CYP2C19 Gene Profiling as a Tool for Personalized Stress Ulcer Prophylaxis With Proton Pump Inhibitors in Critically Ill Patients - Recommendations Proposal.

Autor:	Bořilová Linhartová P; RECETOX, Faculty of Science, Masaryk University, Brno, Czechia.; Clinic of Maxillofacial Surgery, Faculty of Medicine, Institution Shared With University Hospital Brno, Masaryk University, Brno, Czechia., Zendulka O; Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia., Janošek J; Faculty of Medicine, Center for Health Research, University of Ostrava, Ostrava, Czechia., Mlčůchová N; RECETOX, Faculty of Science, Masaryk University, Brno, Czechia., Cvanová M; Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czechia., Daněk Z; RECETOX, Faculty of Science, Masaryk University, Brno, Czechia.; Clinic of Maxillofacial Surgery, Faculty of Medicine, Institution Shared With University Hospital Brno, Masaryk University, Brno, Czechia., Kroupa R; Department of Internal Medicine and Gastroenterology, Faculty of Medicine, Institution Shared With University Hospital Brno, Masaryk University, Brno, Czechia., Bartošová L; Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia., Lipový B; Department of Burns and Plastic Surgery, Faculty of Medicine, Institution Shared With University Hospital BrnoMasaryk University, Brno, Czechia.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2022 Jul 11; Vol. 9, pp. 854280. Date of Electronic Publication: 2022 Jul 11 (Print Publication: 2022).
DOI:	10.3389/fmed.2022.854280
Abstrakt:	To this date, there are no recommendations for personalized stress ulcer prophylaxis (SUP) in critical care that would take the patient's individual genetic predispositions into account. Of drugs used for this purpose, proton pump inhibitors (PPIs) are the first-choice drugs in intensive care unit patients. The degradation of proton pump inhibitors is mediated by cytochrome P450 (CYP) enzymes; in particular, CYP2C19 and, to a lesser extent, CYP3A4 are involved. Expression and metabolic activity of, namely in, CYP2C19 is significantly affected by single nucleotide polymorphisms, the drug metabolization rate varies greatly from ultrarapid to poor and likely influences the optimal dosage. As these CYP2C19 predictive phenotypes via CYP2C19 haplogenotypes (rs12248560/rs4244285) can be relatively easily determined using the current standard equipment of hospital laboratories, we prepared a set of recommendations for personalized PPI-based stress ulcer prophylaxis taking into account the patient's CYP2C19 predictive phenotype determined in this way. These recommendations are valid, in particular, for European, American and African populations, because these populations have the high representations of the CYP 2 C 19 * 17 allele associated with the overexpression of the CYP2C19 gene and ultrarapid degradation of PPIs. We propose the CYP2C19 gene profiling as a tool for personalized SUP with PPI in critically ill patients. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Bořilová Linhartová, Zendulka, Janošek, Mlčůchová, Cvanová, Daněk, Kroupa, Bartošová and Lipový.)
Databáze:	MEDLINE
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