Prevalence of CYP2C19 polymorphisms in the Lebanese population |
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Authors: | Isabelle Djaffar Jureidini Nabil Chamseddine Sose Keleshian Rania Naoufal Laila Zahed Noha Hakime |
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Institution: | (1) Department of Clinical Laboratory, Saint George Hospital University Medical Center, Achrafieh Beirut 1100, 2807 Beirut, Lebanon;(2) Onco-Hematology, Saint George Hospital University Medical Center, Beirut, Lebanon |
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Abstract: | Clopidogrel is one of the most commonly prescribed drugs, as its combination with low-dose aspirin is the recommended oral
anti-platelet therapy, to prevent ischaemic events following coronary syndromes or stent placement. Numerous recent studies
have shown that polymorphisms in the gene encoding the cytochrome P450 (CYP450) 2C19 enzyme (CYP2C19) contribute to variability
in response to clopidogrel; patients with certain common genetic variants of CYP2C19 (*2, *3) have a reduced metabolism of
clopidogrel and have a higher rate of cardiovascular events or stent thrombosis compared to patients with the CYP2C19 (*1)
allele. CYP2C19*2 is most common in Caucasians, Africans and Asians while CYP2C19*3 has been found mostly in Asians. Since
the prevalence of these variants in the Lebanese population has not yet been reported, our aim was to determine the genotypes
of CYP2C19 in our population. CYP2C19 (*1/*2/*3) variants were assessed by Polymerase Chain Reaction-Restriction Length Polymorphism
(PCR–RFLP) assays in a representative sample of 161 unrelated healthy Lebanese volunteers. The allele frequencies of CYP2C19
*2 and *3 were 0.13 and 0.03. Carriers of the CYP2C19 *2 or *3 represented 24.2% of the subjects. Our data show no significant
difference in the frequency of CYP2C19 allelic variants when compared to Caucasian populations and demonstrate that the application
of the recent FDA recommendations would also be beneficial in Lebanon, allowing physicians to identify patients at high risk
for atherothrombotic events, and eventually advising them to consider other antiplatelet medications or alternative dosing
strategies in poor metabolizers. |
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