Association of the C3435T polymorphism of the MDR1 gene and therapeutic doses of warfarin in thrombophilic patients.

摘要

The human multidrug resistance (MDR1) gene encodes the unidirectional efflux transporter MDR1, which is considered the main protein responsible for limiting the absorption of drugs administered orally and the excretion of metabolites by the liver and kidney [1]. The C3435T polymorphism in the MDR1 gene is associated with altered pharmacokinetics of many drugs [2]. Warfarin was identified as one of the MDR1 substrates in a previous study aimed at predicting the metabolism of several drugs [3].In thromboembolic diseases, the maintenance of stable and personalized anticoagulation is the main challenge of preventive treatments. Approximately one-third of all patients who have been anticoagulated by warfarin metabolize it inadequately [4]. Individuals who receive higher or lower doses than those required for the desired anticoagulation present the risk of bleeding or recurrence of thromboembolic events, respectively [4].