Cao Chun-Ge, Sun Hai-Yan, Zhou Fang-Fang, Wang Shi-Ming, Chen Hong-Yan, Lu Da-Ru
School of Life Science, Fudan University, Shanghai, China.
Yi Chuan. 2013 Jul;35(7):923-30. doi: 10.3724/sp.j.1005.2013.00923.
Clopidogrel is a widely used anti-platelet agent for the prevention of arterial thrombosis. It has been suggested that clopidogrel may be less effective in inhibiting platelet aggregation among patients who are carriers of CYP2C192 and CYP2C193, two loss-of-function CYP2C19 alleles, which are associated with reduced conversion of clopidogrel to its active metabolite. The objective of this research was to develop a simple and accurate method for genotyping of CYP2C192 and CYP2C193 simultaneously in one closed-tube using high-resolution melting curve (HRM) analysis. Two amplicons bracketing CYP2C192 and CYP2C193 gene variants were designed, and AT- or GC-rich 5' tails were added to selected primers to ensure two different amplicons with non-overlapping melting curves. Sixty-four random DNA samples were all fast and sensitively genotyped by HRM analysis. This method was validated by DNA sequencingtechnique, and genotypes obtained using the HRM approach perfectly matched the genotypes obtained by DNA sequencing technique. Therefore, this HRM-based assay allows simple and accurate duplex genotyping of CYP2C192 and CYP2C193 simultaneously in one closed-tube. This method is expected to be applied in clinical laboratory to guide indi-vidual dosage design of clopidogrel.
氯吡格雷是一种广泛用于预防动脉血栓形成的抗血小板药物。有研究表明,对于携带CYP2C192和CYP2C193这两个功能缺失的CYP2C19等位基因的患者,氯吡格雷抑制血小板聚集的效果可能较差,这两个等位基因与氯吡格雷向其活性代谢物的转化减少有关。本研究的目的是开发一种简单、准确的方法,利用高分辨率熔解曲线(HRM)分析在一个封闭管中同时对CYP2C192和CYP2C193进行基因分型。设计了两个包含CYP2C192和CYP2C193基因变异的扩增子,并在选定的引物上添加富含AT或GC的5'端,以确保两个不同的扩增子具有不重叠的熔解曲线。通过HRM分析对64个随机DNA样本进行了快速灵敏的基因分型。该方法通过DNA测序技术进行了验证,使用HRM方法获得的基因型与通过DNA测序技术获得的基因型完全匹配。因此,这种基于HRM的检测方法能够在一个封闭管中同时对CYP2C192和CYP2C193进行简单、准确的双重基因分型。该方法有望应用于临床实验室,以指导氯吡格雷的个体化剂量设计。