Objectives Clopidogrel is a prodrug that has to be converted to an active metabolite by hepatic cytochrome P450(CYP) isoenzymes to inhibit platelet aggregation.Individualvariability of platelet inhibition by clopidogr...Objectives Clopidogrel is a prodrug that has to be converted to an active metabolite by hepatic cytochrome P450(CYP) isoenzymes to inhibit platelet aggregation.Individualvariability of platelet inhibition by clopidogrel suggests a possibility for genetic factors having a significant influence on clopidogrel responsiveness.In this study,we sought to determine the association between the single nucleotide polymorphism of CYP 2C19 681G】A and the occurrence of clopidogrel resistance(CR) in Chinese.Methods The study enrolled 614 hospitalized patients who underwentsuccessful percutaneouscoronary intervention with drug-eluting stents were received the treatmentwith dual antiplatelet regimen(aspirin plus clopidogrel).All patients received loading doses of 600 mg clopidogrel and 300 mg aspirin.20μmol/L ADP-induced platelet aggregation ratio(PAR ) was assessed 24 h after clopi- dogrel administration.The maximum residual PAR≥70%was defined as CR.Genomic DNA was extracted from whole blood samples according to standard protocols,the single nucleotide polymorphism of the CYP2C19 681G】A was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in all the patients.Results CR was found in 126 patients(20.5%).There was CYP2C19 681G】A polymorphism in the study population.The frequencies of the three kinds of genotypes(GG,GA,A A) in CR group and non-CR (NCR)group were 32.5%,47.6%,19.8%and 48.0%, 45.0%,7.0%,respectively.The frequency of AA genotype was significantly higher in NCR group than that in CR group (OR =3.03,95%CI:1.889～5.784,P=0.003).The A allele carriers were more likely to develop clopidogrel resistance compared with that of G allele carriers(OR=1.85,95%CI: 1.392～2.459,P=0.002).Conclusions CYP2C19 681G/A polymorphism is associated with the risk of CR,and the A allele carriers may be a possible genetic susceptibility factor for patients with CR.展开更多
目的建立TaqMan-MGB探针检测CYP2C19基因*2、*3和*17三个多态性位点的方法。方法针对CYP2C19基因*2、*3和*17位点设计合成相应引物及双标记探针。选取2021年3月至2022年6月贵州省人民医院心内科门诊已知基因型的剩余全血样本42例,覆盖...目的建立TaqMan-MGB探针检测CYP2C19基因*2、*3和*17三个多态性位点的方法。方法针对CYP2C19基因*2、*3和*17位点设计合成相应引物及双标记探针。选取2021年3月至2022年6月贵州省人民医院心内科门诊已知基因型的剩余全血样本42例,覆盖每个位点的每个基因型各10例,提取DNA进行聚合酶链反应(PCR)检测,产物进行电泳和Sanger法测序分析。加样1、10、100、800 ng DNA,进行PCR检测以评价灵敏度。每个位点的每个基因型5例,每周1次对其检测,连续3周,以评价重复性。结果设计的引物扩增出目的基因片段,电泳显示明亮的单一的DNA条带;90个基因型的PCR结果与测序结果完全一致(P>0.05);不同加样量PCR法均可准确判读基因型,所有基因型在1 ng水平的Ct值均<34。同一基因型3次重复检测的结果一致。结论本研究成功建立了TaqMan-MGB探针检测CYP2C19基因*2、*3和*17三个多态性位点的方法,具有快速、准确、灵敏、简便的特点。展开更多
文摘Objectives Clopidogrel is a prodrug that has to be converted to an active metabolite by hepatic cytochrome P450(CYP) isoenzymes to inhibit platelet aggregation.Individualvariability of platelet inhibition by clopidogrel suggests a possibility for genetic factors having a significant influence on clopidogrel responsiveness.In this study,we sought to determine the association between the single nucleotide polymorphism of CYP 2C19 681G】A and the occurrence of clopidogrel resistance(CR) in Chinese.Methods The study enrolled 614 hospitalized patients who underwentsuccessful percutaneouscoronary intervention with drug-eluting stents were received the treatmentwith dual antiplatelet regimen(aspirin plus clopidogrel).All patients received loading doses of 600 mg clopidogrel and 300 mg aspirin.20μmol/L ADP-induced platelet aggregation ratio(PAR ) was assessed 24 h after clopi- dogrel administration.The maximum residual PAR≥70%was defined as CR.Genomic DNA was extracted from whole blood samples according to standard protocols,the single nucleotide polymorphism of the CYP2C19 681G】A was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in all the patients.Results CR was found in 126 patients(20.5%).There was CYP2C19 681G】A polymorphism in the study population.The frequencies of the three kinds of genotypes(GG,GA,A A) in CR group and non-CR (NCR)group were 32.5%,47.6%,19.8%and 48.0%, 45.0%,7.0%,respectively.The frequency of AA genotype was significantly higher in NCR group than that in CR group (OR =3.03,95%CI:1.889～5.784,P=0.003).The A allele carriers were more likely to develop clopidogrel resistance compared with that of G allele carriers(OR=1.85,95%CI: 1.392～2.459,P=0.002).Conclusions CYP2C19 681G/A polymorphism is associated with the risk of CR,and the A allele carriers may be a possible genetic susceptibility factor for patients with CR.
文摘目的建立TaqMan-MGB探针检测CYP2C19基因*2、*3和*17三个多态性位点的方法。方法针对CYP2C19基因*2、*3和*17位点设计合成相应引物及双标记探针。选取2021年3月至2022年6月贵州省人民医院心内科门诊已知基因型的剩余全血样本42例,覆盖每个位点的每个基因型各10例,提取DNA进行聚合酶链反应(PCR)检测,产物进行电泳和Sanger法测序分析。加样1、10、100、800 ng DNA,进行PCR检测以评价灵敏度。每个位点的每个基因型5例,每周1次对其检测,连续3周,以评价重复性。结果设计的引物扩增出目的基因片段,电泳显示明亮的单一的DNA条带;90个基因型的PCR结果与测序结果完全一致(P>0.05);不同加样量PCR法均可准确判读基因型,所有基因型在1 ng水平的Ct值均<34。同一基因型3次重复检测的结果一致。结论本研究成功建立了TaqMan-MGB探针检测CYP2C19基因*2、*3和*17三个多态性位点的方法,具有快速、准确、灵敏、简便的特点。
