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Human carboxylesterase 1 (CES1) and carboxylesterase 2 (CES2) are serine esterases responsible for the hydrolysis of ester and amide bonds present in a number of pharmaceutical products. Several common genetic variants of the  CES1  and  CES2  genes have been shown to influence drug metabolism and clinical outcomes. Polymorphisms of the  CES1  gene have been reported to affect the metabolism of dabigatran etexilate, methylphenidate, oseltamivir, imidapril, and clopidogrel, whereas variants of the  CES2  gene have been found to affect aspirin and irinotecan. Although the findings of these studies may be preliminary, they demonstrate the potential clinical utility of  CES  polymorphisms; however, more research is required, especially with respect to  CES2 . In this review, we outline the functional, molecular, and genetic properties of CES1 and CES2, and highlight recent studies that have shown relations between  CES1  and  CES2  variants and contemporary pharmacotherapy.

The pharmacogenetics of carboxylesterases: CES1 and CES2 genetic variants and their clinical effect