Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Proton-Pump Inhibitors in Eosinophilic Esophagitis: A Review Focused on the Role of Pharmacogenetics

Leticia Rodríguez-Alcolado
ORCID logo ,
Pilar Navarro
,
Laura Arias-González
ORCID logo ,
Elena Grueso-Navarro
ORCID logo ,
Alfredo J Lucendo
* ,
Emilio J Laserna-Mendieta
* ORCID logo
Version 1 : Received: 26 February 2024 / Approved: 26 February 2024 / Online: 26 February 2024 (23:53:49 CET)

A peer-reviewed article of this Preprint also exists.

Rodríguez-Alcolado, L.; Navarro, P.; Arias-González, L.; Grueso-Navarro, E.; Lucendo, A.J.; Laserna-Mendieta, E.J. Proton-Pump Inhibitors in Eosinophilic Esophagitis: A Review Focused on the Role of Pharmacogenetics. Pharmaceutics 2024, 16, 487. Rodríguez-Alcolado, L.; Navarro, P.; Arias-González, L.; Grueso-Navarro, E.; Lucendo, A.J.; Laserna-Mendieta, E.J. Proton-Pump Inhibitors in Eosinophilic Esophagitis: A Review Focused on the Role of Pharmacogenetics. Pharmaceutics 2024, 16, 487.

Abstract

Proton-pump inhibitors (PPIs) are the most administered first-line treatment for eosinophilic esophagitis (EoE). However, only around half of EoE patients respond histologically to PPI at double dosage. In addition, 70% of responders maintain EoE in remission after tapering the PPI dose. In order to avoid endoscopy with biopsies − the only accurate method of assessing PPI response − efforts have been made to identify PPI responder patients. Clinical or endoscopic features and biomarkers evaluated so far however, have not proved good enough in predicting PPI response. Although new approaches based on omics technologies have uncovered promising biomarkers, the specialized and complex procedures required are difficult to implement in clinical settings. Alternatively, PPI pharmacogenetics based on identifying variations in CYP2C19 and STAT6 genes have shown promising results in EoE, and could easily be performed in most laboratories. Other genetic variations have also been associated with PPI response and may explain those cases not related to CYP2C19 or STAT6. Here, we give an overview of PPI treatment in EoE and evidence of how genetic variations in CYP2C19 and other genes could affect PPI effectiveness, and also discuss studies evaluating the role of pharmacogenetics in predicting PPI response in patients with EoE.

Keywords

Proton-pump inhibitors; eosinophilic esophagitis; pharmacogenetics; CYP219 gene; STAT6 gene.

Subject

Medicine and Pharmacology, Pharmacy

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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