Abstract
Clopidogrel is an antiplatelet drug commonly used to prevent coagulation. This review aimed to investigate the effect of polymorphisms of G6PD, GCLC, GCLM, GSS, GST, GSR, HK and GLRX genes on clopidogrel during phase II metabolism through exploring previous studies. The results revealed that low glutathione plasma levels caused by several alleles related to these genes could affect the bioactivation process of the clopidogrel prodrug, making it unable to inhibit platelet aggregation perfectly and thus leading to severe consequences in patients with a high risk of blood coagulation. However, the study recommends platelet reactivity tests to predict clopidogrel efficacy rather than studying gene mutations, as most of these mutations are rare and other nongenetic factors could affect the drug’s efficacy.
Author contributions
A Alkattan and F Alghanim contributed to conceptualization. A Alkattan, N Radwan, A Alkhalifah and E Alsalameen contributed to original draft preparation. A Alkhalifah and F Alghanim contributed to review and editing of the draft. A Alkattan, N Radwan, E Alsalameen and F Alghanim contributed to resources. All authors have read and agreed to the published version of the manuscript.
Acknowledgments
The authors would like to thank N Mahmoud (Assistant Deputyship for Primary Healthcare, Riyadh, Saudi Arabia) for assistance in reviewing the manuscript.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.