The Value Of CYP2C9 And CYP2C19 Gene Polymorphisms In Guiding Clinical Application Of Cardiovascular Drugs

CYP2C9and CYP2C19 are two important cytochrome oxidase,they are abundant in human liver microparticles,and can metabolize many important cardiovas-cular drugs.There are many single nucleotide polymorphism in both its coding and non-co-ding region.This genetic polymorphism has important influence on the metabolic differences of some important drugs in cardiovascular system diseases.CYP2C9 gene is seen in both CYP2C9*2 and CYP2C9*3mutations.CYP2C9*1(Arg144/Ile359)belongs to the wild type.CYP2C9*2(Cys144/Ile359)is a mutation of C430 > T based on exon3,which leads to the 144 th aminoacids Arg on the polypeptide chain mutate to Cys,casuing the 359 th aminoacids Ile(isoleucine)on the polypeptide chain change to the Leu(leucine).Both of them change the activity of enzyme metabolism substrate by substituting a singe amino acid,which has an effect on drug metabolism,these dtrugs include anticoagulant warfarin,ARB antihypertensive drugs,statins,torasemide,etc.The most common mutation of CYP2C19 gene are CYP2C19*2 and CYP219*3.CYP2C19*2 is caused by a mutation of the 681 th based on exon5(G-->A),thus constitute an abnormal cut site,and then destroy the activity of transcription proteins.CYP2C19*3 is a 636 th single base pair(G-->A)mutation in exon 4 of CYP2C19,which produces a premature stop codon.Both of these two mutations reduce the enzyme activity,which further weakens the body's ability to metabolize drugs,also can effect the metabolism of antiplatelet drugs(clopidogrel).Therefore,understanding the polymorphism of CYP2C9 and CYP2C19 is helpful for clinicians to accurately grasp the dosage of related drugs,so as tomake clinical medication rational and individualized and achieve accurate treatment.