1. Influence of Genetic and Epigenetic Factors of P2Y 12 Receptor on the Safety and Efficacy of Antiplatelet Drugs.
- Author
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Danielak D, Pawlak K, Główka F, and Karaźniewicz-Łada M
- Subjects
- Humans, Polymorphism, Genetic, Blood Platelets drug effects, Blood Platelets metabolism, Cytochrome P-450 CYP2C19 genetics, Cytochrome P-450 CYP2C19 metabolism, Pharmacogenomic Variants, Treatment Outcome, Receptors, Purinergic P2Y12 drug effects, Receptors, Purinergic P2Y12 genetics, Purinergic P2Y Receptor Antagonists adverse effects, Purinergic P2Y Receptor Antagonists pharmacokinetics, Purinergic P2Y Receptor Antagonists pharmacology, Purinergic P2Y Receptor Antagonists therapeutic use, Platelet Aggregation Inhibitors adverse effects, Platelet Aggregation Inhibitors pharmacology, Platelet Aggregation Inhibitors pharmacokinetics, Epigenesis, Genetic drug effects
- Abstract
Purpose: P2Y
12 receptor inhibitors are drugs that decrease the risk of stent thrombosis and lower the long-term risk of non-stent-related myocardial infarction and stroke. They inhibit the binding of adenosine diphosphate (ADP) to the P2Y12 receptor and effectively reduce platelet reactivity. However, considerable variability in the pharmacodynamics response contributes to a failure of antiplatelet therapy; this phenomenon is especially notorious for older drugs, such as clopidogrel. Some genetic polymorphisms associated with these drugs' metabolic pathway, especially in the CYP2C19 gene, can significantly decrease antiplatelet efficacy. There are few reports on the variability stemming from the target of this drug class that is the P2Y12 receptor itself., Results and Conclusion: This review summarizes the results of research that focus on the influence of P2Y12 genetic polymorphisms on the pharmacodynamics and the efficacy of P2Y12 inhibitors. We found that the conclusions of the studies are unequivocal, and despite several strong candidates, such as G52T (rs6809699) or T744C (rs2046934), they may not be independent predictors of the inadequate response to the drug. Most probably, P2Y12 genetic polymorphisms contribute to the effect exerted by other gene variants (such as CYP2C19*2/*3/*17), drug interactions, or patient habits, such as smoking. Also, epigenetic modifications, such as methylation or miRNA levels, may play a role in the efficacy of antiplatelet treatment., (© 2022. The Author(s).)- Published
- 2024
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