INSTITUTE
OF GENETICS & CYTOLOGY

Warfarin is the most common drug that belongs to indirect anticoagulants. In a number of cases, it is prescribed for long-term use. Pharmacogenetic testing for Warfarin allows individualizing the drug’s dose, predicting its effectiveness and safety both before and during its use. To achieve the drug effect and prevent possible risks to the health of patients, it is recommended to conduct the study on the CYP2C9 and VKORC1 genes.

Clopidogrel is an antiplatelet drug, which is widely used to treat and prevent a recurrent myocardial infarction and a stroke, and is also prescribed to patients who have undergone coronary interventions (coronary stent insertion). To achieve the effect of taking the drug and preventing possible health risks to patients, it is recommended to conduct a study on the CYP2C19 and ABC1 genes.

Methotrexate is a drug used to treat the acute forms of psoriasis, a number of autoimmune pathologies and oncological diseases. Methotrexate is a toxic drug that causes serious side-effects. The presence of unfavorable variants of the MTHRF gene leads to an increased risk of toxic reaction development in the course of drug administration. The MTHFR gene polymorphisms are analyzed.

Vasodilators from the group of nitrogen donors. Nitric oxide (NO) is a universal mediator in the regulation of cellular functions and intercellular communication. Drugs of the nitrogen donors’ group regulate the widening of blood vessels. The group includes such drugs as Vasoton, L-arginine. The identification of the eNOS gene variant will allow us to establish the efficacy of the use of pharmacological drugs from the group of nitrogen donors. The eNOS G894T polymorphism is analyzed.

Drug efficacy: β-blockers, antiarrhythmics, analeptics, antidepressants and narcotic analgesics. To date, the International Pharmacogenetics Consortium has established the need for testing the CYP2D6 gene for the safe use of at least 48 drugs. Gene mutations affect the metabolism of drugs used in a wide range of medical disciplines, including psychiatry, oncology and cardiology. The CYP2D6 gene is analyzed.

Antipsychotics and antidepressants. The established genetic causes of low tolerance and inefficacy of antipsychotics and antidepressants may be various mutations in the genes of metabolic enzymes, receptors and neurotransmitter transporters. To reduce the risk of severe side- effects and select effective drugs, it is necessary to conduct a molecular analysis of the most common mutations in the genes CYP2D6 (rs3892097 locus of the cytochrome P450 gene); GSTM1 and GSTT1 (deletions in the genes of glutathione S-transferases mu 1 and theta 1); MDR1 (locus rs1045642 of the P-glycoprotein gene); and DRD2 (locus rs1800497 of the dopamine receptor gene).

The established genetic causes of low tolerance and inefficacy of antipsychotics and antidepressants may be various mutations in the genes of metabolic enzymes and neurotransmitter transporters. To reduce the risk of severe side-effects and select effective drugs, it is necessary to conduct a molecular analysis of the most common mutations in the GSTM1 and GSTT1 genes (deletions in the genes of glutathione S-transferases mu 1 and theta 1); MDR1 (locus rs1045642 of the P-glycoprotein gene), as well as the genes of cytochrome P450 isoenzymes — the loci CYP1A2*1F, CYP2D6*4, CYP2C9*2, CYP2C9*3, CYP2C19*2 and CYP2C19*17.