The influence of the CYP2C19*10 allele on clopidogrel activation and CYP2C19*2 genotyping

Pharmacogenet Genomics. 2014 Aug;24(8):381-6. doi: 10.1097/FPC.0000000000000068.

Abstract

Background/objectives: The polymorphic hepatic enzyme CYP2C19 catalyzes the metabolism of clinically important drugs such as clopidogrel, proton-pump inhibitors, and others and clinical pharmacogenetic testing for clopidogrel is increasingly common. The CYP2C19*10 single-nucleotide polymorphism (SNP) is located 1 bp upstream the CYP2C19*2 SNP. Despite the low frequency of the CYP2C19*10 allele, its impact on metabolism of CYP2C19 substrates and CYP2C19*2 genotyping makes it an important SNP to consider for pharmacogenetic testing of CYP2C19. However, the effect of the CYP2C19*10 allele on clopidogrel metabolism has not been explored to date.

Methods: We measured the enzymatic activity of the CYP2C19.10 protein against clopidogrel. DNA samples from two clinical studies were genotyped for CYP2C19*2 and *10 by pyrosequencing genotyping method.

Results: The catalytic activity of CYP2C19.10 in the biotransformation of clopidogrel and 2-oxo-clopidogrel was significantly decreased relative to the wild-type CYP2C19.1B. We also reported that the CYP2C19*10 SNP interferes with the CYP2C19*2 TaqMan genotyping assay, resulting in miscalling of CYP2C19*10/*2 as CYP2C19*2/*2.

Conclusions: Our data provide evidence that CYP2C19.10 variant partially metabolizes clopidogrel and 2-oxo-clopidogrel, and the presence of CYP2C19*10 allele affects the CY2C19*2 TaqMan genotyping assay and results in misclassification of CYP2C19*10/*2 as CYP2C19*2/*2.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Alleles*
  • Aryl Hydrocarbon Hydroxylases / genetics*
  • Catalysis
  • Chromatography, Liquid
  • Clopidogrel
  • Cytochrome P-450 CYP2C19
  • Genotype
  • Humans
  • Kinetics
  • Mephenytoin / metabolism
  • Omeprazole / metabolism
  • Pharmacogenetics
  • Polymorphism, Single Nucleotide
  • Sequence Analysis, DNA
  • Tandem Mass Spectrometry
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / metabolism

Substances

  • 2-oxo-clopidogrel
  • Clopidogrel
  • Aryl Hydrocarbon Hydroxylases
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19
  • Omeprazole
  • Ticlopidine
  • Mephenytoin