Related Experiment Videos
CYP2C19 and ABCB1 gene polymorphisms are differently distributed according to ethnicity in the Brazilian general
Paulo C J L Santos1, Renata A G Soares, Diogo B G Santos
1Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, SP, Brazil.
Insights
Genetic variations in CYP2C19 and ABCB1 influence clopidogrel metabolism. Ethnic differences in these gene variants affect clopidogrel-predicted metabolic phenotypes in a diverse Brazilian population.
Area of Science:
- Pharmacogenomics
- Clinical Pharmacology
- Population Genetics
Background:
- CYP2C19 and ABCB1 gene polymorphisms are crucial for personalized clopidogrel treatment.
- Understanding allele frequencies is key to predicting drug response.
Purpose of the Study:
- Evaluate frequencies of CYP2C19 and ABCB1 polymorphisms.
- Identify clopidogrel-predicted metabolic phenotypes across ethnic groups in Brazil.
Main Methods:
- Genotyping of ABCB1 c.C3435T, CYP2C19*2, CYP2C19*17, and other CYP2C19 variants.
- Analysis included 183 Amerindians and 1,029 individuals from diverse ethnic backgrounds.
- Polymerase chain reaction and high-resolution melting analysis were employed.
Main Results:
- Significant inter-ethnic differences in allelic frequencies for ABCB1 c.C3435T, CYP2C19*2, and CYP2C19*17 were observed.
- CYP2C19*3 and CYP2C19*5 alleles were not detected; CYP2C19*4 was rare (0.3%).
- Ethnicity predicted distinct clopidogrel-predicted metabolic phenotypes in this admixed population.
Conclusions:
- Inter-ethnic variations in ABCB1 and CYP2C19 allele frequencies exist in the Brazilian population.
- This data aids in stratifying individuals for clopidogrel therapy personalization.
- Findings support cost-effective programs for individualized clopidogrel treatment.
Background:
Recent studies have reported the clinical importance of CYP2C19 and ABCB1 polymorphisms in an individualized approach to clopidogrel treatment. The aims of this study were to evaluate the frequencies of CYP2C19 and ABCB1 polymorphisms and to identify the clopidogrel-predicted metabolic phenotypes according to ethnic groups in a sample of individuals representative of a highly admixtured population.
Methods:
One hundred and eighty-three Amerindians and 1,029 subjects of the general population of 4 regions of the country were included. Genotypes for the ABCB1c.C3435T (rs1045642), CYP2C19*2 (rs4244285), CYP2C19*3 (rs4986893), CYP2C19*4 (rs28399504), CYP2C19*5 (rs56337013), and CYP2C19*17 (rs12248560) polymorphisms were detected by polymerase chain reaction followed by high resolution melting analysis. The CYP2C19*3, CYP2C19*4 and CYP2C19*5 variants were genotyped in a subsample of subjects (300 samples randomly selected).
Results:
The CYP2C19*3 and CYP2C19*5 variant alleles were not detected and the CYP2C19*4 variant allele presented a frequency of 0.3%. The allelic frequencies for the ABCB1c.C3435T, CYP2C19*2 and CYP2C19*17 polymorphisms were differently distributed according to ethnicity: Amerindian (51.4%, 10.4%, 15.8%); Caucasian descent (43.2%, 16.9%, 18.0%); Mulatto (35.9%, 16.5%, 21.3%); and African descent (32.8%, 20.2%, 26.3%) individuals, respectively. As a result, self-referred ethnicity was able to predict significantly different clopidogrel-predicted metabolic phenotypes prevalence even for a highly admixtured population.
Conclusion:
Our findings indicate the existence of inter-ethnic differences in the ABCB1 and CYP2C19 variant allele frequencies in the Brazilian general population plus Amerindians. This information could help in stratifying individuals from this population regarding clopidogrel-predicted metabolic phenotypes and design more cost-effective programs towards individualization of clopidogrel therapy.
Related Concept Videos
Pharmacogenetics of Drug Transporters: P-Glycoprotein and Solute Carrier Transporters
Pharmacogenetics of Phase I Enzymes: Cytochrome P450 Isozymes
Pharmacogenetic Phenotypes: Alterations in Pharmacokinetics, Drug Targets and Biologic Milieu
Principles of Pharmacogenetics: Types of Genetic Variants
Pharmacogenetics of Drug Metabolism: Overview
Pharmacogenetics of Drug Targets: β₂-Adrenergic Receptors, Apo E, Thymidylate Synthase