therapeuticЮжно-Российский журнал терапевтической практикиSouth Russian Journal of Therapeutic Practice2712-8156РостГМУ10.21886/2712-8156-2024-5-1-15-22therapeutic-488Research ArticleОБЗОРЫREVIEWSСвязь генотипов CYP2C19 с особенностями фармакокинетики и фармакодинамики ингибиторов протонной помпы: обзор литературыRelationship between CYP2C19 genotypes and proton pump inhibitorsʹs pharmacokinetics and pharmacodynamics: reviewhttps://orcid.org/0000-0001-6500-7877РутаА. В.RutaA. V.

Рута Артем Викторович, к.м.н., доцент кафедры профпатологии, гематологии и клинической фармакологии

Саратов

Artem V. Ruta, Cand. Sci. (Med.), Associate Professor of the Department of Occupational Pathology, Hematology and Clinical Pharmacology

Saratov

artem_ruta@mail.ruhttps://orcid.org/0000-0002-3120-8491ЛучининаЕ. В.LuchininaE. V.

Лучинина Елена Валентиновна, к.м.н., доцент кафедры профпатологии, гематологии и клинической фармакологии 

Саратов

Elena V. Luchinina, Cand. Sci. (Med.), Associate Professor of the Department of Occupational Pathology, Hematology and Clinical Pharmacology

Saratov

eluchinina16@mail.ruhttps://orcid.org/0000-0002-4737-7695ШелеховаТ. В.ShelekhovaT. V.

Шелехова Татьяна Владимировна, д.м.н., профессор, заведующая кафедрой профпатологии, гематологии и клинической фармакологии 

Саратов

Tatyana V. Shelekhova, Dr. Sci. (Med.), Professor, Head of the Department of Occupational Pathology, Hematology and Clinical Pharmacology

Saratov

tshelexova@mail.ruhttps://orcid.org/0000-0001-6304-4594ЛучининЕ. А.LuchininE. A.

Лучинин Евгений Алексеевич, преподаватель кафедры профпатологии, гематологии и клинической фармакологии 

Саратов

Evgeny A. Luchinin, Associate Professor of the Department of Occupational Pathology, Hematology and Clinical Pharmacology

Saratov

luchinin.gly10@gmail.comЗайцеваМ. Р.ZaitsevaM. R.

Зайцева Марина Рудольфовна, к.м.н., доцент кафедры профпатологии, гематологии и клинической фармакологии

Саратов

Marina R. Zaitseva, Cand. Sci. (Med.), Associate Professor of the Department of Occupational Pathology, Hematology and Clinical Pharmacology

Saratov

zayceva5505@mail.ruФГБОУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава РоссииРоссияSaratov State Medical University of V.I. RazumovskyRussian Federation202429032024511522Copyright © Рута А.В., Лучинина Е.В., Шелехова Т.В., Лучинин Е.А., Зайцева М.Р., 20242024Рута А.В., Лучинина Е.В., Шелехова Т.В., Лучинин Е.А., Зайцева М.Р.Ruta A.V., Luchinina E.V., Shelekhova T.V., Luchinin E.A., Zaitseva M.R.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therapeutic-j.ru/jour/article/view/488

Цель данного обзора литературы — предоставить врачам информацию, облегчающую интерпретацию результатов фармакогенетического тестирования на генотип цитохрома P450 2C19 (CYP2C19) при выборе дозы ингибитора протонной помпы (ИПП). Лекарственные средства из группы ИПП широко используются для лечения и профилактики распространённых заболеваний желудочно-кишечного тракта, включая гастроэзофагальную рефлюксную болезнь, язвенную болезнь желудка и двенадцатиперстной кишки, эрозивный эзофагит и другие гиперсекреторные состояния. Большинство ИПП метаболизируется преимущественно ферментами семейства CYP2C19 с образованием неактивных метаболитов. Действие ИПП, их эффективность и возможные побочные эффекты связаны с генотипом CYP2C19. Зачастую в клинической практике врач-гастроэнтеролог или терапевт сталкиваются с проблемами недостаточной эффективности или развития нежелательных реакций при назначении ИПП. Таким образом, учёт данных о генотипе CYP2C19 представляется необходимым для определения оптимального режима дозирования ИПП. Вышесказанное послужило поводом для обобщения в представленном обзоре данных литературы по назначению ИПП в зависимости от генотипа CYP2C19.

The purpose of this review is to provide clinicians with information and a concise interpretation of the results of pharmacogenetic testing for the cytochrome P450 2C19 (CYP2C19) genotype when choosing a proton pump inhibitor (PPI) dosage. PPIs are widely used for the treatment and prevention of common gastrointestinal diseases, including gastroesophageal reflux disease, gastric and duodenal ulcers, erosive esophagitis, and other hypersecretory conditions. Most PPIs are metabolized predominantly by cytochrome P450 2C19 (CYP2C19) to form inactive metabolites, and the CYP2C19 genotype determines the action of PPIs, their efficacy and possible side effects. In clinical practice, a gastroenterologist or therapist is faced with problems of insufficient effectiveness or the development of adverse reactions when prescribing PPIs. Thus, consideration of CYP2C19 genotype appears to be necessary to determine the optimal PPI dosing regimen. The above served as a reason for generalizing in the presented review of literature data on the prescription of PPIs depending on the CYP2C19 genotype.

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The authors declare that there are no conflicts of interest present.