Pharmaceutical Analysis, Drug Discovery and Designing Chemistry

Oral antidiabetic drugs are used for more than a half century in the treatment of type 2 diabetes. Only in the last five years intensive research has been conducted in the pharmacogenetics of these drugs based mainly on the retrospective register studies, but only a handful of associations detected in these studies were replicated. Th e gene variants in CYP2C9, ABCC8/ KCNJ11 and TCF7L2 were associated with the eff ect of sulfonylureas. CYP2C9 encodes sulfonylurea metabolising cytochromeP450 isoenzyme 2C9, ABCC8 and KCNJ11 genes encode proteins SUR1 and Kir6.2,respectively. Th ose proteins constitute theATP-sensitive K+-channel which is a therapeutic target for sulfonylureas. TCF7L2 is a gene with the strongest association with type 2 diabetes that infl uences insulin secretion. SLC47A1, ATM and SLC2A2 gene variants were associated with the response to metformin. SLC47A1 and SLC2A2 encode MATE1 metformin transporter and GLUT2 glucose transporter, respectively.The function of a gene variant near ATM (ataxia-telangiectasia mutated) gene is probably related to activation of AMPK. In the recent years, the fi rst studies related to the pharmacogenetics of response to DPP-4 inhibitors were published, although none of them was replicated so far. Among identifi ed genes are TCF7L2, CTRB1/2 encoding chymotrypsinogen, and GLP1R encoding the downstream therapeutic target for gliptins – GLP-1 receptor. With the accumulating pharmacogenetic evidence in type 2 diabetes there are reasonable expectations that genetics might help in the adjustment of drug doses to reduce severe side effects,as well as to make better therapeutic choices among the drugs available for the treatment of diabetes.