Establishment of gene analytic method to prevent the development of the steroid induced osteonecrosis of the femoral head.

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In advanced organ transplantation technology, steroid-induced osteonecrosis of femoral head (ONF) is one of troublesome complications. Steroid sensitivity could vary in individuals, and the involvement of polymorphism of various gene which relates to the steroid metabolism is suggested. The present study investigated the relationship between single nucleotide polymorphism (SNP) on DNA sequence of cytochrome P450 and ONF development. Subjects were renal transplant patients. Genome DNA was obtained from the peripheral blood, and SNP analyses for CYP3A4, CYP2D6 and CYP2C19 were conducted by using various methods ; direct sequencing, PCR-restriction fragment length polymorphism and DNA Chip. Statistical analysis on the relationship between ONF development and SNP was done. Adusted odds ratio was higher in patients who had CYP2D6^*2 homozygote (odds ratio : 4.7) and CYP2D6^*10B homozygote (odds ratio : 1.8), while significant difference was not observed. It is very useful if the generating risk judging according to SNPs to prevention of steroid induced ONF is possible. This time, SNPs to which it is clearly related with ONF generating was not accepted, but reference of SNPs which may be related to steroid metabolism is important. We think that it is necessary to examine from now on.