinese ischemic stroke patients. Acta Neurol Belg 122, 1057–1064 (2022). https://doi.org/10.1007/s13760-021-01714-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-021-01714-1

Keywords

Navigation