University of Cape Town, Faculty of Health Sciences, Pharmacogenetics and Cancer Research Group, Division of Human Genetics, Department of Clinical Laboratory Sciences , Anzio Road Observatory, 7925, Cape Town , South Africa +27 21 406 6506 ;
Expert Opin Drug Metab Toxicol. 2014 Jun;10(6):769-85. doi: 10.1517/17425255.2014.894020. Epub 2014 Mar 3.
Africa harbors a disproportionate burden of disease when taking into account the triple challenge caused by HIV/AIDS, tuberculosis (TB) and malaria, against a backdrop of an increasing burden of noncommunicable diseases. More than 80% of therapeutic drugs used in the management of these diseases/conditions are metabolized by CYP enzymes that exhibit genetic polymorphisms.
There is variability in the expression and activities of CYPs resulting in interindividual differences in the response to standard doses of therapeutic drugs, due to genetic polymorphisms, which exhibit both quantitative and qualitative differences between racial and between ethnic groups. The review aims to evaluate the implications of the genetic variation in CYPs on the public health of Africans. The CYPs reviewed here metabolize most of the commonly used therapeutic drugs and include CYP1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 3A4 and 3A5. Allele frequencies are compared between African ethnic groups and among populations of African, Asian and European origin. Data are obtained from our own studies and literature.
The variability in the pattern of genetic variation between populations translates into differences in drug response. Understanding CYP variability improves rational drug use and has public health significance.
考虑到艾滋病毒/艾滋病、结核病 (TB) 和疟疾这三重挑战，非洲在疾病负担方面极不均衡，再加上非传染性疾病负担不断增加。在这些疾病/病症的管理中使用的 80%以上的治疗药物是由 CYP 酶代谢的，这些酶表现出遗传多态性。
由于遗传多态性，CYP 的表达和活性存在差异，导致个体对标准治疗药物剂量的反应存在差异，这种差异表现为种族和族裔群体之间的数量和质量差异。本综述旨在评估 CYP 遗传变异对非洲人的公共卫生的影响。这里综述的 CYP 代谢了大多数常用的治疗药物，包括 CYP1A2、2A6、2B6、2C8、2C9、2C19、2D6、3A4 和 3A5。在非洲族群之间以及非洲、亚洲和欧洲人群之间比较了等位基因频率。数据来自我们自己的研究和文献。
人群之间遗传变异模式的可变性转化为药物反应的差异。了解 CYP 变异性可改善合理用药，具有公共卫生意义。
