Open AccessCytochrome P450 2C9 gene polymorphism in phenytoin induced gingival enlargement: A case report
Author(s) -
S P K Kennedy Babu,
V. Ramesh,
Agila Samidorai,
Noronha Shyam Curtis Charles
Publication year - 2013
Publication title -
journal of pharmacy and bioallied sciences
Language(s) - English
Resource type - Journals
eISSN - 0976-4879
pISSN - 0975-7406
DOI - 10.4103/0975-7406.116828
Subject(s) - cyp2c9 , phenytoin , cytochrome p450 , gingival enlargement , drug metabolism , genotype , pharmacology , cyp3a4 , pharmacogenetics , cyp2d6 , allele , drug , biology , gene , medicine , metabolism , genetics , epilepsy , endocrinology , pathology , neuroscience
Gingival enlargement comprises any clinical condition in which an increase in the size of the gingiva is observed. Among the drugs that induce gingival enlargement, the antiepileptic agent phenytoin has been widely related to this condition. The Cytochrome P450(CYP) superfamily is the most commonly involved enzymes in metabolism of drugs. Common coding region CYP variants that affects drug elimination and response has been studied in great detail. Pharmacogenetic influences on drug metabolism have been widely reviewed and gene polymorphism of cytochrome P450 2C9 appeared to be responsible for much of the interindividual variability on drug elimination. Genetic variation in the CYP2C9 gene can affect metabolism, leading to altered phenotypes. Individuals with poor metaboliser alleles of CYP2C9 gene were shown to have a reduced metabolism of phenytoin compared with wild-type alleles. Thus identification of patients genotype prior to anti-epileptic drug administration could potentially prevent higher serum drug concentrations leading to adverse side effects such as gingival enlargement. This case report addresses the influence of CYP2C9 genetic polymorphism on Phenytoin drug metabolism thereby causing gingival enlargement.