Cytochrome P450 2C19 (CYP2C19) (CYP2C19)

Cytochrome P450 2C19 (CYP2C19) is a liver enzyme belonging to the cytochrome P450 superfamily, specifically the CYP2C subfamily. It plays a central role in the metabolism of at least 10% of commonly prescribed drugs, including proton pump inhibitors, antiplatelets, antidepressants, benzodiazepines, anticonvulsants, and antifungals. CYP2C19 exhibits significant genetic polymorphism, leading to variable enzyme activity categorized as ultrarapid, extensive, intermediate, or poor metabolizer phenotypes, which directly impacts drug efficacy and safety. The enzyme’s activity can also be modulated by drug-drug interactions, notably inhibition or induction, which may result in clinically significant changes in drug exposure and therapeutic outcomes. Structural studies reveal that CYP2C19 has a substrate-binding cavity distinct from closely related enzymes, conferring unique substrate specificity and inhibitor binding profiles. CYP2C19 is a critical determinant of individualized drug response and is increasingly recognized for its role in precision medicine and pharmacogenomics.

Other names

CYP2C19 enzymeP450 2C19Cytochrome P450 IIc19Human microsomal cytochrome P450 2C19CYP2C19 protein

Catalyzes the oxidative metabolism of drugs and xenobiotics, primarily in the liver. Uses molecular oxygen to insert one oxygen atom into a substrate (monooxygenation), reducing the second to water. Genetic variants can alter enzyme activity (ultrarapid, extensive, intermediate, or poor metabolizers), affecting drug clearance and plasma concentrations. Inhibition or induction of enzyme activity can cause clinically significant drug-drug interactions.