HIGH FREQUENCY OF CYP2C19 ULTRARAPID METABOLIZERS IN RUSSIAN PATIENTS WITH PEPTIC ULCER

Abstract The main enzyme responsible for metabolism of proton pump inhibitors (PPI) is cytochrome P-4502C19 (CYP2C19). Among all CYP2C19 polymorphisms ulrarapid CYP2C19*17 allele plays an important role in clinical practice as in CYP2C19*17 allele carriers acid suppression achieved with PPI including eradication regimens may be insufficient. To find the frequency of CYP2C19 ultrarapid metabolizers in Russian patients with peptic ulcer We retrospectively reviewed the results of pharmacogenetic tests of 971 Russian patients with endoscopically and histologically proven ulcers, 428 male (44%) and 543 female (56%). The mean age was 44.6 ± 11.9 years (range 15-88 years). DNA was extracted from EDTA whole blood samples (10 mL). The polymorphisms CYP2C19 *2, *3 *17 were evaluated using real-time polymerase chain reaction (RT-PCR). We found that among 971 peptic ulcer patients ultrarapid metabolizers (CYP2C19*1/*17, CYP2C19*17/*17) were the most frequent genotype--39.75%. Extensive metabolizers with CYP2C19*1/*1 genotype were less frequent--32.65%. Frequency of poor and intermediate metabolizers was found to be 1.5% and 25.85% respectively. We were the first to investigate CYP2C19*17 allele frequency in Russian patients with peptic ulcer which was found to be 27.4%. High frequency of CYP2C19 ultrarapid metabolizers in Russian patients with peptic ulcer may be associated with insufficient response to proton pump inhibitors.