■质子泵抑制剂(PPI)被广泛用于减少胃酸和治疗各种与酸有关的胃肠道(GIT)疾病。然而,遗传变异,特别是在CYP2C19基因中,影响PPI的代谢和疗效。CYP2C19的变异可导致不同的PPI代谢率,影响其有效性。个性化医疗策略,如CYP2C19基因分型,有可能提高PPI治疗的有效性和患者安全性.这篇综述旨在描述CYP2C19基因谱在印度人群中的相关性,包括正常功能(例如CYP2C19*1、*11、*13、*15、*18、*28和38),函数减少(例如,CYP2C19*9、*10、*16、*19、*25和26),功能丧失(例如,CYP2C19*2、*3、*4、*5、*6、*7、*8、*22、*24、*35、*36和*37),和增加的功能(例如,CYP2C19*17)变体。这篇综述还研究了临床药物基因组学实施联盟(CPIC)-CYP2C19-PPI指南,以强调药物基因组学(PGx)知情的个性化PPI治疗对胃食管反流病和消化性溃疡疾病治疗的重要性。平均而言,印度的每个人都拥有八种具有临床意义的药物遗传学(PGx)变体,强调先发制人测试的必要性。在印度实施CYP2C19基因检测需要扩大实验室能力,增加初级保健的可及性,提高公众意识,药物警戒和PGx计划之间的合作,投资先进的测序技术,数据管理系统,并与电子健康记录和临床决策支持系统集成。应对遗传多样性等挑战,社会经济因素,医疗保健问题,缺乏训练有素的专业人员对实施至关重要。由于印度药品监管机构缺乏明确的针对具体国家的政策和PGx指南,来自国际联盟的指南,如临床药物遗传学实施联盟和药物标签提供了重要的基础证据。这些证据可用于提高患者的治疗效果,并确保在印度安全有效地使用PPI。
UNASSIGNED: Proton-pump inhibitors (PPIs) are widely prescribed to decrease stomach acid and treat various acid-related Gastrointestinal tract (GIT) diseases. However, genetic variations, particularly in the CYP2C19 gene, affect PPIs metabolism and efficacy. Variants in CYP2C19 can result in different rates of PPI metabolism, influencing their effectiveness. Personalized medicine strategies, such as genotyping for CYP2C19, have the potential to enhance the effectiveness of PPI therapy and patient safety. This review aims to describe the relevance of CYP2C19 genetic profiling in the indian population, including normal function (e.g. CYP2C19*1, *11, *13, *15, *18, *28, and 38), decreased function (e.g., CYP2C19*9, *10, *16, *19, *25, and 26), loss of function (e.g., CYP2C19*2, *3, *4, *5, *6, *7, *8, *22, *24, *35, *36, and *37), and increased function (e.g., CYP2C19*17) variants. This review also examines the clinical pharmacogenomics implementation consortium (CPIC)-CYP2C19-PPI guidelines to highlight the importance of pharmacogenomics (PGx)-informed personalized PPI therapy for gastroesophageal reflux disease and peptic ulcer disease treatment. On average, each person in India possesses eight pharmacogenetic (PGx) variants that can be clinically significant, underscoring the need for preemptive testing. Implementing CYP2C19 genetic testing in India requires expanding laboratory capacity, increasing accessibility in primary care, increasing public awareness, collaboration between pharmacovigilance and PGx programs, investing in advanced sequencing technologies, data management systems, and integration with electronic health records and clinical decision support systems. Addressing challenges such as genetic diversity, socioeconomic factors, health-care access issues, and shortage of trained professionals is essential for implementation. Due to the lack of definitive country-specific policies and PGx guidelines from Indian drug regulatory agencies, guidelines from international consortia such as the Clinical Pharmacogenetics Implementation Consortium and drug labeling offer crucial foundational evidence. This evidence can be used to enhance patient outcomes and ensure the safe and effective use of PPIs in India.