| Objective: To investigate the occurrence of anti-tuberculosis drug-induced liver injury(ATLI) and related factors, and explore the relationship between cytochrome P4502E1 RsaI locus gene polymorphism and susceptibility to ATLI, and to systematically review the correlation between the CYP2E1 RsaI locus gene polymorphism and the risk of ATLI. In order to further elucidate the pathogenesis of ATLI, implement individualized chemotherapy regimens, find ATLI patients as early as possible and reduce the risk of high-risk groups. Method: From January 2010 to August 2012, Uyghur tuberculosis patients who were registered in the Center for Disease Control of the research sites and accepted standard short course chemotherapy were enrolled in our study. With the survey,case history materials and liver function tests, the incidence of ATLI were investigated.The genotypes of CYP2E1 gene RsaI polymorphism were determined by through multiplex PCR assay. All eligible studies published to June 2015 were identified by searching EMBASE, PubMed, The Cochrane Library, Web of science, CNKI, CBM, VIP,and WanFang databases. Result: 1. In the study, the incidence of ATLI was 4.81%(84/1746). The single factor analysis found that areas, regimen, whether to participate in medical insurance and whether to take preventive drugs to protect liver in case group and control group the difference were statistically significant(P < 0.05). Multi-factor unconditioned Logistic regression analysis found that the precautionary liver drugs associated with the incidence of ATLI(OR=1.988, 95%CI=1.988~3.161). 2. In the Uighur tuberculosis patients the wild type(79.3%) was found as a major genotype of RsaICYP2E1 gene loci, followed by hybrid type(19.1%), and the genotype distribution between different gender the difference was statistically significant(χ2=8.771, P=P=0.013). 3. The additive model(C1C2 vs. C1C1, C2C2 vs. C1C1), the dominant model(C1C1 vs. C1C2+C2C2) and recessive model(C2C2 vs. C1C1+C1C2) analysis were found that the ATLI group and control group of Uighur populations the difference were no statistically significant(P>0.05). 4. Using the fixed dose combination drug compound preparation and CYP2 E RsaI gene polymorphism have the negative interactions under additive model, RERI=1.615, S<1, the test of U P value is 0.044. 5. A total of 27 studies were included in this review. The frequence of CYP2 E RsaI genotype was found wild type(C1C1) was the highest for ATLI group(medina=81.8%) and control group(medina=75.0%). 6. The result of meta-analysis showed that, significant association was found between CYP2 E RsaI gene polymorphism and the risk of ATLI in the total analysis(OR=1.44,95%CI=1.08~1.92,Z=2.51,P=0.012). In the subgroup analysis, significant was found in Chinese(OR=2.12,95%CI=1.45~3.10), but not in others. Conclusion: A lower incidence of ATLI was found in Uighur tuberculosis patients of the XinJiang Uygur Autonomous Region. Taking preventive protect liver medicine and patients carry C1C1 genotype in RsaI loci might be the risk factors for ATLI, and may be closely related with the incidence of ATLI. Due to the limited research design, the quality and quantity of included studies, more high quality studies are needed to verify the above conclusion. |
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