Clopidogrel Pharmacogenetics
A test for detecting genetic polymorphisms ABCB1: 3435 C>T, CYP2C19*2 (CYP2C19: 681 G>A), CYP2C19*3 (CYP2C19: 636 G>A) CYP2C19*17 (CYP2C19: -806 C>T) associated with clopidogrel metabolism.
Clopidogrel Pharmacogenetics
Testing for genetic polymorphisms affecting clopidogrel metabolism is important in the context of personalized therapy. Clopidogrel is currently one of the most widely used antiplatelet agents in the world. It irreversibly inhibits the adenosine diphosphate receptor on the platelet surface, helping to attenuate platelet aggregation.
However, the efficacy and safety of clopidogrel use may vary significantly depending on genetic factors that affect its metabolism.
ABCB1: 3435 C>T
The ABCB1 gene encodes a specific glycoprotein that plays a key role in transporting drugs across cell membranes. The ABCB1:3435 C>T polymorphism is associated with changes in the expression level and function of the glycoprotein, which may affect the absorption and bioavailability of clopidogrel. Carriers of the C allele may have reduced intestinal absorption of clopidogrel, leading to changes in its concentration in blood plasma, reduced therapy effectiveness and an increased risk of thrombotic complications in homozygotes.
CYP2С19*2 (CYP2C19: 681 G>A) and CYP2C19*3 (CYP2C19: 636 G>A)
The CYP2C19 gene encodes cytochrome P450 2C19 enzyme responsible for biotransformation of clopidogrel in the liver into its active metabolite. CYP2C19:681 G>A and 636 G>A polymorphisms are associated with decreased activity or complete inactivation of the enzyme. Carriers of these polymorphisms have reduced antiplatelet effect of clopidogrel and an increased risk of thrombotic complications and ischemic events.
CYP2C19*17 (CYP2C19: -806 C>T)
The CYP2C19: -806 C>T *17 polymorphism in the promoter region of the CYP2C19 gene is associated with increased expression of the enzyme. Carriers of the C allele tend to have accelerated clopidogrel metabolism. This leads to a faster transformation of clopidogrel into its active metabolite and an increased risk of bleeding upon receiving standard doses of the drug.
Identification of ABCB1 and CYP2C19 gene polymorphisms in patients receiving clopidogrel makes it possible to personalize and adjust the treatment. Patients with polymorphisms causing reduced metabolic activity may need to have their clopidogrel dosage modified. Carriers of CYP2C19: -806 C>T *17 polymorphism may be prescribed reduced doses of clopidogrel or put on alternative antiplatelet drugs to prevent side effects.
Indications for testing
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Clopidogrel prescription -
Ineffectiveness of antiplatelet treatment -
Scheduled surgical interventions -
High risk of thrombosis -
Coronary artery stenting -
Family history of thromboembolic complications
Clopidogrel Pharmacogenetics
The Clopidogrel Pharmacogenetics REAL-TIME PCR Genotyping Kit is intended for detection and allelic discrimination of genetic polymorphisms associated with clopidogrel metabolism features.
Sample: peripheral blood.
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