Genetic Polymorphism of CYP2C19: An Assessment of In-vivo Activity
Keywords:
phenotype, omeprazole, metabolites, extensive and poor metabolizersAbstract
The present study aimed as a first attempt on the North Indian population to establish the CYP2C19 phenotype frequencies among the population of Uttarakhand. A total of 20 physically healthy and unrelated human subjects of either sex (both male and female), with age range from 18-30 yrs, body weight ≥ 40 kg, participated in this study. After an overnight fast, each subject received a single dose of 20 mg omeprazole capsule orally. Blood samples (5ml) were collected just before (at 0 hr) and 3 hr after the drug administration. Plasma was separated after centrifugation and stored at -20ºC until analysis. The plasma concentrations of omeprazole and its metabolite, 5- hydroxyomeprazole, were determined by using High performance liquid chromatography (HPLC) method of analysis with some modifications. The metabolites were separated using a mixture of acetonitrile: 0.05 M phosphate buffer (20:80, ph 8.5) at flow rate of 1.5 ml/min. Metabolites were detected by their absorbance at 250 nm. Amounts were calculated from standard curves of omeprazole and its metabolite constructed in the concentration range of 10–1000 ng/ml. Out of 20 subjects, 17 (85%) were EMs and 03 (15%) were PMs. The prevalence of PMs in study population of Uttarakhand was found to be 15% by phenotyping, which is slightly greater than frequencies of South Indians (14%), Gujratis and Marwadis (10.32%), Southeast Asians like Thai (9.2%), Burmese (11%) and Karen (8.4%), Koreans (12.6%) and some other North Indians (10-12%). On the other hand, this PM frequency of 15% is found to be lower than the frequency found in Mexicans (31%), Japanese (27-35%). Our study population possesses 15% PMs, which is essential to evaluate the phenotypegenotypes correlation in this population after the genotyping data is available. It is now further suggested that future studies on genetic polymorphism on subjects of Uttarakhand be carried out on large study population for better interpretation and may involve the correlation of phenotype-genotype data along with observations that relate them to the findings such as adverse drug reaction monitoring, drug therapy decisions like cost and duration of therapy.
References
Abraham BK, Adithan C. Genetic
polymorphism of CYP2D6. Indian Journal
of Pharmacology. 2001;33: 147-169.
Linder MW, Prough RA, Valdes R.
Pharmacogenetics: a laboratory tool for
optimizing therapeutic efficiency. Clin
Chem. 1997;43: 254-266.
Ma MK, Woo MH, Mcleod HL. Genetic
Basis of Drug Metabolism. Am J HealthSyst Pharm. 2002;59:2061-2069.
Kortunay S, Basci NE, Bozkurt A, Isimer A,
Sayal A, Kayaalp SO. The hydroxylation of
omeprazole correlates with S –mephenytoin
and proguanil metabolism. Eur J Clin
Pharmacol. 1997;53:261-264.
Gogtay NJ, Panchabhai TS, Noronha SF,
Davis S, Shinde VM, Kshirsagar NA.
Evaluation of the activity of CYP2C19 in
Gujrati and Marwadi subjects living in
Mumbai (Bombay). BMC Clinical
Pharmacology. 2006;6:8
Gonzalez HM, Pomero TEM, Peregrina
LAA, Chavez CTJ, Escobar-Islas E, Lozano
KF, Hoyo-Vadillo C. CYP2C19- and
CYP3A4-Dependent Omeprazole
Metabolism in West Mexicans. J Clin
Pharmacol. 2003;43:1211-1215.
Yin OQP, Tomlinson B, Chow AHL, Waye
MMY, Chow MSS. Omeprazole as a
CYP2C19 Marker in Chinese Subjects:
Assessment of Its Gene-Dose Effect and
Intrasubject Variability. J Clin Pharmacol. 2004;
582-589.
Shu Y, Wang LS, Xu ZH, He N, Xiao WM,
Wang W, Huang SL, Zhou HH. 5-
Hydroxylation of Omeprazole by Human Liver
Microsomal Fractions from Chinese Populations
Related to CYP2C19 Gene Dose and Individual
Ethnicity. J Pharmacol Exp Ther. 2000;295:844-
Lee J, Yoon Y, Jeong H, Lee S, Liu K, Kang W,
Cha I, Shin J. Extensive evaluation of genetic
polymorphism of CYP2C19 in a Korean
population: interethnic comparison among
Asian populations. Clin Pharmacol Ther.
;75:69.
Roh HK, Dahl ML, Tybring G, Yamada H, Cha
YN, Bertilsson L. CYP2C19 genotype and
phenotype determined by omeprazole in a
Korean population. Pharmacogenetics.
;6:547-551.
Rosemary J, Adithan C, Padmaja N,
Shashindran CH, Gerard N, Krishnamoorthy R.
The effect of the CYP2C19 genotype on the
hydroxylation index of omeprazole in South
Indians. Eur J Clin Pharmacol. 2005;61:19-23.
Gonzalez HM, Gomez-Martinez LE, Chavez
TC, Trevino R, Romero EM, Hoyo-Vadillo C.
Prevalence of CYP2C19 and CYP3A4 in Poor
Metabolizers among Inhabitants of Tlaxcala,
Mexico. Proc West Pharmacol Soc.
;49:102-103.
Tassaneeyakul W, Mahatthanatrakul W,
Niwatananun K, Bangchang KN, Tawalee A,
Krikreangsak N, Cykleng U, Tassaneeyakul W.
CYP2C19 Genetic Polymorphism in Thai,
Burmese and Karen Populations. Drug
Metabolism and Pharmacokinetics.
;21:286-290.
Yang YS, Wong LP, Lee TC, Mustafa AM,
Mohamed Z, Lang CC. Genetic polymorphism
of cytochrome P450 2C19 in healthy Malaysian
subjects. Br J Clin Pharmacol. 2004;58:332–
Kimura M, Ieiri I, Wada Y, Mamiya K, Urae A,
Iimori E, Sakai T, Otsubo K, Higuchi S.
Reliability of the omeprazole hydroxylation
index for CYP2C19 phenotyping: possible
effect of age, liver disease and length of
therapy. Br J Clin Pharmacol. 1999;47:115-
Lamba JK, Dhiman RK, Kohli KK.
CYP2C19 genetic mutations in North
Indians. Clin Pharmacol Ther. 2000;68:328-
Lamba JK, Dhiman RK, Kohli KK. Genetic
polymorphism of the hepatic cytochrome P450
C19 in North Indian subjects. Clin Pharmacol
Ther. 1998;63:422-427.
Tassaneeyakul W, Tassaneeyakul W,
Vannaprasaht S, Yamazoe Y. Formation of
omeprazole sulphone but not 5-
hydroxyomeprazole is inhibited by grapefruit
juice. Br J Clin Pharmacol. 2000;49:139-144.