Human Pharmacogenetics in the Zanzibar Islands – The Beginning of the CYP2C8 Story in the Malaria World

Title:Human Pharmacogenetics in the Zanzibar Islands – The Beginning of the CYP2C8 Story in the Malaria World

Volume: 12 Issue: 2

Author(s): Isa Cavaco

Affiliation:

Keywords: Amodiaquine, CYP2C8, drug metabolism, pharmacogenetic, zanzibar islands.

Abstract: The interest in personalized medicine, together with the search for good genetic biomarkers that predict the individual response to drugs, has increased during the last decades. Several decades have passed since the first description in the 1950’s of variability in the clinical response of patients but still today the use of pharmacogenetics in clinical practice is not a reality worldwide. This is particularly far from happening in developing countries, where the cost of genetic testing is higher than the cost of food or treatment for common diseases. Pharmacogenetics in Africa has focused almost entirely on the description of frequencies of known genetic variants in enzymes related with drug metabolism. The Zanzibar islands are one of the areas where such genotypic information is available. Cytochrome P450 2C8 (CYP2C8) genetic variability was described in the Zanzibar population in 2005, in a study that raised for the first time the hypothesis that the genetic variation of the CYP2C8 gene could be connected with the interindividual variability observed in the clinic outcome of malaria patients treated with amodiaquine. Moreover, this study also raised the possibility that slow metabolizers (CYP2C8*2 and 2C8*3 carriers) of amodiaquine could be more prone to develop side effects after treatment. Other studies followed that addressed these specific aspects in malaria chemotheraphy, but general pharmacogenetic studies were also performed in other African countries. The information available today can be used to help health authorities and agencies to establish guidelines that will increase the awareness for toxicity or efficacy issues in drug administration at a regional or national scale. With the development of affordable genotyping methods this reality could change in developing countries and pharmacogenetics could be used in clinical practice to provide individual therapy, leading to better treatment of patients.

Cite this article as:

Cavaco Isa, Human Pharmacogenetics in the Zanzibar Islands – The Beginning of the CYP2C8 Story in the Malaria World, Current Pharmacogenomics and Personalized Medicine 2014; 12 (2) . https://dx.doi.org/10.2174/1875692112666140529002533