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Two patients with COMT inhibitor–induced hepatic dysfunction and UGT1A9 genetic polymorphism

From the Department of Medical Science (Dr. Martignoni), University of Piemonte Orientale "Amedeo Avogadro," and Department of Neurorehabilitation and Movement Disorders, "Salvatore Maugeri" Foundation, Scientific Institute of Veruno, Novara; Department of Clinical Medicine (Drs. Cosentino and Lecchini, F. Marino), Section of Experimental and Clinical Pharmacology, University of Insubria, Varese; Department of Experimental and Clinical Biomedical Sciences (Dr. Porta and E. Mattarucchi), University of Insubria, Varese, Italy; Department of Neurology and Otorhinolaryngology (Dr. Nappi), University "La Sapienza", Rome, and I.R.C.C.S. Neurological Institute C. Mondino (Dr. Nappi), Pavia, Italy.

Address correspondence and reprint requests to Dr. Marco Cosentino, Department of Clinical Medicine, Section of Experimental and Clinical Pharmacology, Via Ottorino Rossi n. 9, 21100 Varese VA, Italy; e-mail: marco.cosentino{at}uninsubria.it

The authors report two cases of catechol-O-methyltransferase (COMT) inhibitor–induced asymptomatic hepatic dysfunction in women with Parkinson disease. The patients were genotyped for the UDP-glucuronosyltransferase (UGT) 1A9 gene (which encodes the main COMT inhibitor-metabolizing enzyme), and found to carry mutations leading to defective glucuronidation activity. This suggests that UGT1A9 poor metabolizer genotype(s) may be a predisposing factor for COMT inhibitor–induced hepatotoxicity.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the December 13 issue to find the title link for this article.

E. Martignoni was in charge of the patients and initially observed the cases. Preliminary discussion and planning of the clinical and laboratory assessments were made together with M. Cosentino, M. Ferrari, and F. Marino, in collaboration for the sequencing strategy with G. Porta and E. Mattarucchi. Results were finally examined and discussed for their implications together with S. Lecchini and G. Nappi. M. Cosentino and E. Martignoni wrote the manuscript, and all the authors revised and finally approved the report.

Disclosure: The authors report no conflicts of interest.

Received May 3, 2005. Accepted in final form August 18, 2005.

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Neurology 2005 65: 1686-1687. [Full Text] [PDF]

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